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The Internal Revenue Service (IRS) is a government agency responsible for collecting taxes and administering the federal statutory tax laws of the United States. The IRS provide tax assistance to taxpayers and pursue and resolve fraudulent tax filings.

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Attention:
Copy A of this form is provided for informational purposes only. Copy A appears in red,
similar to the official IRS form. The official printed version of Copy A of this IRS form is
scannable, but the online version of it, printed from this website, is not. Do not print and file
copy A downloaded from this website; a penalty may be imposed for filing with the IRS
information return forms that can’t be scanned. See part O in the current General
Instructions for Certain Information Returns, available at www.irs.gov/form1099, for more
information about penalties.
Please note that Copy B and other copies of this form, which appear in black, may be
downloaded and printed and used to satisfy the requirement to provide the information to
the recipient.
To order official IRS information returns, which include a scannable Copy A for filing with
the IRS and all other applicable copies of the form, visit www.IRS.gov/orderforms
. Click on
Employer and Information Returns, and we’ll mail you the forms you request and their
instructions, as well as any publications you may order.
Information returns may also be filed electronically using the IRS Filing Information Returns
Electronically (FIRE) system (visit www.IRS.gov/FIRE
) or the IRS Affordable Care Act
Information Returns (AIR) program (visit www.IRS.gov/AIR).
See IRS Publications 1141, 1167, and 1179 for more information about printing these tax
forms.
Form 1099-MISC
2021
Cat. No. 14425J
Miscellaneous
Information
Copy A
For
Internal Revenue
Service Center
Department of the Treasury - Internal Revenue Service
File with Form 1096.
OMB No. 1545-0115
For Privacy Act
and Paperwork
Reduction Act
Notice, see the
2021 General
Instructions for
Certain
Information
Returns.
9595
VOID CORRECTED
PAYER’S name, street address, city or town, state or province, country, ZIP
or foreign postal code, and telephone no.
PAYER’S TIN RECIPIENT’S TIN
RECIPIENT’S name
Street address (including apt. no.)
City or town, state or province, country, and ZIP or foreign postal code
Account number (see instructions) FATCA filing
requirement
2nd TIN not.
1 Rents
$
2 Royalties
$
3 Other income
$
4
Federal income tax withheld
$
5 Fishing boat proceeds
$
6
Medical and health care payments
$
7
Payer made direct sales
totaling $5,000 or more of
consumer products to
recipient for resale
8
Substitute payments in lieu of
dividends or interest
$
9
Crop insurance proceeds
$
10 Gross proceeds paid to an
attorney
$
11 Fish purchased for resale
$
12 Section 409A deferrals
$
13 Excess golden parachute
payments
$
14 Nonqualified deferred
compensation
$
15 State tax withheld
$
$
16 State/Payer’s state no. 17 State income
$
$
Form 1099-MISC
www.irs.gov/Form1099MISC
Do Not Cut or Separate Forms on This Page — Do Not Cut or Separate Forms on This Page
Form 1099-MISC
2021
Miscellaneous
Information
Copy 1
For State Tax
Department
Department of the Treasury - Internal Revenue Service
OMB No. 1545-0115
VOID CORRECTED
PAYER’S name, street address, city or town, state or province, country, ZIP
or foreign postal code, and telephone no.
PAYER’S TIN RECIPIENT’S TIN
RECIPIENT’S name
Street address (including apt. no.)
City or town, state or province, country, and ZIP or foreign postal code
Account number (see instructions) FATCA filing
requirement
1 Rents
$
2 Royalties
$
3 Other income
$
4
Federal income tax withheld
$
5 Fishing boat proceeds
$
6
Medical and health care payments
$
7
Payer made direct sales
totaling $5,000 or more of
consumer products to
recipient for resale
8
Substitute payments in lieu of
dividends or interest
$
9
Crop insurance proceeds
$
10 Gross proceeds paid to an
attorney
$
11 Fish purchased for resale
$
12 Section 409A deferrals
$
13 Excess golden parachute
payments
$
14 Nonqualified deferred
compensation
$
15 State tax withheld
$
$
16 State/Payer’s state no. 17 State income
$
$
Form 1099-MISC
www.irs.gov/Form1099MISC
Form 1099-MISC
2021
Miscellaneous
Information
Copy B
For Recipient
Department of the Treasury - Internal Revenue Service
This is important tax
information and is
being furnished to
the IRS. If you are
required to file a
return, a negligence
penalty or other
sanction may be
imposed on you if
this income is
taxable and the IRS
determines that it
has not been
reported.
