eff @ 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 net 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.aoviform1099, for more information about penalties. Please note that Copy B and other copies of this form, which appear in black, may be downloaded and printed and used to satisfy the requirement to provide the information to the recipient. To order official IRS information returns, which include a scannable Copy A for filing with the IRS and all other applicable copies of the form, visit www.IRS.gov/orderforms. Click on Employer and Information Returns, and we'll mail you the forms you request and their instructions, as well as any publications you may order. Information retums may also be filed electronically using the IRS Filing Information Retums. Electronically (FIRE) system (visit www.IRS.qov/FIRE) or the IRS Affordable Care Act Information Returns (AIR) program (visit www.IRS.gov/AIR). See IRS Publications 1141, 1167, and 1179 for more information about printing these tax forms8080 (Livoin _[j correcten TENDERS rare, eet sates, eyo Tow sate or rover, county, ZP ef orig postal cade, ra elphone ro. Form 1099-A, Acquisition or Abandonment of Secured Property 20 F osteo ders scquaton of Balsce af pol Copy A Krowndge soundonmert | outaardna ee $ Internal Revenue ‘Service Genter fa Far mavtet value of rape $ File with Form 1096, For Privacy Act Sees sarensQoclang spt Pa) and Paperwork Reduction Act FTI} Notice, see the [Sy ortown sate ov prowice, coun, and ZIP or Torin posal eoae Tirber bee rauctors) current General instructions for ‘Certain Information Returns, Fem 1099-A (Rev. 1.207%) a Na, TG wo rs. gouFomnTOB8A ‘Deparment ofthe Trearury nemalReverue Sere Do Not Cut or Separate Forms on This Page — Do Not Cut or Separate Forms on This Page[J CORRECTED (i checked) orig postal cade, ra elphone no. TENDERS rare, eet same, eyo Tour sale rover, county, ZP ef Form 1099-A, (Rev. daruny2027|| Abandonment of Tercardvyew | Secured Property 20. F Date fenders acquaton a eontedge o!sounaorrert oustanding $ Steet adress Qntudng spt na) cay or town, tate or province, county, snd ZP or fereign postal code fa Far marie value of rope $ ecourtrarber eee namuctansy Copy B For Borrower yt raat i= TRS deters reported Fem 1099-A fev. (Keep for your records) wr sou Forni OHBA Deparment ofthe Treasury ‘eral Revenue SoviesInstructions for Borrower Guanes rc eet ty at rs siauh emresty ne meso on err ke SE ce pee ee eas Sorte bens esr nee nya ey yar pene my Saitthcta eager gcse roe Sed Sr nt ee ee Box Shows he deo incipl ony owed othe lender on the ean when he terest inthe propery was acquired by the lene ooh the date te re et fnew oad reason now athe property was abendonee Box 4 Shows the ar market va ofthe property. the amount in boxe ess than he snountin bon, ana your debt canon, you may have exrceton teat ineome I he propery Was Your man home ee Pub 523 to hg ai) {hable gan or ordnay income Bex. Sans wheter you were psn lable fot ese ofthe det Bex 6 Shows the desertion ol the property acquire by the lender or sandaned by you “CGO shown, te farm indestes the snouts ‘Sommodity Greet Cerperaon ian austangng when you tereted your Future development, Forth lest formation about developments ested Fon 1000-A and frst. such a legato enacted ater he ete publehed, go to worst. govFormtOseA Free Fe Program. Go to wns govFrefil to se you quay er no-cost ‘tne fede tax preperation «ling, and rect depos or payrel optionsFivoin _F] correctep LENDERS pve, ston ste ooo, Hae or oe Tey, ZP Ona Ne EST ewig oval cde an toephee re rom1099-A| _ Acquisition or rev uxy2000| Abandonment of Forcardsryer | Secured Property o F Date of endersacqution or] Balance of prepa Copy & TENDERS TIN BORROWER'S TIN ‘erowledge of abandonment} outstanding For Lender $ For Pivacy Aat snd Paperwork $ Reduction Act street address Qnetudng apt. no) [S Check tthe borower was personaly lable forrepayment | Notice, see the frewng current General ine dob ~ Instructions for Information Returns Fem 1O99-A (Rev. 1-207) “roa gouF om IORBA, ‘Deparment ofthe Tear nemalRevenue SereInstructions for Lender To complete Form 1099-A, use: + The current General Instructions for Certain Information Returns, and + The current Instructions for Forms 1099-A and 1099-C. ‘To order thase instructions and additional forms, go to www irs.gov/EmployerForms. ‘Caution: Because paper forms are scanned during processing, you cannot fle certain Forms 1096, 1097, 1098, 4089, 3971, or $498 that you print from the IRS website. Filing and furnishing. For fling and furnishing instructions, including due dates, and to request fling or furnishing ‘extensions, see the current General Instructions for Certain Information Retums. Need help? If you have questions about reporting on Form 1098-A, call the information reporting customer service site toll free at 866-455-7438 or 304-283-8700 (nat toll free) Persons with a hearing or speech disability with access to TTY/TDD equipment can call 304-573-4827 (not toll free)