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This Product Contains Sensitive Taxpayer Data

Wage and Income Transcript

Request Date: 01-04-2022
Response Date: 01-04-2022
Tracking Number: 999999999999

SSN Provided: 503-00-1959
Tax Period Requested: December, 2018

Form 1099-C Cancellation of Debt

Creditor:

Creditor's Federal Identification Number (FIN): 00-5888357
SAMPLE PAYER 1
7537 LAKE AVE
KANSAS CITY, MO 64112

Debtor:

Debtor's Identification Number: 503-00-1959
CHRIS JOHNSON
1990 FOURTH ST
TAMPA, FL 33607

Submission Type:Original document
Account Number (Optional):999999999
Date Canceled:12-31-2018
Property Fair Market Value:$0.00
Amount of Debt Discharged:$8,348.00
Interest Forgiven Amount:$0.00
Identifiable Event Code:Creditor's debt collection Policy
Debt Description:DDA EXPENDITURE
Personal Liability Indicator:Box checked-Personally Liable

Form 1099-C Cancellation of Debt

Creditor:

Creditor's Federal Identification Number (FIN): 00-4625582
SAMPLE PAYER 2
6252 OAK ST
AKRON, OH 44223

Debtor:

Debtor's Identification Number: 503-00-1959
CHRIS JOHNSON
1990 FOURTH ST
TAMPA, FL 33607

Submission Type:Original document
Account Number (Optional):999999999
Date Canceled:12-31-2018
Property Fair Market Value:$0.00
Amount of Debt Discharged:$7,940.00
Interest Forgiven Amount:$0.00
Identifiable Event Code:Creditor's debt collection Policy
Debt Description:DDA EXPENDITURE
Personal Liability Indicator:Box checked-Personally Liable

Form 1099-INT

Payer:

Payer's Federal Identification Number (FIN): 00-4664014
SAMPLE PAYER 3
6015 ELM AVE
DETROIT, MI 48216

Recipient:

Recipient's Identification Number: 503-00-1959
CHRIS JOHNSON
1990 FOURTH ST
TAMPA, FL 33607

Submission Type:Original document
Account Number (Optional):999999999
Interest:$4.00
Tax Withheld:$0.00
Savings Bonds:$0.00
Investment Expense:$0.00
Interest Forfeiture:$0.00
Foreign Tax Paid:$0.00
Tax-Exempt Interest:$0.00
Specified Private Activity Bond Interest:$0.00
Market Discount:$0.00
Bond Premium:$0.00
Bond Premium on Tax Exempt Bond:$0.00
Bond Premium on Treasury Obligations:$0.00
Second Notice Indicator:No Second Notice
Foreign Country or US Possession:
CUSIP Number:
FATCA Filing Requirement:Box not checked no Filing Requirement

Form 1099-INT

Payer:

Payer's Federal Identification Number (FIN): 00-2875258
SAMPLE PAYER 4
9885 CEDAR ST
ATLANTA, GA 30305

Recipient:

Recipient's Identification Number: 503-00-1959
CHRIS JOHNSON
1990 FOURTH ST
TAMPA, FL 33607

Submission Type:Original document
Account Number (Optional):999999999
Interest:$4.00
Tax Withheld:$0.00
Savings Bonds:$0.00
Investment Expense:$0.00
Interest Forfeiture:$0.00
Foreign Tax Paid:$0.00
Tax-Exempt Interest:$0.00
Specified Private Activity Bond Interest:$0.00
Market Discount:$0.00
Bond Premium:$0.00
Bond Premium on Tax Exempt Bond:$0.00
Bond Premium on Treasury Obligations:$0.00
Second Notice Indicator:No Second Notice
Foreign Country or US Possession:
CUSIP Number:
FATCA Filing Requirement:Box not checked no Filing Requirement

Form 1099-INT

Payer:

Payer's Federal Identification Number (FIN): 00-8298575
SAMPLE PAYER 5
9885 MAPLE AVE
DETROIT, MI 48216

