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9797 VOID CORRECTED PAYER’S name, street address, city or town, state or province, country, 1 Patronage dividends OMB No. 1545-0118 ZIP or foreign postal code, and telephone no. Taxable $ 2 Nonpatronage distributions Form 1099-PATR Distributions $ (Rev. January 2023) Received From 3 Per-unit retain allocations For calendar year Cooperatives $ 20 PAYER’S TIN RECIPIENT’S TIN 4 Federal income tax withheld 5 Redeemed nonqualified notices Copy A $ $ For RECIPIENT’S name 6 Section 199A(g) deduction 7 Qualified payments Internal Revenue (Section 199A(b)(7)) Service Center $ $ File with Form 1096. Street address (including apt. no.) 8 Section 199A(a) qual. items 9 Section 199A(a) SSTB items For Privacy Act and Paperwork $ $ Reduction Act City or town, state or province, country, and ZIP or foreign postal code 10 Investment credit 11 Work opportunity credit Notice, see the $ $ current General Instructions for Account number (see instructions) 2nd TIN not. 12 Other credits and deductions 13 Specified Coop Certain Information $ Returns. Form 1099-PATR (Rev. 1-2023) Cat. No. 14435F www.irs.gov/Form1099PATR Department of the Treasury - Internal Revenue Service Do Not Cut or Separate Forms on This Page — Do Not Cut or Separate Forms on This Page |
CORRECTED (if checked) PAYER’S name, street address, city or town, state or province, country, 1 Patronage dividends OMB No. 1545-0118 ZIP or foreign postal code, and telephone no. Taxable $ 2 Nonpatronage distributions Form 1099-PATR Distributions $ (Rev. January 2023) Received From 3 Per-unit retain allocations For calendar year Cooperatives $ 20 PAYER’S TIN RECIPIENT’S TIN 4 Federal income tax withheld 5 Redeemed nonqualified notices Copy B $ $ For Recipient RECIPIENT’S name 6 Section 199A(g) deduction 7 Qualified payments (Section 199A(b)(7)) This is important tax information and is $ $ being furnished to the Street address (including apt. no.) 8 Section 199A(a) qual. items 9 Section 199A(a) SSTB items IRS. If you are required to file a return, a $ $ negligence penalty or City or town, state or province, country, and ZIP or foreign postal code 10 Investment credit 11 Work opportunity credit other sanction may be imposed on you if this $ $ income is taxable and Account number (see instructions) 12 Other credits and deductions 13 Specified Coop the IRS determines that it has not been $ reported. Form 1099-PATR (Rev. 1-2023) (keep for your records) www.irs.gov/Form1099PATR Department of the Treasury - Internal Revenue Service |
Instructions for Recipient Box 6. Shows your share of the cooperative’s section 199A(g) deduction passed through to you. The amount must have been designated in a written notice sent Distributions you received from a cooperative may be includible in your income. to you from the cooperative during the section 1382(d) payment period. To claim Generally, if you are an individual, report any amounts shown in boxes 1, 2, 3, and 5 the deduction, you must not be a C corporation. as ordinary income, unless nontaxable, on your income tax return. You must report Box 7. Shows the amount of qualified payments paid to you on which the any redemptions in boxes 2 and 5 as ordinary income to the extent of the stated cooperative computed its section 199A(g) deduction. If there is an amount in dollar value because they were not taxable when issued to you. Amounts shown in this box and the amount is related to a trade or business for which you are boxes 7, 8, and 9 are information needed to compute your section 199A(a) claiming a section 199A(a) deduction, you are required to compute a reduction deduction. See the instructions for Form 8995 or 8995-A for more information. to your deduction per section 199A(b)(7). Recipient’s taxpayer identification number (TIN). For your protection, this Box 8. Shows items received and reported in boxes 1, 2, 3, and 5 that may form may show only the last four digits of your TIN. However, the issuer has qualify as qualified items from trades or businesses that are not a specified reported your complete TIN to the IRS. service trade or business (SSTB) for purposes of the section 199A(a) deduction. Account number. May show an account or other unique number the payer Items relating to SSTBs are reported separately in box 9. assigned to distinguish your account. Box 9. Shows amounts received and reported in boxes 1, 2, 3, and 5 from an Box 1.Shows