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.
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See IRS Publications 1141, 1167, and 1179 for more information about printing these tax forms.
8585 |
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CORRECTED |
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CREDITOR’S name, street address, city or town, state or province, country, |
1 Date of identifiable event |
OMB No. 1545-2281 |
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ZIP or foreign postal code, and telephone no. |
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Form 1099-C |
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Cancellation |
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2 Amount of debt discharged |
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$ |
(Rev. January 2022) |
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of Debt |
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3 Interest, if included in box 2 |
For calendar year |
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$ |
20 |
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CREDITOR’S TIN |
DEBTOR’S TIN |
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4 Debt description |
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Copy A |
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For |
DEBTOR’S name |
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Internal Revenue |
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Service Center |
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File with Form 1096. |
Street address (including apt. no.) |
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5 Check here if the debtor was personally liable for |
For Privacy Act and |
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repayment of the debt . |
. . . . . . . ▶ |
Paperwork Reduction |
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Act Notice, see the |
City or town, state or province, country, and ZIP or foreign postal code |
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current General |
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Instructions for |
Account number (see instructions) |
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6 Identifiable event code |
7 Fair market value of property |
Certain Information |
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$ |
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Returns. |
Form 1099-C (Rev. 1-2022) |
Cat. No. 26280W |
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www.irs.gov/Form1099C |
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