How to Fitl Out the 1099-A / 1099-OID

Form 1099-A fnstructions:

Please read through instructions completely before beginning!!

**lBefore you begrn, please keep in mind, there

are three (3) forms on each sheet of the l0g9-A. This is also true for the
1099-OID, but until just recently the Form 1099-OID now has 2 Forms to fill ou! but it do not change
anything.***

1. Starting with the first box labeledLENDER'S name etc.: Enter the STRAWMAN information (NAME, ADDRESS,
ETC) or the information as it is recorded on your bill. EX: JOHN E DoE.

2. LENDER'S federal ID #: enter your SSN in the EIN format. EX: SSN 123-45-6789 would be entered as l}-34567t9-
3' BORROWER'S ID #: Enterthe Borrower (biller) EIN. This may be available on your Wages and Income Statement
received from the IRS. If unknown, leave blank.
4. BORROWER'S name: Enter the information of whomever was paid (Debtor/ Biller). If for a court case, enter the Judge
or Prosecutor's (see instructions for Box I below). The address will be headquarters of the Debtor or the address of the court
proceedings.
5. Account Number: Here you will enter the tracking / account number, or the account and routing number if for a bank
transaction. Enter the case number if for a court case.

Back to the top of the Form 1099:4:

. Box 1: Date of Londer's etc- This will be the date of your last statement or bill received for the filing year.
* For a mortgage, car notg, or other transaction with a promissory note attached, this will be the datl you signed
for the
note.
* case, this will be the date the case was filed using the opposing afforney as Debtor. This
_ _ For a. court
judgment
will be the date
was issued and the name of the judge as Debtor for cases where judgment has been passed.
* For debts listed on your credit report, enter the date you accessed your report.
Box 2: Balance of Principle Outstanding- This will be the TOTAL payments and/ or deposits made to that account
or
vendor that year.
* For a promissory note/ mortgage: The value of the note/ mortgage.
* Please note: For promissory note/ mortgage transactions: The value of the note will be one claim filed on your 1099's.
The total payments subsequently made to that account will be a separate claim.
* EX: John purchased a house for $120K in 2010. He then made $12K in payments that year.
He will flll out one form--
listing the bank as debtor-for the value of the note. He will fill out another form-using the same bank
as debtor-for the
$12K in payments. The account number will be the same for these two entries.
. For accounts with a balance due: Payments made to this account + the balance due The total to
- enter in Box 2
. Box 4: Fair Market value of property- Enter the total from Box 2.
. Box 5: Check Yes.
. Box 6: Ilescriptior of Property* Enter the following based on the typ" of transaction: CREDIT
USED ON CIIECKING
ACCT/ SAVINGS ACCT/ COIJRT TDGEMENTi MORTGAGE NOTEI CAR NOTE/ UTILITY BILLI
RENTAL
AGREEMENTI MISC (use these last two only if you have an account or tracking number for these
* With regard to notes, please be sure to differentiate transactions).
in your description thal one claim is for the note and one for the
payments.
* EX: JOhN ENTETS CREDIT USED ON
MORTGAGE NOTE for the note itself, then CREDIT USED oN MoRTGAGE
ACCOIINT forthe payments made.

Once completed, the inforrration on these Forms 1099-A need to be entered onto a Form
1096. This form will serve as the
cover letter for your completed Forms 1099-,4.,

Page I
 IIow to Fill Out the 1099-A / 1099-OID

Form 1096 Instructions for Form 1099-A:

. FILER'S Name: This portion can remain blank. Only the contact person is needed.
. Name or person to contact: This will be your natural person's information (the authorized representative)oi if you have a
corporation set up with correctly filed Form 56 or Forrn 2848, enter the appropriate contact person (an appointed authorized
representative).
. Box l: EIN- Leave blank.
. Box 2: SSN- Enter SSN # with dashes. Ex: 123-45-6789.
. Box 3: Total number of forms* Please note, each SHEET of the Form 1099-A has 3 FORMS, so this enty will be the
number of FORMS you actually filled out.
. Box 4 end Box 5: Leave blanlc
. Box 6: Enter an t'X'r in only one hor..-- Place an oXu (NOT a check mark!!) in the box labeled 1099-A.
. Box 7: If this ie your tlnal return...- Place an 'Xu in the box indicated as this will be your final return for the year. This
would be left unchecked if you were doing this process on a monthly or quarterly basis.
Sign the form as the Authorized Represontative and date.

