Fillable Payment Card and Third Party Network Transactions Form 1099-K

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Payment Card and Third Party Network Transactions Form 1099-K

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The Payment Card and Third Party Network Transactions Form 1099-K form is 7 pages long and contains:

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Country of origin: US
File type: PDF

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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-K
2019
Cat. No. 54118B
Payment Card and
Third Party
Network
Transactions
Copy A
For
Internal Revenue
Service Center
File with Form 1096.
Department of the Treasury - Internal Revenue Service
OMB No. 1545-2205
For Privacy Act
and Paperwork
Reduction Act
Notice, see the
2019 General
Instructions for
Certain Information
Returns.
1010
VOID CORRECTED
FILER'S name, street address, city or town, state or province, country, ZIP
or foreign postal code, and telephone no.
Check to indicate if FILER is a (an):
Payment settlement entity (PSE)
Electronic Payment Facilitator
(EPF)/Other third party
Check to indicate transactions
reported are:
Payment card
Third party network
PAYEE’S name
Street address (including apt. no.)
City or town, state or province, country, and ZIP or foreign postal code
PSE’S name and telephone number
Account number (see instructions) 2nd TIN not.
FILER’S TIN
PAYEE’S TIN
1a Gross amount of payment
card/third party network
transactions
$
1b Card Not Present
transactions
$
2 Merchant category code
3 Number of payment
transactions
4 Federal income tax
withheld
$
5a January
$
5b February
$
5c March
$
5d April
$
5e May
$
5f June
$
5g July
$
5h August
$
5i September
$
5j October
$
5k November
$
5l December
$
6 State 7 State identification no. 8
State income tax withheld
$
$
Form 1099-K
www.irs.gov/Form1099K
Do Not Cut or Separate Forms on This Page — Do Not Cut or Separate Forms on This Page
Form 1099-K
2019
Payment Card and
Third Party
Network
Transactions
Copy 1
For State Tax
Department
Department of the Treasury - Internal Revenue Service
OMB No. 1545-2205
VOID CORRECTED
FILER'S name, street address, city or town, state or province, country, ZIP
or foreign postal code, and telephone no.
Check to indicate if FILER is a (an):
Payment settlement entity (PSE)
Electronic Payment Facilitator
(EPF)/Other third party
Check to indicate transactions
reported are:
Payment card
Third party network
PAYEE’S name
Street address (including apt. no.)
City or town, state or province, country, and ZIP or foreign postal code
PSE’S name and telephone number
Account number (see instructions)
FILER’S TIN
PAYEE’S TIN
1a Gross amount of payment
card/third party network
transactions
$
1b Card Not Present
transactions
$
2 Merchant category code
3 Number of payment
transactions
4 Federal income tax
withheld
$
5a January
$
5b February
$
5c March
$
5d April
$
5e May
$
5f June
$
5g July
$
5h August
$
5i September
$
5j October
$
5k November
$
5l December
$
6 State 7 State identification no. 8
State income tax withheld
$
$
Form 1099-K
www.irs.gov/Form1099K
Form 1099-K
2019
Payment Card and
Third Party
Network
Transactions
Copy B
For Payee
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
taxable income
results from this
transaction and the
IRS determines that it
has not been
reported.
OMB No. 1545-2205
CORRECTED (if checked)
FILER'S name, street address, city or town, state or province, country, ZIP
or foreign postal code, and telephone no.
Check to indicate if FILER is a (an):
Payment settlement entity (PSE)
Electronic Payment Facilitator
(EPF)/Other third party
Check to indicate transactions
reported are:
Payment card
Third party network
PAYEE’S name
Street address (including apt. no.)
City or town, state or province, country, and ZIP or foreign postal code
PSE’S name and telephone number
Account number (see instructions)
FILER’S TIN
PAYEE’S TIN
1a Gross amount of payment
card/third party network
transactions
$
1b Card Not Present
transactions
$
2 Merchant category code
3 Number of payment
transactions
4 Federal income tax
withheld
$
5a January
$
5b February
$
5c March
$
5d April
$
5e May
$
5f June
$
5g July
$
5h August
$
5i September
$
5j October
$
5k November
$
5l December
$
6 State 7 State identification no. 8
State income tax withheld
$
$
Form 1099-K
(Keep for your records) www.irs.gov/Form1099K
Instructions for Payee
You have received this form because you have either (a) accepted
payment cards for payments, or (b) received payments through a third
party network that exceeded $20,000 in gross total reportable
transactions and the aggregate number of those transactions
exceeded 200 for the calendar year. Merchant acquirers and third
party settlement organizations, as payment settlement entities (PSEs),
must report the proceeds of payment card and third party network
transactions made to you on Form 1099-K under Internal Revenue
Code section 6050W. The PSE may have contracted with an
electronic payment facilitator (EPF) or other third party payer to make
payments to you.
If you have questions about the amounts reported on this form,
contact the FILER whose information is shown in the upper left corner
on the front of this form. If you do not recognize the FILER shown in
the upper left corner of the form, contact the PSE whose name and
phone number are shown in the lower left corner of the form above
your account number.
See the separate instructions for your income tax return for using
