VOID            CORRECTED 
FILER'S name, street address, city, state, ZIP code, and telephone no.                                OMB No. 1545-2221
                                                                                                                          Mortgage 
                                                                                                          2019
                                                                                                                          Assistance 
                                                                                                                          Payments
                                                                                                     Form 1098-MA

FILER'S TIN                          HOMEOWNER'S TIN                   1. Total State HFA and homeowner mortgage payments     Copy A
                                                                       $                                                      For 
HOMEOWNER'S name                                                       2. State HFA mortgage assistance payments          Internal Revenue 
                                                                                                                          Service Center
                                                                       $                                                  For Privacy Act 
Street address (including apt. no.) (optional)                         3. Homeowner mortgage payments                     and Paperwork 
                                                                       $                                                  Reduction Act 
City, state, and ZIP code (optional)                                                                                          Notice, see 
                                                                                                                          the 2019 General 
                                                                                                                          Instructions for 
Account number (optional)                                                                                                 Certain Information 
                                                                                                                              Returns.
Form 1098-MA                         Cat. No. 58017D                    www.irs.gov/Form1098MA 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)
FILER'S name, street address, city, state, ZIP code, and telephone no.                                OMB No. 1545-2221
                                                                                                                          Mortgage 
                                                                                                          2019            Assistance 
                                                                                                                          Payments
                                                                                                     Form 1098-MA

FILER'S TIN                          HOMEOWNER'S TIN                   1. Total State HFA and homeowner mortgage payments Copy B
                                                                       $                                                  For Homeowner
HOMEOWNER'S name                                                       2. State HFA mortgage assistance payments          This is important 
                                                                                                                          tax information 
                                                                       $                                                  and is being 
Street address (including apt. no.) (optional)                         3. Homeowner mortgage payments                     furnished to the IRS.
                                                                       $ 
City, state, and ZIP code (optional) 

Account number (optional)

Form 1098-MA             (keep for your records)                        www.irs.gov/Form1098MA Department of the Treasury - Internal Revenue Service 

Instructions for Homeowner
Form 1098-MA. The information on this statement is submitted to      actually made during the year to your mortgage servicer or the 
the IRS by State Housing Finance Agencies (HFAs) to report: (1)      State HFA. However, the amount you may deduct cannot exceed 
payments made by a State HFA under the Housing Finance               the sum of the amounts shown on your Form 1098 in box 1 
Agency Innovation Fund for the Hardest Hit Housing Markets           (Mortgage interest received from payer(s)/borrower(s)), any 
(HFA Hardest Hit Fund) (State HFA mortgage assistance                deductible MIP reported in box 5, and real estate taxes reported 
payments) and (2) payments made by you (homeowner mortgage           in box 10. However, you are not required to use this safe-harbor 
payments) under this program.                                        method to compute your deduction for mortgage interest and real 
Homeowner's taxpayer identification number (TIN). For your           property taxes on your main home.  
protection, this form may show only the last four digits of your TIN Account number (optional). May show an account number the 
(social security number (SSN) or individual taxpayer identification  filer has assigned to distinguish your account. 
number (ITIN)). However, the filer has reported your complete TIN    Box 1. Shows the total amount of State HFA mortgage assistance 
to the IRS.                                                          payments and homeowner mortgage payments.
Safe-harbor deduction computation. You may use a safe-               Box 2. Shows the amount of State HFA mortgage assistance 
harbor method to compute your deduction for mortgage interest,       payments.
mortgage insurance premiums (MIP) (if deductible, see Form 1040      Box 3. Shows the amount of homeowner mortgage payments you 
(Sch A)), and real property taxes on your main home if you meet      paid to the State HFA.
two tests. First, you meet the rules to deduct all of the mortgage   Future developments. For the latest information about 
interest on your loan, all of your MIP, and all of the real property developments related to Form 1098-MA and its instructions, such 
taxes on your main home. Second, you participated in an HFA          as legislation enacted after they were published, go to              
Hardest Hit Fund program in which program payments could be          IRS.gov/Form1098MA.
used to pay mortgage interest. If you meet these tests, then you 
may deduct an amount equal to the sum of all payments you  

                                     VOID      CORRECTED 
FILER'S name, street address, city, state, ZIP code, and telephone no.                                OMB No. 1545-2221
                                                                                                                          Mortgage 
                                                                                                          2019            Assistance 
                                                                                                                          Payments
                                                                                                     Form 1098-MA

FILER'S TIN                          HOMEOWNER'S TIN                   1. Total State HFA and homeowner mortgage payments     Copy C
                                                                       $                                                      For Filer
HOMEOWNER'S name                                                       2. State HFA mortgage assistance payments          For Privacy Act 
                                                                                                                          and Paperwork 
                                                                       $                                                  Reduction Act 
Street address (including apt. no.) (optional)                         3. Homeowner mortgage payments                         Notice, see 
                                                                                                                          the 2019 General 
                                                                       $                                                  Instructions for 
City, state, and ZIP code (optional)                                                                                      Certain Information 
                                                                                                                              Returns.
Account number (optional) 

Form 1098-MA                                                            www.irs.gov/Form1098MA Department of the Treasury - Internal Revenue Service 

Instructions for Filer
General instructions for this form are provided in the 2019 General              If you file the paper single statement, it must contain each 
Instructions for Certain Information Returns. To order instructions and          homeowner's name and TIN, and corresponding reportable amounts 
additional forms, go to IRS.gov.                                                 in boxes 1, 2, and 3 for each homeowner. 
This form is used to provide information to the IRS and to                       Due dates. Furnish Copy B of this form or the statement to the 
homeowners regarding mortgage payments made by the homeowners                    recipient homeowner by January 31, 2020. File Copy A of this form or 
and mortgage assistance payments made with funds allocated from                  the paper single statement with the IRS by February 28, 2020. You 
the Housing Finance Agency Innovation Fund for the Hardest Hit                   may request an extension of time for filing Copy A or the paper single 
Housing Markets (HFA Hardest Hit Fund).                                          statement in lieu of Copy A with the IRS by filing Form 8809, 
Furnish to homeowner. Furnish Copy B of this form or a substitute                Application for Extension of Time To File Information Returns, 
statement in lieu of Copy B to each recipient homeowner. If you                  available at IRS.gov/Form8809.   
furnish a statement to each recipient homeowner in lieu of Copy B, it                      Form 1098-MA may not be filed electronically with the IRS. 
must contain that homeowner's name and taxpayer identification                             Form 1098-MA is not scanned during processing at the 
number (TIN), and the corresponding reportable amounts in boxes 1,               ▲!        IRS. Therefore, you may file Copy A that you print from 
2, and 3 for that homeowner.                                                     CAUTION   IRS.gov. 
File with IRS. File Copy A or a paper single statement in lieu of Copy           Need help? If you have questions about reporting on Form 1098-MA, 
A with the IRS at the following address.                                         call the information reporting customer service site toll free at 
       Department of Treasury                                                    866-455-7438 or 304-263-8700 (not toll free). Persons with a hearing 
       Internal Revenue Service Center                                           or speech disability with access to TTY/TDD equipment can call 
       Stop 6728AUSC                                                             304-579-4827 (not toll free).
       Austin, TX 73301