And you're done! Gather all your completed forms and, referring to the instructions on the Form 1096, mail all the originals
to thp IRS. It is HIGHLY suggested you make a scan and/ or copy all your sheets for your records before mailing even
though you have the carbon copies that are attached to each sheet This mailing will serve as notice to the IRS and precede
your Forms 1099-OID and 1040 frling. Now lefs move onto to Forrn 1099-OID process!

f0E)-OIl) Process

How to Fill Out the 1099-OID

Now that you have completed the Form 1099-A process and given the IRS time to investigate your claims (two weeks should
be sufficient), you are ready to proceed with the Forms 1099-OID. This form is used to request the funds recorded on the
Forms 1099-A be moved from the DEBTOR/ VENDORi BILLERS account to your Treasury account, then issued back to
you in the form of a refund. You will need the copies of your Forms 1099-A to ensure your Forms 1099-OID are filled out
correctly. For this prosess, you will be transferring information from the Forms 1099-4 to the Forms 1099,OID, wit6 a few
adjusffnents.

Form I 099-OID Instructions:

1. Starting with the first box labeled PAYER'S name etc.: Enter the BORROWER'S information (NAME, ADDRESS, ETC)
as recorded on your Form 1099-4.
2. PAYER'S federal II) #; Leave blank unless known.
3. RECIPIENT'S ID #: Enteryour SSN in standard form. EX: 123-45-G7t9.
4. RECIPIENI'S name: Enter the LENDER information as recorded on Form 1099-A in proper English/ Upper and Lower
case. EX: John E. Doe. The same should be done with your address information.
5. Account numbert This will be the same accounl hansaction information recorded on the Form 1099-A.

Backto the top of the Fo{m 1099-OID:

. Box 1: Original issue discount* This will be the amount entered in Box 2 /Box4 of your Form 1099-4
. Box 2tI*ave blank.
. Box 3: Leave blank.
. Box 4: tr'ederal Income tax withheld-- Enter amount recorded in Box 1, unless the transaction is from an account from
which cash could be acquired, ie. checking or savings accounts. In this case, subtract l0% from the amount recorded in Box
l.
Pago 2
 Eow to Fill Out the 1099-A / 1099-OID

. Box 5: Description- Enter your STRAW NAME in all caps.

. Box 6 and Box 7: kave blank.
Once completed, the information on these Forms 1099-OID need to be entered onto a FoTm 1{D6. This form #ill serve as the
cover letter for your Form 1099-OIDs completed.

Form l096Instructions for Form 1099-OID:

The process to fill out the 1096 for the Forms 1099OID are the same as followed for the Forms 1099-A with a couple of
changes.

Follow 1096 instructions above up to Box 3 (Box 3 on this 1096 should be the same as Box 3 of the 1096 filled out for the
Forms 1099-4).

. Box 4: Federal income tax withheld- Total of all Box 4s on your Forms 1099-OID (if you noticeo you will see Box 4 on
you OID is also titled "Federal income tax withheld").
. Box 5: Total amount reported with this Form 1096- Total of all Box ls on your Forms 1099-OID.
. Box 6: Enter an 'tX, in only one bor*.- Place an "X" (NOT a check mark!!) in the box labeled 1099-OID.
. Box 7: If this is your final return...-- Place an "X' in the box indicated as this will be your final return forthe year.
This would be left unchecked if you were doing this process on a monthly or quarterly basis. Sign the fonn as the Authorized
Representative and date.

