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1099 and Exemption Affidavit
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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