Field Name | Size | Type | Description | Notes |
See Form Filer Common Fields |
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| Filer fields common to all form types. |
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See Recipient Common Fields |
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| Recipient fields common to all form types. |
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2nd TIN Notice | 1 | Checkbox | Second TIN Notice (Optional) | X / Y / T / 1 = Checked |
FATCA Checkbox | 1 | Checkbox | FATCA Filing Requirement Indicator | X / Y / T / 1 = Checked |
Box 1 Amount | 12 | Amount | Box 1: Interest income |
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Box 2 Amount | 12 | Amount | Box 2: Early withdrawal penalty |
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Box 3 Amount | 12 | Amount | Box 3: Interest on U.S. Savings Bonds and Treas. obligations |
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Box 4 Amount | 12 | Amount | Box 4: Federal income tax withheld |
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Box 5 Amount | 12 | Amount | Box 5: Investment expenses |
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Box 6 Amount | 12 | Amount | Box 6: Foreign tax paid |
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Box 7 Foreign | 16 | Text | Box 7: Foreign Country or U.S. Possession |
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Box 8 Amount | 12 | Amount | Box 8: Tax-exempt interest |
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Box 9 Amount | 12 | Amount | Box 9: Specified private activity bond interest |
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Box 10 Amount | 12 | Amount | Box 10: Market discount |
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Box 11 Amount | 12 | Amount | Box 11: Bond premium |
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Box 12 Amount | 12 | Amount | Box 12: Bond premium on Treasury obligations |
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Box 13 Amount | 12 | Amount | Box 13: Bond premium on tax-exempt bond |
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Box 14 CUSIP No | 13 | Number | Box 14: Tax-exempt bond CUSIP |
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Box 15 State | 2 | Text | Box 15: State | Use state abbreviation |
Box 16 ID Number | 20 | Text | Box 16: State identification no. | Given by State Department of Revenue |
Box 17 Amount | 12 | Amount | Box 17: State tax withheld |
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