Let us proceed now to the Forms 1040 series that will complete this process...ifyou are issuing a claim for a year already
filed, you w.ill need to complete/ click the Form 1040X instmctions to do an amended return. For a year you have yet to file
for, please complete/ click the instructions for Form 1040.

Ifow to Fill Out the Form 1040

Fom l040Instructions Using Form 1099-OID:

Form 1040 can either be ordered frorn the IRS via their website or phone, acquired at your local library or IRS office, or
downloaded from their website. Past year Forms 1040 can be secured by doing a search for a particular year on your favorite
search engine.

As you complete this form, please keep in mind that you are filing as a creditor, not a debtor-you will take/ claim no
exemptions or credits!

. Label: Fill out as you would for a standard filing using ALL CAPS for your entries.
. Filing Statns: For the sake of ease and simplicity, please check Box 1/ Single.
' Exemptions: You will take no exemptions. Exemptions are for debtors, not creditors. This process is for CREDITORS
ONLY. Skip this section.
. Income:
* Line 7: Enter infonnation from your W-2, wages, salaries, tips, etc.
* Line 21: On the blank line, enter 'SEE 1099-OID.' In the box on the same line, enter the total from Box 4 of the Form
1096 completed for your Fonns 1099-OID (Federal income tax withheld).
t Line 22: Enterthe total from box on Llrnre 21
Adjusted Gross Income: Skip to line 37.
* Line 37: Enter the total from box on Line 21.

Page 3
 How to Fill Out the 10D.A / lOry-OII)

. Taxes and Credits: Skip this section

* Line 38: Enter &e total from Line 37 per the instructions.
* Line 40: Enter 0.
* Line 41: Enter total from Line 38.
r Line 43r44rffi,55, and 56: Enter 0.
. Other Taxes: Skip to Line 6l
* Line 6l: Enter 0.
. Pa;ments:
* Line 62 and 71: Enter total from Line 38.
. Refund:
* Line 72 *nd 73al Enter total from Line 38.
The remaining entries ask where you wish to have your refund sent and other inforrration. It is HIGTILY suggested you
have your funds direct deposited into a business account. Please follow the instructions to complete the Form 1040. Sign the
bottom ofyour return as the Authorized Representative and you ane done! See the Form 1040 instructiorrs foryour proper
filing location.

..Insert Schedule B instructions here......

When preparing your refum, be considerate to the agent who will be examining your documents and stack them in numerical
order (1040, 1096, then 1099{ID). Nothing should be stapled. Be sure to make a copy of your documents for your records,
sending all originals to the IRS.

Page 4
ilbH L.Ib!
{glB*,& t$&a[il
*- tug8 *mmmt $unxn*ry erd Mttal d
ffi;ffi* FrmgtEsE
U.S. lnfurrratiwr Rstena ,8
ffir* *!H& Fdkery rsun mra*slEr$q

trry. e, aw#rouE

tmllo {s FEsffil t* Esffi ts[FF#flffi F# $f&ht rH *ntr

John,Doe t,123r 45G71
&rdt.*ffi
JokDoe(Eernail-com
{ Ef$FrrffiishrEffi t S#r9Esrl$fi.m[E I I Tsr rr.srcE$
Fs ttx!&Er
{i ttr
lnzqs-e:.t,s I *
| a FsS,ihEG* EffiltE I I Tfl ft!8{rt€Gtlt ffir ffi F*7fi rm

i Fffi m +lr qn str trlEM ** E tEE& sa !sl**{

rs $ s+- rzr-m I Beo. ooo.oo
EoHe*e t il$fE}lr*rffin*iB s#rstr*iiw. . F I$
'*m
truu r.ffi rfrE{
*:-Id!
F4
-rm5
&l * $88-e
.{*
tqnB.'l
8r ,m
r,s&**
t*
*ffitE*F
?t
lmB.StiS
{,,
1Sp.-B
m
{!E;},i
?t
1r*ts-ff4 ilml-16
fil
D il il t] n m n n n tl n n tl m
.s-i*B*tr fry.a* tffiIx{tB !ffi& 1&E| fffi-ln a**,rs
B * lR !'l BC
1qs,€
ET
a{-E
,d
S.ffi'.€8n
,t
il m fI u u n tr n n rl
ut

BetlJl}fik ffie W & tu Ettgrorl &ustge Ssvlce ph@hs {rG ngt ecs50firfih.

