Form 1099-RThis field is hidden when viewing the formUser Logged In?Create Form 1099-RThis field is hidden when viewing the formForm 1099-RSelect Tax Year*2023How many 1099 forms you need?*12345This field is hidden when viewing the formContact InfoEmail* Already have an account? Login now.Payer's InfoPayer's Name*Payer's Tax ID*Payer's Address* Street Address City Select StateAlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Recipient's InfoRecipient's Name*Recipient's Tax ID*Recipient's Address* Street Address City Select StateAlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Account NumberMay show an account or other unique number the payer assigned to distinguish your account.Gross DistributionTaxable AmountTaxable Amount Not Determined Taxable amount not determined Total Distribution Total distribution Capital Ggain (included in box 2a)Federal Income Tax WithheldEmployee Contributions/ Designated Roth Contributions or Insurance PremiumsNet Unrealized Appreciation In Employer’s SecuritiesDistribution Code(s)IRA/ SEP/ SIMPLE IRA/ SEP/ SIMPLE OtherYour Percentage of Total DistributionTotal Employee ContributionsAmount Allocable to IRR Within 5 Years1st Year of Desig. Roth ContributionsFATCA Filing Requirement FATCA filing requirement Date of Payment MM slash DD slash YYYY State Tax WithheldState DistributionLocal Tax WithheldPlease enter a number greater than or equal to 0.Name of LocalityLocal DistributionPlease enter a number greater than or equal to 0.This field is hidden when viewing the formSection BreakSecond Recipient's InfoSecond Recipient's Name*Second Recipient's Tax ID*Second Recipient's Address* Street Address City Select StateAlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Account NumberMay show an account or other unique number the payer assigned to distinguish your account.Gross DistributionTaxable AmountTaxable Amount Not Determined Taxable amount not determined Total Distribution Total distribution Capital Ggain (included in box 2a)Federal Income Tax WithheldEmployee Contributions/ Designated Roth Contributions or Insurance PremiumsNet Unrealized Appreciation In Employer’s SecuritiesDistribution Code(s)IRA/ SEP/ SIMPLE IRA/ SEP/ SIMPLE OtherYour Percentage of Total DistributionTotal Employee ContributionsAmount Allocable to IRR Within 5 Years1st Year of Desig. Roth ContributionsFATCA Filing Requirement FATCA filing requirement Date of Payment MM slash DD slash YYYY State Tax WithheldState DistributionLocal Tax WithheldPlease enter a number greater than or equal to 0.Name of LocalityLocal DistributionPlease enter a number greater than or equal to 0.This field is hidden when viewing the formSection BreakThird Recipient's InfoThird Recipient's Name*Third Recipient's Tax ID*Third Recipient's Address* Street Address City Select StateAlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Account NumberMay show an account or other unique number the payer assigned to distinguish your account.Gross DistributionTaxable AmountTaxable Amount Not Determined Taxable amount not determined Total Distribution Total distribution Capital Ggain (included in box 2a)Federal Income Tax WithheldEmployee Contributions/ Designated Roth Contributions or Insurance PremiumsNet Unrealized Appreciation In Employer’s SecuritiesDistribution Code(s)IRA/ SEP/ SIMPLE IRA/ SEP/ SIMPLE OtherYour Percentage of Total DistributionTotal Employee ContributionsAmount Allocable to IRR Within 5 Years1st Year of Desig. Roth ContributionsFATCA Filing Requirement FATCA filing requirement Date of Payment MM slash DD slash YYYY State Tax WithheldState DistributionLocal Tax WithheldPlease enter a number greater than or equal to 0.Name of LocalityLocal DistributionPlease enter a number greater than or equal to 0.This field is hidden when viewing the formSection BreakFourth Recipient's InfoFourth Recipient's Name*Fourth Recipient's Tax ID*Fourth Recipient's Address* Street Address City Select StateAlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Account NumberMay show an account or other unique number the payer assigned to distinguish your account.Gross DistributionTaxable AmountTaxable Amount Not Determined Taxable amount not determined Total Distribution Total distribution Capital Ggain (included in box 2a)Federal Income Tax WithheldEmployee Contributions/ Designated Roth Contributions or Insurance PremiumsNet Unrealized Appreciation In Employer’s SecuritiesDistribution Code(s)IRA/ SEP/ SIMPLE IRA/ SEP/ SIMPLE OtherYour Percentage of Total DistributionTotal Employee ContributionsAmount Allocable to IRR Within 5 Years1st Year of Desig. Roth ContributionsFATCA Filing Requirement FATCA filing requirement Date of Payment MM slash DD slash YYYY State Tax WithheldState DistributionLocal Tax WithheldPlease enter a number greater than or equal to 0.Name of LocalityLocal DistributionPlease enter a number greater than or equal to 0.This field is hidden when viewing the formSection BreakFifth Recipient's InfoFifth Recipient's Name*Fifth Recipient's Tax ID*Fifth Recipient's Address* Street Address City Select StateAlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Account NumberMay show an account or other unique number the payer assigned to distinguish your account.Gross DistributionTaxable AmountTaxable Amount Not Determined Taxable amount not determined Total Distribution Total distribution Capital Ggain (included in box 2a)Federal Income Tax WithheldEmployee Contributions/ Designated Roth Contributions or Insurance PremiumsNet Unrealized Appreciation In Employer’s SecuritiesDistribution Code(s)IRA/ SEP/ SIMPLE IRA/ SEP/ SIMPLE OtherYour Percentage of Total DistributionTotal Employee ContributionsAmount Allocable to IRR Within 5 Years1st Year of Desig. Roth ContributionsFATCA Filing Requirement FATCA filing requirement Date of Payment MM slash DD slash YYYY State Tax WithheldState DistributionLocal Tax WithheldPlease enter a number greater than or equal to 0.Name of LocalityLocal DistributionPlease enter a number greater than or equal to 0.This field is hidden when viewing the formPDF PreviewClick refresh icon to see changes to the pdf.PDF Preview Full Screen Rotate your phone sideways for larger preview.PDF Preview Full Screen Rotate your phone sideways for larger preview.PDF Preview Full Screen Rotate your phone sideways for larger preview.PDF Preview Full Screen Rotate your phone sideways for larger preview.PDF Preview Full Screen Rotate your phone sideways for larger preview.Select 1099 to previewFirst RecipientSecond RecipientThird RecipientFourth RecipientFifth RecipientTotal $0.00 100% Money-Back Guarantee Complete satisfaction guarantee or your money back. Select 1099 PDF to previewFirst RecipientSecond RecipientThird RecipientFourth RecipientFifth RecipientPDF Preview Full Screen Rotate your phone sideways for larger preview.PDF Preview Full Screen Rotate your phone sideways for larger preview.PDF Preview Full Screen Rotate your phone sideways for larger preview.PDF Preview Full Screen Rotate your phone sideways for larger preview.PDF Preview Full Screen Rotate your phone sideways for larger preview.This field is hidden when viewing the formShow Modal Checkout Almost there! Complete checkout to receive your PDF without watermarks or restrictions. Click “Previous” if you still have some edits to make.Checkout Now 100% Money-Back Guarantee Complete satisfaction guarantee or your money back.
