1099 and Exemption Affidavit

7575

VOID

CORRECTED

FILER'S name, street address, city, state, and ZIP code		1 Date of closing (MMDDYY)	OMB No. 1545-0997	Proceeds From Real Estate Transactions
		2. Gross proceeds
FILER'S Federal ID No.	TRANSFEROR'S ID No.	3 Address or legal description (including city, state, and ZIP code)		For TRANSFEROR'S name Internal Revenue Service Center File with Form 1096.
TRANSFEROR'S name
Street address (including apt. no.)
City, state, and ZIP code		4. Check here if transferor received or will receive) property or services as part of the consideration. ⇒
Account number (optional)		5. Buyer's part of real estate tax) $

Form 1099-S

Cat. No. 64292E

Department of the Treasury - Internal Revenue Service

MISC NY: 1099 AND EXEMPTION AFFIDAVIT