OMB No. 1545-0115
CORRECTED (if checked)
PAYER’S name, street address, city or town, state or province, country, ZIP
or foreign postal code, and telephone no.
PAYER’S TIN RECIPIENT’S TIN
RECIPIENT’S name
Street address (including apt. no.)
City or town, state or province, country, and ZIP or foreign postal code
Account number (see instructions) FATCA filing
requirement
1 Rents
$
2 Royalties
$
3 Other income
$
4 Federal income tax withheld
$
5 Fishing boat proceeds
$
6
Medical and health care payments
$
7
Payer made direct sales
totaling $5,000 or more of
consumer products to
recipient for resale
8
Substitute payments in lieu of
dividends or interest
$
9
Crop insurance proceeds
$
10 Gross proceeds paid to an
attorney
$
11 Fish purchased for resale
$
12 Section 409A deferrals
$
13 Excess golden parachute
payments
$
14 Nonqualified deferred
compensation
$
15 State tax withheld
$
$
16 State/Payer’s state no. 17 State income
$
$
Form 1099-MISC
(keep for your records)
www.irs.gov/Form1099MISC
Instructions for Recipient
Recipient’s taxpayer identification number (TIN). For your protection, this
form may show only the last four digits of your social security number (SSN),
individual taxpayer identification number (ITIN), adoption taxpayer identification
number (ATIN), or employer identification number (EIN). However, the payer has
reported your complete TIN to the IRS.
Account number. May show an account or other unique number the payer
assigned to distinguish your account.
FATCA filing requirement. If the FATCA filing requirement box is checked, the
payer is reporting on this Form 1099 to satisfy its account reporting requirement
under chapter 4 of the Internal Revenue Code. You may also have a filing
requirement. See the Instructions for Form 8938.
Amounts shown may be subject to self-employment (SE) tax. Individuals
should see the Instructions for Schedule SE (Form 1040). Corporations,
fiduciaries, or partnerships must report the amounts on the appropriate line of
their tax returns.
Form 1099-MISC incorrect? If this form is incorrect or has been issued in error,
contact the payer. If you cannot get this form corrected, attach an explanation
to your tax return and report your information correctly.
Box 1. Report rents from real estate on Schedule E (Form 1040). However,
report rents on Schedule C (Form 1040) if you provided significant services to
the tenant, sold real estate as a business, or rented personal property as a
business. See Pub. 527.
Box 2. Report royalties from oil, gas, or mineral properties; copyrights; and
patents on Schedule E (Form 1040). However, report payments for a working
interest as explained in the Schedule E (Form 1040) instructions. For royalties on
timber, coal, and iron ore, see Pub. 544.
Box 3. Generally, report this amount on the “Other income” line of Schedule 1
(Form 1040) and identify the payment. The amount shown may be payments
received as the beneficiary of a deceased employee, prizes, awards, taxable
damages, Indian gaming profits, or other taxable income. See Pub. 525. If it is
trade or business income, report this amount on Schedule C or F (Form 1040).
Box 4. Shows backup withholding or withholding on Indian gaming profits.
Generally, a payer must backup withhold if you did not furnish your TIN. See
Form W-9 and Pub. 505 for more information. Report this amount on your
income tax return as tax withheld.
Box 5. Shows the amount paid to a fishing boat crew member who is
considered by the operator to be self-employed. Self-employed individuals must
report this amount on Schedule C (Form 1040). See Pub. 334.
Box 6. For individuals, report on Schedule C (Form 1040).
Box 7. If checked, consumer products totaling $5,000 or more were sold to you
for resale, on a buy-sell, a deposit-commission, or other basis. Generally, report
any income from your sale of these products on Schedule C (Form 1040).
Box 8. Shows substitute payments in lieu of dividends or tax-exempt interest
received by your broker on your behalf as a result of a loan of your securities.
Report on the “Other income” line of Schedule 1 (Form 1040).
Box 9. Report this amount on Schedule F (Form 1040).
Box 10. Shows gross proceeds paid to an attorney in connection with legal
services. Report only the taxable part as income on your return.
Box 11. Shows the amount paid for the purchase of fish for resale from any
person engaged in the trade or business of catching fish. See the instructions
for your tax return for reporting this income.
Box 12. May show current year deferrals as a nonemployee under a
nonqualified deferred compensation (NQDC) plan that is subject to the
requirements of section 409A plus any earnings on current and prior year
deferrals.
Box 13. Shows your total compensation of excess golden parachute payments
subject to a 20% excise tax. See your tax return instructions for where to report.
