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1. Tax Year

Tax Year

2. Payer's Information

Payer's name

Payer's TIN

Payer's telephone number

Country

Street address

Room or suite no. (Optional)

City or town

State or province

ZIP or foreign postal code

3. Recipient's Information

Recipient's name

Recipient's TIN

Country

Street address

Apt. no. (Optional)

City or town

State or province

ZIP or foreign postal code

4. Original Issue Discount

Account number (Optional)

Second TIN notice

FATCA filing requirement

Box 1. Original issue discount for the year (Optional)

Box 2. Other periodic interest (Optional)

Box 3. Early withdrawal penalty (Optional)

Box 4. Federal income tax withheld (Optional)

Box 5. Market discount (Optional)

Box 6. Acquisition premium (Optional)

Box 7. Description (Optional)

Box 8. Original issue discount on U.S. Treasury obligations (Optional; may be negative)

Box 9. Investment expenses (Optional)

Box 10. Bond premium (Optional)

Box 11. Tax-exempt OID (Optional)

Box 12. State (line 1) (Optional)

Box 13. State identification no. (line 1) (Optional)

Box 14. State tax withheld (line 1) (Optional)

Do you want to enter state tax withheld for a second state?

5. Email Information

Email is optional. Your completed 1099-OID PDF is downloaded from the Summary page.

Your email address (Optional)

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Tax Year 2026

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