Form 1099-B - Proceeds From Broker And Barter Exchange Transactions

Form 1099-B - Proceeds From Broker And Barter Exchange Transactions - 2016 Page 8

VOID

CORRECTED

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

Applicable check box on Form 8949

OMB No. 1545-0715

Proceeds From

or foreign postal code, and telephone no.

2016

Broker and

Barter Exchange

Transactions

1099-B

Form

1a Description of property (Example 100 sh. XYZ Co.)

1b Date acquired

1c Date sold or disposed

Copy C

PAYER'S federal identification number

RECIPIENT'S identification number

1d Proceeds

1e Cost or other basis

For Payer

1f Accrued market discount

1g Wash sale loss disallowed

RECIPIENT'S name

2 Short-term gain or loss

3 Check if basis reported to

IRS

Long-term gain or loss

Ordinary

Street address (including apt. no.)

4 Federal income tax withheld

5 Check if noncovered

security

For Privacy Act

6 Reported to IRS:

7 Check if loss is not allowed

and Paperwork

based on amount in 1d

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

Gross proceeds

Reduction Act

Notice, see the

Net proceeds

2016 General

8 Profit or (loss) realized in

9 Unrealized profit or (loss) on

2016 on closed contracts

open contracts—12/31/2015

Instructions for

Account number (see instructions)

2nd TIN not.

Certain

Information

CUSIP number

FATCA filing

10 Unrealized profit or (loss) on

11 Aggregate profit or (loss)

Returns.

requirement

open contracts—12/31/2016

on contracts

14 State name

15 State identification no. 16 State tax withheld

12 Check if proceeds from

13 Bartering

collectibles

1099-B

Form

Department of the Treasury - Internal Revenue Service

Form 1099-B - Proceeds From Broker And Barter Exchange Transactions - 2016 Page 8

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