Recipient:

Recipient's Identification Number: 503-00-1959
CHRIS JOHNSON
1990 FOURTH ST
TAMPA, FL 33607

Submission Type:Original document
Account Number (Optional):999999999
Interest:$4.00
Tax Withheld:$0.00
Savings Bonds:$0.00
Investment Expense:$0.00
Interest Forfeiture:$0.00
Foreign Tax Paid:$0.00
Tax-Exempt Interest:$0.00
Specified Private Activity Bond Interest:$0.00
Market Discount:$0.00
Bond Premium:$0.00
Bond Premium on Tax Exempt Bond:$0.00
Bond Premium on Treasury Obligations:$0.00
Second Notice Indicator:No Second Notice
Foreign Country or US Possession:
CUSIP Number:
FATCA Filing Requirement:Box not checked no Filing Requirement

Form 1099-INT

Payer:

Payer's Federal Identification Number (FIN): 00-8062958
SAMPLE PAYER 6
2518 VIEW ST
PHOENIX, AZ 85005

Recipient:

Recipient's Identification Number: 503-00-1959
CHRIS JOHNSON
1990 FOURTH ST
TAMPA, FL 33607

Submission Type:Original document
Account Number (Optional):999999999
Interest:$0.00
Tax Withheld:$0.00
Savings Bonds:$0.00
Investment Expense:$0.00
Interest Forfeiture:$0.00
Foreign Tax Paid:$0.00
Tax-Exempt Interest:$0.00
Specified Private Activity Bond Interest:$0.00
Market Discount:$0.00
Bond Premium:$0.00
Bond Premium on Tax Exempt Bond:$0.00
Bond Premium on Treasury Obligations:$0.00
Second Notice Indicator:No Second Notice
Foreign Country or US Possession:
CUSIP Number:
FATCA Filing Requirement:Box not checked no Filing Requirement

Form 1099-MISC

Payer:

Payer's Federal Identification Number (FIN): 00-5900950
SAMPLE PAYER 7
9683 THIRD ST
BOSTON, MA 02123

Recipient:

Recipient's Identification Number: 503-00-1959
CHRIS JOHNSON
1990 FOURTH ST
TAMPA, FL 33607

Submission Type:Original document
Account Number (Optional):999999999
Tax Withheld:$0.00
Non-Employee Compensation:$1,000.00
Medical Payments:$0.00
Fishing Income:$0.00
Rents:$0.00
Royalties:$0.00
Other Income:$0.00
Substitute Payments for Dividends:$0.00
Excess Golden Parachute:$0.00
Crop Insurance:$0.00
Attorney Fees:$0.00
Foreign Tax Paid:$0.00
Section 409A Deferrals:$0.00
Section 409A Income:$0.00
Direct Sales Indicator:Not Direct Sales
FATCA Filing Requirement:Box not checked no Filing Requirement
Second Notice Indicator:No Second Notice

Form 1099-MISC

Payer:

Payer's Federal Identification Number (FIN): 00-7072923
SAMPLE PAYER 8
3580 THIRD AVE
NEW YORK, NY 10005

Recipient:

Recipient's Identification Number: 503-00-1959
CHRIS JOHNSON
1990 FOURTH ST
TAMPA, FL 33607

Submission Type:Original document
Account Number (Optional):
Tax Withheld:$0.00
Non-Employee Compensation:$4,174.00
Medical Payments:$0.00
Fishing Income:$0.00
Rents:$0.00
Royalties:$0.00
Other Income:$0.00
Substitute Payments for Dividends:$0.00
Excess Golden Parachute:$0.00
Crop Insurance:$0.00
Attorney Fees:$0.00
Foreign Tax Paid:$0.00
Section 409A Deferrals:$0.00
Section 409A Income:$0.00
Direct Sales Indicator:Not Direct Sales
FATCA Filing Requirement:Box not checked no Filing Requirement
Second Notice Indicator:No Second Notice

This Product Contains Sensitive Taxpayer Data