!ryry.esryffi d-Frquy. t {Hs8 ttl* t rrrE t'tr{tr! tlr lEt # ffi{Tgq#l* {hqmd&, {fir, 6D 116 b6i it nr} BHisdlts rr{t BHIEF. riry rE arr"
mf!{t*tficarffi,
fra Dn
'1

ffi,{/ Tlf,a >4r1tr6rir*6 Reoresentative k > 03i1812011

 l

tEl,OEg'8 nirme, 3trefi sd&*6, {rk. si*€. AP eod*" and ld€Ohdfie flo. Claim on mortgage

JOHN E. DOE account

I23 FAKE STREET r Entet dateof ftnal
ANYWTIERE,ST 12345 stalement
| 0{E eI bd$k {tE{isilim It
L$Effi'g fddsrl idsilithiliotr ruRlbff harrrds{ d iksihfimst Copf i r Enter the total
For
t2-3456789 12lt5na10 k*trnal figrernre
8oflft&YaFSffi value ofnote and
{ FaF rfifid vanre ot $svkc C*ntff
FilG rYitr Form {O0S.
deposits/
NATIONAL F{r PiiYgry Act
ard Fraprrso.k payrnents made to
SrBetsdgffi {rEedrE @. n ,} I We &ariqtrer B€fgrrdy ff&t*e lor rpeyRs{ ot $E dsbt?
&drEtiofi Ael
t{cffei!, sor th6 the account.
Cty. strts. ed AF s:de n nes0&ih*ofproFsty 3010 Brflsrd
krttrorfiarrs fur
CREDIT USED ONMORTGAGE SE{tein
ACCOUNT lr*omatbn
Retl{rii.
Cst. No- 14,1128 D6pBrEret 0f th*Trgalry- flf$ft* Atrgl{F Sane
Ilo t{ot Gut or Sepsrflte Forme aB Thb Paglr Do t{ot Gut or &paale Frnm on Thb

LEt{]ffi'S nffiie. Efirst eB5& .*ry, si6*e. aP code. sld tote!tune no Claim on savings
account,
JOHN E. DOE
123 FAKE STREET . Enter dateof final
ANYWI{ERE, ST 12345 statement.
I B& at isrds'g eqdsiton or
Copy A
LfIoEfh&d nhsffkdo*
S numbar
kr{iled$dMommt
Fat
r Enter the total
12-3456?89 t2/23t2010 k*€'rnd Fl€qemls
SsfSc,6 Ci}||ltaf value of note and
F*. niur Fortl lOS
AUTO FINANCEINC deposits/
Far ftivady *et
ard Papeil.ro* pa3rments made to
5 Wx banurw personary &tle lor !€patfntrlt ot ttls d€bf,?
Redrcten fi61
$Sce, esthB the account-
6 DesfllptBi o{ p€p€rty l0t0 Omeral
tnrlruetionB lot
CREDIT USED ON AUTO C*rt in
LOANACCOLINT tnfem*ion
Rettrnt.
mm l00e*A DeSag!!€irt d lhc Trca#y - lfit€m* nfi/srs: S€{rd*
Do t{ot Cgt or Fonns on lhh Pge Do l{ot Cut m Sqparrte Forma or ?hk Pafo

