Fillable Form 1099-S, Proceeds From Real Estate Transactions. If (Foundation Title)

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Form 1099-S, Proceeds From Real Estate Transactions. If (Foundation Title)

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CERTIFICATION FOR NO INFORMATION REPORTING (1099-S) ON PRINCIPAL RESIDENCE
This form may be completed by the seller of a principal residence. This information is necessary to
determine whether the sale or exchange should be reported to the seller, and to the Internal Revenue Service on
Form 1099-S, Proceeds From Real Estate Transactions. If the seller properly completes Parts I and III, and makes a
“yes” response to assurances (1) through (6) in Part II (or a “not applicable” response to assurance (6)), no
information reporting to the seller or to the Service will be required for that seller. The term “seller” includes each
owner of the residence that is sold or exchanged. Thus, if a residence has more than one owner, a real estate
reporting person must either obtain a certification form each owner (whether married or not) or file an information
return and furnish a payee statement for any owner that does not make the certification.
Part I. Seller Information
1. Name (All sellers if more than 1 seller)
2. Street (or legal description)
City, State, ZIP
3. Taxpayer Identification Number (TIN):
Part II. Seller Assurances
Check “true” or “false” for assurances (1) through (5), and "true", "false", or "not applicable" for assurance (6)
True False
(1) I owned and used the residence as my principal residence for periods aggregating 2
years or more during the 5-year period ending on the date of the sale or exchange of the
residence.
(2) I have not sold or exchanged another principal residence during the 2-year period
ending on the date of the sale or exchange of the residence
(3) I (or my spouse or former spouse, if I was married at any time during the period
beginning after May 6, 1997, and ending today) have not used any portion of the residence
for business or rental purposes after May 6, 1997.
(4) At least one of the following three statements applies:
The sale or exchange is of the entire residence for $250,000 or less.
OR
I am married, the sale or exchange is of the entire residence for $500,000 or less, and the
gain on the sale or exchange of the entire residence is $250,000 or less.
OR
I am married, the sale or exchange is of the entire residence for $500,000 or less, and (a) I
intend to file a joint return for the year of the sale or exchange, (b) my spouse also used
the residence as his or her principal residence for periods aggregating 2 years or more
during the 5-year period ending on the date of the sale or exchange of the residence, and
(c) my spouse also has not sold or exchanged another principal residence during the 2-
year period ending on the date of the sale or exchange of the residence.
(5) During the 5-year period ending on the date of the sale or exchange of the residence, I
did not acquire the residence in an exchange to which section 1031 of the Internal Revenue
Code applied.
N/A
(6) If my basis in the residence is determined by reference to the basis in the hands of a
person who acquired the residence in an exchange to which section 1031 of the Internal
Revenue Code applied, the exchange to which section 1031 applied occurred more than 5
years prior to the date I sold or exchanged the residence.
Part III. Seller Certification (All sellers must sign)
Under penalties of perjury, I certify that all the above information is true as of the end of the day of the sale
or exchange.
__________________________________________
DATED:
__________________________________________
DATED:
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Form 1099-S, Proceeds From Real Estate Transactions. If (Foundation Title)

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Completed 23 September 2021

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