Eastern Iowa Tax & Accounting - 1099 INFORMATION FORM

Eastern Iowa Tax & Accounting - 1099 INFORMATION FORM

Phone: 563-577-2216 | Email: dfarrell@eiatax.com
PERSONAL/BUSINESS INFORMATION
Name*

First NameLast Name
Business Name (If Applicable)*
Tax ID # - EIN or SSN?*

SSNEIN
SSN
EIN
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Email*
example@example.com
Bill upon completion?*

YesNo
Signature*
By signing your name, you hereby certify that all information provided on this document is true and accurate to the best of your knowledge.
RECIPIENTS

Please fill out each box COMPLETELY for each recipient. W9 forms (official request for Tax ID Numbers) available upon request.
Recipient # 1 Tax ID EIN/SSN*
Recipients Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Recipients Phone Number*
Format: (000) 000-0000.
1099 Form Needed (Misc, NEC, Etc.)*
1099 Amount*
Recipient # 2 Tax ID EINSSN
Recipients Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Recipients Phone Number
Format: (000) 000-0000.
1099 Form Needed (Misc, NEC, Etc.)
1099 Amount
Recipient # 3 Tax ID EINSSN
Recipients Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Recipients Phone Number
Format: (000) 000-0000.
1099 Form Needed Misc NEC Etc
1099 Amount
Recipient # 4 Tax ID EINSSN
Recipients Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Recipients Phone Number
Format: (000) 000-0000.
1099 Form Needed Misc NEC Etc
1099 Amount
Recipient # 5 Tax ID EINSSN
Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Recipients Phone Number
Format: (000) 000-0000.
1099 Form Needed Misc NEC Etc
1099 Amount
Recipients # 6 Tax ID EINSSN
Recipient's Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Recipients Phone Number
Format: (000) 000-0000.
1099 Form Needed Misc NEC Etc
1099 Amount
Recipients # 7 Tax ID EINSSN
Recipient's Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Recipients Phone Number
Format: (000) 000-0000.
1099 Form Needed Misc NEC Etc
1099 Amount
Recipient # 8 Tax ID EIN/SSN
Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Recipients Phone Number
Format: (000) 000-0000.
1099 Form Needed Misc NEC Etc
1099 Amount
Should be Empty:

Eastern Iowa Tax & Accounting - 1099 INFORMATION FORM

PERSONAL/BUSINESS INFORMATION

RECIPIENTS