Box 14. Shows income as a nonemployee under an NQDC plan that does not meet
the requirements of section 409A. Any amount included in box 12 that is currently
taxable is also included in this box. Report this amount as income on your tax
return. This income is also subject to a substantial additional tax to be reported on
Form 1040, 1040-SR, or 1040-NR. See the instructions for your tax return.
Boxes 15–17. Show state or local income tax withheld from the payments.
Future developments. For the latest information about developments related to
Form 1099-MISC and its instructions, such as legislation enacted after they
were published, go to www.irs.gov/Form1099MISC.
Free File. Go to www.irs.gov/FreeFile to see if you qualify for no-cost online
federal tax preparation, e-filing, and direct deposit or payment options.
Form 1099-MISC
2021
Miscellaneous
Information
Copy 2
Department of the Treasury - Internal Revenue Service
To be filed with
recipient’s state
income tax return,
when required.
OMB No. 1545-0115
CORRECTED (if checked)
PAYER’S name, street address, city or town, state or province, country, ZIP
or foreign postal code, and telephone no.
PAYER’S TIN RECIPIENT’S TIN
RECIPIENT’S name
Street address (including apt. no.)
City or town, state or province, country, and ZIP or foreign postal code
Account number (see instructions) FATCA filing
requirement
1 Rents
$
2 Royalties
$
3 Other income
$
4
Federal income tax withheld
$
5 Fishing boat proceeds
$
6
Medical and health care payments
$
7
Payer made direct sales
totaling $5,000 or more of
consumer products to
recipient for resale
8
Substitute payments in lieu of
dividends or interest
$
9
Crop insurance proceeds
$
10 Gross proceeds paid to an
attorney
$
11 Fish purchased for resale
$
12 Section 409A deferrals
$
13 Excess golden parachute
payments
$
14
Nonqualified deferred
compensation
$
15 State tax withheld
$
$
16 State/Payer’s state no. 17 State income
$
$
Form 1099-MISC
www.irs.gov/Form1099MISC
Form 1099-MISC
2021
Miscellaneous
Information
Copy C
For Payer
Department of the Treasury - Internal Revenue Service
OMB No. 1545-0115
For Privacy Act
and Paperwork
Reduction Act
Notice, see the
2021 General
Instructions for
Certain
Information
Returns.
VOID CORRECTED
PAYER’S name, street address, city or town, state or province, country, ZIP
or foreign postal code, and telephone no.
PAYER’S TIN RECIPIENT’S TIN
RECIPIENT’S name
Street address (including apt. no.)
City or town, state or province, country, and ZIP or foreign postal code
Account number (see instructions) FATCA filing
requirement
2nd TIN not.
1 Rents
$
2 Royalties
$
3 Other income
$
4
Federal income tax withheld
$
5 Fishing boat proceeds
$
6
Medical and health care payments
$
7
Payer made direct sales
totaling $5,000 or more of
consumer products to
recipient for resale
8
Substitute payments in lieu of
dividends or interest
$
9
Crop insurance proceeds
$
10 Gross proceeds paid to an
attorney
$
11 Fish purchased for resale
$
12 Section 409A deferrals
$
13 Excess golden parachute
payments
$
14
Nonqualified deferred
compensation
$
15 State tax withheld
$
$
16 State/Payer’s state no. 17 State income
$
$
Form 1099-MISC
www.irs.gov/Form1099MISC
Instructions for Payer
To complete Form 1099-MISC, use:
• The 2021 General Instructions for Certain Information
Returns, and
• The 2021 Instructions for Forms 1099-MISC and
1099-NEC.
To complete corrected Forms 1099-MISC, see the
2021 General Instructions for Certain Information
Returns.
To order these instructions and additional forms, go
to www.irs.gov/Form1099MISC.
Caution: Because paper forms are scanned during
processing, you cannot file Forms 1096, 1097, 1098,
1099, 3921, or 5498 that you print from the IRS website.
Due dates. Furnish Copy B of this form to the recipient
by January 31, 2022. The due date is extended to
February 15, 2022, if you are reporting payments in box
8 or 10.
File Copy A of this form with the IRS by February 28,
2022, if you file on paper, or by March 31, 2022, if you
file electronically.
To file electronically, you must have software that
generates a file according to the specifications in Pub.
1220. The IRS does not provide a fill-in form option for
Copy A.
Need help? If you have questions about reporting on
Form 1099-MISC, call the information reporting
customer service site toll free at 866-455-7438 or
304-263-8700 (not toll free). Persons with a hearing or
speech disability with access to TTY/TDD equipment
can call 304-579-4827 (not toll free).
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Completed 10 February 2022

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