patronage dividends paid to you during the year in cash, qualified SSTB that may qualify as qualified items for purposes of the section 199A(a) written notices of allocation (at stated dollar value), or other property (not including deduction. Use Form 8995 or 8995-A to determine your section 199A(a) deduction. nonqualified allocations). Any dividends paid on (1) property bought for personal Box 10. Shows investment credits passed through to you by the cooperative. use or (2) capital assets or depreciable property used in your business are not Use Form 3468 to compute your allowable credit. taxable. However, if (2) applies, reduce the basis of the assets by this amount. Box 11. Shows work opportunity credits passed through to you. Use Form 5884 Box 2. Shows nonpatronage distributions paid to you during the year in cash, or 3800 to compute your allowable credit. qualified written notices of allocation, or other property, and amounts you Box 12. Shows other credits and deductions passed through to you. For information received in redemption of nonqualified written notices of allocation from on how to report credits, see the instructions for the specific credit form. nonpatronage sources. Box 3. Shows patronage per-unit retain allocations paid to you during the year Box 13. If this box is checked, the information reported to you is from a specified in cash, qualified per-unit retain certificates, or other property. agricultural or horticultural cooperative, as defined in section 199A(g)(4)(A). Box 4. Shows backup withholding. Generally, a payer must backup withhold if Future developments. For the latest information about developments related to you didn’t furnish your TIN. See Form W-9 and Pub. 505 for more information. Form 1099-PATR and its instructions, such as legislation enacted after they Report this amount on your income tax return as tax withheld. were published, go to www.irs.gov/Form1099PATR. Box 5.Shows amounts you received when you redeemed nonqualified written notices Free File Program. Go to www.irs.gov/FreeFile to see if you qualify for no-cost of allocation and nonqualified per-unit retain allocations from patronage sources. online federal tax preparation, e-filing, and direct deposit or payment options. |
VOID CORRECTED PAYER’S name, street address, city or town, state or province, country, 1 Patronage dividends OMB No. 1545-0118 ZIP or foreign postal code, and telephone no. Taxable $ 2 Nonpatronage distributions Form 1099-PATR Distributions $ (Rev. January 2023) Received From 3 Per-unit retain allocations For calendar year Cooperatives $ 20 PAYER’S TIN RECIPIENT’S TIN 4 Federal income tax withheld 5 Redeemed nonqualified notices Copy C $ $ For Payer RECIPIENT’S name 6 Section 199A(g) deduction 7 Qualified payments (Section 199A(b)(7)) For Privacy Act $ $ and Paperwork Street address (including apt. no.) 8 Section 199A(a) qual. items 9 Section 199A(a) SSTB items Reduction Act Notice, see the $ $ current General City or town, state or province, country, and ZIP or foreign postal code 10 Investment credit 11 Work opportunity credit Instructions for $ $ Certain Information Returns. Account number (see instructions) 2nd TIN not. 12 Other credits and deductions 13 Specified Coop $ Form 1099-PATR (Rev. 1-2023) www.irs.gov/Form1099PATR Department of the Treasury - Internal Revenue Service |
Instructions for Payer Filing and furnishing. For filing and furnishing instructions, including due dates, and requesting filing or furnishing To complete Form 1099-PATR, use: extensions, see the current General Instructions for Certain • The current General Instructions for Certain Information Information Returns. Returns, and Foreign recipient. If the recipient is a nonresident alien, • The current Instructions for Form 1099-PATR. you may have to withhold federal income tax and file To get and to order these instructions and additional Form 1042-S. See the Instructions for Form 1042-S and forms, go to www.irs.gov/EmployerForms. Pub. 515. Caution: Because paper forms are scanned during Need help? If you have questions about reporting on Form processing, you cannot file certain Forms 1096, 1097, 1099-PATR, call the Technical Services Operation (TSO) 1098, 1099, 3921, or 5498 that you print from the IRS toll free at 866-455-7438 or 304-263-8700 (not toll free). website. Deaf or hard of hearing customers may call any of our toll-free numbers using their choice of relay service. |