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1 Payer Information

Calendar Year *

Payer's Name (business) *

Street Address *

City or Town *

State *

ZIP *

Telephone Number

Payer's TIN *

2 Recipient Information

Recipient's Name *

Recipient's TIN *

Street Address *

Apt. No.

City or Town *

State *

ZIP *

Account Number

3 Payment Details

Box 1 — Rents

Box 2 — Royalties

Box 3 — Other Income

Box 4 — Federal Income Tax Withheld

Box 5 — Fishing Boat Proceeds

Box 6 — Medical & Health Care Payments

Box 8 — Substitute Payments

Box 10 — Gross Proceeds to an Attorney

Box 16 — State Tax Withheld

Box 17 — State / Payer's State No.

Box 18 — State Income

4 Your Email & Checkout

Your email address *

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IRS & State CompliantCalculations & formats

Paying an independent contractor? You probably need the 1099-NEC (Nonemployee Compensation) — fill it here.

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