the information reported on this form.
Payee's taxpayer identification number (TIN). For your protection,
this form may show only the last four digits of your TIN (social security
number (SSN), individual taxpayer identification number (ITIN),
adoption taxpayer identification number (ATIN), or employer
identification number (EIN)). However, the issuer has reported your
complete TIN to the IRS.
Account number. May show an account number or other unique
number the PSE assigned to distinguish your account.
Box 1a. Shows the aggregate gross amount of payment card/third
party network transactions made to you through the PSE during the
calendar year.
Box 1b. Shows the aggregate gross amount of all reportable payment
transactions made to you through the PSE during the calendar year
where the card was not present at the time of the transaction or the
card number was keyed into the terminal. Typically, this relates to
online sales, phone sales, or catalogue sales. If the box for third party
network is checked, or if these are third party network transactions,
Card Not Present transactions will not be reported.
Box 2. Shows the merchant category code used for payment card/
third party network transactions (if available) reported on this form.
Box 3. Shows the number of payment transactions (not including
refund transactions) processed through the payment card/third party
network.
Box 4. Shows backup withholding. Generally, a payer must backup
withhold if you did not furnish your TIN or you did not furnish the
correct TIN to the payer. See Form W-9, Request for Taxpayer
Identification Number and Certification, and Pub. 505. Include this
amount on your income tax return as tax withheld.
Boxes 5a–5l. Shows the gross amount of payment card/third party
network transactions made to you for each month of the calendar
year.
Boxes 6–8. Shows state and local income tax withheld from the
payments.
Future developments. For the latest information about developments
related to Form 1099-K and its instructions, such as legislation
enacted after they were published, go to www.irs.gov/Form1099K.
Form 1099-K
2019
Payment Card and
Third Party
Network
Transactions
Copy 2
To be filed with the
recipient's state
income tax return,
when required.
Department of the Treasury - Internal Revenue Service
OMB No. 1545-2205
CORRECTED (if checked)
FILER'S name, street address, city or town, state or province, country, ZIP
or foreign postal code, and telephone no.
Check to indicate if FILER is a (an):
Payment settlement entity (PSE)
Electronic Payment Facilitator
(EPF)/Other third party
Check to indicate transactions
reported are:
Payment card
Third party network
PAYEE’S name
Street address (including apt. no.)
City or town, state or province, country, and ZIP or foreign postal code
PSE’S name and telephone number
Account number (see instructions)
FILER’S TIN
PAYEE’S TIN
1a Gross amount of payment
card/third party network
transactions
$
1b Card Not Present
transactions
$
2 Merchant category code
3 Number of payment
transactions
4 Federal income tax
withheld
$
5a January
$
5b February
$
5c March
$
5d April
$
5e May
$
5f June
$
5g July
$
5h August
$
5i September
$
5j October
$
5k November
$
5l December
$
6 State 7 State identification no. 8
State income tax withheld
$
$
Form 1099-K
www.irs.gov/Form1099K
Form 1099-K
2019
Payment Card and
Third Party
Network
Transactions
Copy C
For FILER
Department of the Treasury - Internal Revenue Service
OMB No. 1545-2205
For Privacy Act
and Paperwork
Reduction Act
Notice, see the
2019 General
Instructions for
Certain Information
Returns.
VOID CORRECTED
FILER'S name, street address, city or town, state or province, country, ZIP
or foreign postal code, and telephone no.
Check to indicate if FILER is a (an):
Payment settlement entity (PSE)
Electronic Payment Facilitator
(EPF)/Other third party
Check to indicate transactions
reported are:
Payment card
Third party network
PAYEE’S name
Street address (including apt. no.)
City or town, state or province, country, and ZIP or foreign postal code
PSE’S name and telephone number
Account number (see instructions) 2nd TIN not.
FILER’S TIN
PAYEE’S TIN
1a Gross amount of payment
card/third party network
transactions
$
1b Card Not Present
transactions
$
2 Merchant category code
3 Number of payment
transactions
4 Federal income tax
withheld
$
5a January
$
5b February
$
5c March
$
5d April
$
5e May
$
5f June
$
5g July
$
5h August
$
5i September
$
5j October
$
5k November
$
5l December
$
6 State 7 State identification no. 8
State income tax withheld
$
$
Form 1099-K
www.irs.gov/Form1099K
Instructions for FILER Who Is a Payment
Settlement Entity or Electronic Payment
Facilitator/Other Third Party
To complete Form 1099-K, use:
• The 2019 General Instructions for Certain Information
Returns, and
• The 2019 Instructions for Form 1099-K.
To order these instructions and additional forms, go
to www.irs.gov/Form1099K.
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, 2020.
File Copy A of this form with the IRS by February 28,
2020. If you file electronically, the due date is March 31,
2020. 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-K, 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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Payment Card and Third Party Network Transactions Form 1099-K

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Completed 21 May 2019

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