LEfr$ffits ners, Etr* addrs6" d8, stdre_ Ap od6_ and tet6$hffis m. Claim on credit
JOHN E. DOE card account.
123 FAKE STREET r [nter dateof {tnal
ANY\ryHERE, ST 12345
I BBb sI [$d!r's a{lrisifior] sr
siatement
erd hro*ds&3 dahrhwrc0t copy A r
$Xffn'S 6dldifirelDa nur$bs,
Far
Enterthe total
12-3456789 htermlRrwn*e
BOqn$rVER'S ndnB Ssr,ic6 Ga$t r
amount of
fk *At Form f{trq paSrments made
MUMCIPAL WATER For Fr*uasy Ac,
rr.l ber*s €nd P+€ftvql into the accorttlt
slr€el ddrEBa SrFludqo aFt. 6 We p€rcorsgy Satu|e *0r ruF*!ilsrt 4{ tB ffi? Bs&rofelAst
456 CORPOR.ATE LANE I't5*ico" Ese l&€ plus the balance
Cty, stdo. eld AP oqdg 6 Descriptlm ot p.opsty 2010 eaflo,el
A}IYCITY. ST 12345 h*truciiono kr dueon final
CREDIT USED ON UTILITY Csrt*r
lnfantutir:a statement.
ACCOUNT HafuaEra,
W drhe Trpcury - Frtrrtt* Rfi66nF S€rrie
Ilo ttot *qt c $cparete Fornrs en fhk Paga Do ttd Cut or Saparate Fornp on lhis Fr$c
 rBre" stffil addss, civ- stat8, ZP ffide. and

NATIONAL MORTGAGE
456 CORPORATE LANE
ANYCTTY, ST 12345
FAYERT tuH idE lfbdion rtrnrb€r HECIFI*F{fS Uarfricatim nuofier a Fddrd imafi'* lar *iti*!dd
12345-6789
HESlPlEfff'$ iunr€ [ Ossaipt+on

John E Doe JOHNE.DOE

Sk8st d*B {inc*rdrE spt. no] 6 &igind iEsue dssomt cn U,"S. iieaqury offio€Rttrls
123 Fake Street $
Eily, staH. andaP ao&
Anycity, State 12345

tQ$'OlD
F6?m od. ils. 144rtE klrefit ot $!s Trgirr, - tiltffid Her.aerp ssry&E
OE ilut Ggt or Ssoarat* Forar* on Tlris Pade Do Hot eut

PAYEf,'S *ame, stisBt ddr48s, .rty, st&te, AP c6de, ard td6phon* na f eioildis6edswn
for t010
AUTO FINANCE
456 CORPORATE LANE $ 14,{m0
ANYCITY, ST 12345

HE$HEF{T SidEntrir{tion $rlrhtr 4 ffiirmilgtus*rficd

2345-6789
RfClPlEl,{T:S rsma 5 Dsdr*ip1t6r

John E Doe JO}IN E- DOE

fut addseft F*ca$tui0 ryL no_) t &rgind isue diseant m U-$. Tr*wury ot{q**:m
123 fake Sreet $
Sfty, *ts6, aEd lF oo*
Aaycity, State 12345

rsrr 100$.OlD Oeagffi of &e TtEBsny - lntemd Bew|trs Sarace

Dq t{ot Egt or

MUNICIPAL WATER
456 CORPORATELANE I otlE Firiods i*sBst
ANYCITY, ST 12345
$
E€fiPlESlT'S ld*tiilic*lo rxxrber a F€dFd rFomc tfl wfrl"ftdd
1234s4789
f;ECIYIENT'S n6rnr 5 0e8crlFli6n

John E Doe JOHN E. DOE

$te6l $ddr€ss fr*hr.fng {*rt lo., 6 Oagirxl isare Sswunt sfi U.$. Treaery oS$sdi$16
123 Fake Sheet
OiS, stat6, ardZlPoade
Anvcitv. State 12345

c61. ib- 1442rF Eawfniili dA!6 Tr€a$t.(y - lr*eonal EevsnueSe8ice