Form 1097-Btc - Bond Tax Credit - Department Of Treasury - 2013 Page 2
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2
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4
5
6VOID
CORRECTED
5050
FORM 1097-BTC ISSUER'S name, street address, city or town, province or
1 Total
OMB No. 1545-2197
state, country, ZIP or foreign postal code, and telephone no.
13
20
$
Bond
2a Code
Tax
Credit
1097-BTC
Form
2b Unique Identifier
FORM 1097-BTC ISSUER'S federal
RECIPIENT'S federal identification
identification number
number
3 Bond type
4
Copy A
For
RECIPIENT'S name
5a January
5b February
Internal Revenue
$
$
Service Center
5c March
5d April
$
$
File with Form 1096.
Street address (including apt. no.)
5e May
5f June
$
$
For Privacy Act
City or town, province or state, country, and ZIP or foreign postal code
5g July
5h August
and Paperwork
$
$
Reduction Act
5i September
5j October
Notice, see the
$
$
Form 1097-BTC issuer is (check one):
2013 General
5k November
5l December
Instructions for
Issuer of bond or its agent filing 2013
$
$
Certain Information
Form 1097-BTC for credit being reported
Returns.
6 Comments
An entity or a person that received or should have received
a 2013 Form 1097-BTC and is distributing part or all of that
credit to others
1097-BTC
Form
Cat. No. 54293T
Department of the Treasury - Internal Revenue Service
Do Not Cut or Separate Forms on This Page — Do Not Cut or Separate Forms on This Page
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