1099 - 1 - CMS Form No. NJ-612
INFORMATION FOR REAL ESTATE 1099-S REPORT FILING
S
ection 6045 of the Internal Revenue Code, as amended by the Tax Reform Act of 1996, requires the reporting of
certain information on every real estate transaction. From the information you provide below, a form 1099-S will be
produced and furnished to the IRS no later than January 31
st
of the next year. If you fail to furnish adequate
information (in particular, a tax payer ID number), then you will be subject to all IRS Regulations, including the
possibility withholding twenty percent (20%) of the current sales price.
File Number: _________________ Taxpayer ID Number: ___________________
Taxpayer ID Type: INDIVIDUAL BUSINESS
Name: __________________________________________________________
F
ORWARDING ADDRESS:
M
AILING ADDRESS
T
RANSACTION INFORMATION
Closing Date: _____________________ Contract Sales Price: $__________________________
D
escription of Property(s): _______________________________________________________________
Tax Lot ____________, Tax Block ___________ in the____________ of __________________________,
County of ____________________________ and State of New Jersey.
Prior to this transaction, was the subject property the seller’s principal residence? Yes No
B
uyer’s Portion of Real Estate Tax (i.e., tax credits received by seller): $______________________
I
, ______________________ do swear and depose that the above information is correct and understand that it will
appear on a Form 1099 that will be sent to me and to the IRS.
D
ate: ______________
____
_____________________________________
PLEASE RETAIN FOR INCOME TAX PURPOSES
