1099 Form
Your Name or Business Name
First Name
Last Name
Your Employer ID # Or SS#
Phone Number
Please enter a valid phone number.
Email
example@example.com
Your Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Payee Name
First Name
Last Name
Payee SSN or EIN
*
*REQUIRED
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Type of Income
Please Select
Rent
Custom Hire
Interest
Other_ Describe
Amount $
Payee Name
First Name
Last Name
Payee SSN or EIN
*REQUIRED
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Type of Income
Please Select
Rent
Custom Hire
Interest
Other_ Describe
Amount $
Payee Name
First Name
Last Name
Payee SSN or EIN
*REQUIRED
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Type of Income
Please Select
Rent
Custom Hire
Interest
Other_ Describe
Amount $
Payee Name
First Name
Last Name
Payee SSN or EIN
*REQUIRED
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Type of Income
Please Select
Rent
Custom Hire
Interest
Other_ Describe
Amount $
Payee Name
First Name
Last Name
Payee SSN or EIN
*REQUIRED
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Type of Income
Please Select
Rent
Custom Hire
Interest
Other_ Describe
Amount $
Payee Name
First Name
Last Name
Payee SSN or EIN
*REQUIRED
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Type of Income
Please Select
Rent
Custom Hire
Interest
Other_ Describe
Amount $
Payee Name
First Name
Last Name
Payee SSN or EIN
*REQUIRED
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Type of Income
Please Select
Rent
Custom Hire
Interest
Other_ Describe
"OTHER" Description
Amount $
Payee Name
First Name
Last Name
Payee SSN or EIN
*REQUIRED
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Type of Income
Please Select
Rent
Custom Hire
Interest
Other_ Describe
Description
Amount $
Your signature and submission is you authorization for us to efile your forms on your behalf: Signature
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