4080 Cvow {Xj conRecteD forign peetal code, ard telephone na. Acquisition or FIRST MIDDLE LAST i GENERAL DELIVERY 2020 ee 1234 POST OFFICE ADDRESS __ Form 1098-8 CIty / TOWN, ST 12345 1 Dns of er acquon [2 alroso pil Copy A eo RE Koortedgecresansonrent | exalndng re SSN-XX-XXXX (LEAVE BLANK) [DATE OF A4V|s AMOUNT** | internal Revenue BORROWERS rane ay aFarmataivauetpeay] Service Center COMPANY / COURT NAME HERE aMounT+s — [Te NthForm 1096. Js For Pivacy Act reat eros jong ow Tad Sec fteborowernespesonay ie ereporm=neet| ANG Papervork 1234 THEIR ADDRESS ST. the debi +. 5 oom) ieeucton fet Tay aroun seo poo. eeu ane AP orf pom cose EDsesipion = aay 2020 General city / TOWN, ST 12345 VOLUNTARY CONVEYANCE | l=tvctgng {or Tessa rare ca ratuctors Information See coe NOMBER OF ISSUED INSTRUMENT grmation Fam 1059-0 Crary * BORROWER'S T.I.N. (TAXPAYER CAN BE FOUND BY A RECORDS YOU MAY LEAVE ** THE AMOUNT SHOULD (EITHER A4V, PROMISSORY NOTE, Went gov OMnIORSA ;Dopaarent oe Treasury nema Revenue Sarvs Do Not Cut or Separate Forms on This Page — Do Not Cut or Separate Forms on This Page REQUEST USING A 4506-A IT BLANK. BE THE TOTAL AMOUNT PAID TO THE COMPANY WITH YOUR INSTRUMENT MUST BE FILLED OUT ON CARBON COPY ORDERED FROM THE I.R.S. (FREE TO ORDER) or PRINTED IN COLOR (RED INK) IDENTIFICATION NUMBER) FORM. OR BILL OF EXCHANGE).[xX] CORRECTED (if checked) ACCOUNT / CASE NUMBER race mn nee oom can 2 uisttion or FIRST MIDDLE LAST ‘Acq GENERAL DELIVERY 2020 aor ment of 1234 POST OFFICE ADDRESS Fon 1099-8 CITY / TOWN, ST 12345 Dato of rer aun | Balance of pial Copy 8 ey eae Troweaon ersoanserment | edslanding For Bowrower SSN-Xx-xxxX | (LEAVE BLANK) [DATE OF A4V|s AMOUNT** | oi icpranim BORROWERS rane yi Farmar vali fpepary| moran aes bong COMPANY / COURT NAME HERE g AMouNT++ [roiseruiediotes ‘Svvet addrose Gnoluirg apt. ro} 5 lt checked, the borower nas personaly able for repayment eee es 1234 THEIR ADDRESS ST. ores P| inposeden uit (Gey orton, state or pounce. caurty an Porte pasa coce | EDsepion@ peoany ete pearete city / TOWN, ST_12345 VOLUNTARY CONVEYANCE =| antttwinsetwmnine: acount rma eee stators) OF UssueD SHETRUMENT “hatin nt oon Fam 1089-0, (keep for your records) * BORROWER'S T,I.N. CAN BE FOUND BY A RECORDS YOU MAY LEAVE ** THE AMOUNT SHOULD PAID TO THE (EITHER AAV, (TAXPAYER COMPANY PROMISSORY NOTE, ONS ao FOMDICRSA IDENTIFICATION NUMBER) REQUEST USING A 4506-A IT BLANK. BE THE TOTAL AMOUNT WITH YOUR INSTRUMENT OR BILL OF EXCHANGE MUST BE FILLED OUT ON CARBON COPY ORDERED FROM THE I.R.S. (FREE TO ORDER) PRINTED or IN COLOR (RED INK) ‘Deport oft Treasury eral Revenue Savion FORM, ys