Form 1099-Oid - Original Issue Discount Department Of Treasury

Form 1099-Oid - Original Issue Discount Department Of Treasury - 2013 Page 4

CORRECTED (if checked)

PAYER’S name, street address, city or town, province or state, country, ZIP

1 Original issue discount for

OMB No. 1545-0117

or foreign postal code, and telephone no.

2013*

Original Issue

2013

2 Other periodic interest

Discount

1099-OID

Form

3 Early withdrawal penalty

4 Federal income tax withheld

Copy B

PAYER’S federal identification number RECIPIENT’S identification number

5 Foreign tax paid

6 Foreign country or U.S. possession

For Recipient

RECIPIENT’S name

7 Description

This is important tax

information and is

Street address (including apt. no.)

being furnished to

the Internal Revenue

Service. If you are

required to file a

City or town, province or state, country, and ZIP or foreign postal code

8 Original issue discount on U.S. Treasury obligations*

return, a negligence

penalty or other

sanction may be

imposed on you if

this income is

9 Investment expenses

* This may not be the correct

taxable and the IRS

figure to report on your income

determines that it

tax return. See instructions on

the back.

has not been

reported.

Account number (see instructions)

10 State 11 State identification no. 12 State tax withheld

1099-OID

(keep for your records)

Form

Department of the Treasury - Internal Revenue Service

Form 1099-Oid - Original Issue Discount Department Of Treasury - 2013 Page 4

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