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Lab addistant

Location:
Moulton, Alabama, 35650, United States
Posted:
January 31, 2018

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EXPLANATIONS

THIS IS NOT A BILL

STATE OF ALABAMA

DEPARTMENT OF REVENUE

This shows the refund recipient's identification number or social security number. If a joint return was filed, the first number listed on the return appears in this box. This shows refunds, credits, or offsets to state income tax you received in 2016. If there is an entry or entries in this box, the amount may be taxable to you (for federal purposes) if you deducted the tax paid as an itemized deduction on your federal income tax return. Please refer to your federal income tax booklet for additional instructions about your state refund on your federal income tax return.

Box 3 - This identifies the tax year(s) corresponding to the refund(s) in box 2. BOX 2 -

BOX 1 -

STATEMENT FOR RECIPIENTS OF CERTAIN GOVERNMENT PAYMENTS ALABAMA DEPARTMENT OF REVENUE

50 RIPLEY STREET

MONTGOMERY, AL 36132-7410

63-6000619

1. Recipient's I.D. No. 2. Income tax refund(s) 3. Refund for tax year(s) Recipient's Name, Address and ZIP Code:

Federal law requires this information be furnished to the I.R.S. Form 1099-G See Explanation Above

Dear Taxpayer:

Federal law requires that the Alabama Department of Revenue notify you in January of the amount(s) of refunds, credits or offsets of Alabama income taxes you received during 2016. This information is also being furnished to the U.S. Internal Revenue Service.

The amount(s) shown in box 2 of this form may be reportable on your 2016 U.S. income tax return and taxable to you if you deducted this tax as an itemized deduction on your U.S. return for a previous year.

The amount(s) shown in box 2 are not REPORTABLE on your 2016 Alabama income tax return.

Additional explanations are given in the center of this page. If you have any further questions, consult your tax advisor or the Alabama Department of Revenue.

This is required information only, not a bill.

TRISHA LAUBHAM

PO BOX 325

WOLFLAKE, IN 46796-0325

XXX-XX-7285 $64.00 2015

TRISHA LAUBHAM

PO BOX 325

WOLFLAKE, IN 46796-0325

PRESORTED

FIRST CLASS MAIL

U.S.POSTAGE PAID

MONTGOMERY

ALABAMA

Permit No. 109

ALABAMA DEPARTMENT OF REVENUE

INDIVIDUAL & CORPORATE TAX DIVISION

PO BOX 327410

MONTGOMERY, AL 36132-7410

Provider Code 4409



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