Payment Card and
Third Party
Network
Transactions
X
X
Department of the Treasury - Internal Revenue Service CORRECTED (if checked)
FILER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.
Uber Technologies, Inc.
1515 3rd Street
San Francisco, CA 94158
FILER'S federal identification no.
452647441
OMB No. 1545-2205
2022
Form 1099-K
PAYEE'S taxpayer identification no.
XXXXXXX78
1a Gross amount of payment
card/third party network
transactions
$38,986.42
1b Card not present transactions 2 Merchant category code 0000
Copy B
Check to indicate if FILER is a (an): Check to indicate transactions For Payee reported are:
Payment settlement entity (PSE) Payment card
3 Number of payment transactions
2871
4 Federal income tax
withheld
$0.00
Electronic Payment Facilitator
(EPF)/Other third party Third party network
PAYEE'S name
GARRY DORSAINVIL
Street address (including apt. no.)
3 TOLAND AVE
City or town, state or province, country, and ZIP or foreign postal code WATERLOO, IA 50707
5a January
$3,587.21
5b February
$2,101.06
This is important tax
information and is
being furnished to
the Internal Revenue
Service. If you are
required to file a
return, a negligence
penalty or other
sanction may be
imposed on you if
taxable income
results from this
transaction and the
IRS determines that it
has not been
reported.
5c March
$2,296.93
5d April
$1,272.24
5e May
$2,404.66
5f June
$4,103.85
5g July
$4,933.15
5h August
$5,930.66
5i September
$3,242.71
5j October
$4,710.44
PSE'S name and telephone number 5k November
$2,527.18
5l December
$1,876.33
Account number (see instructions) 6 State 7 State identification no. 8 State income withheld 5174ADAA4D28BCAB3DB9 IA
Form 1099-K (keep for your records) www.irs.gov/form1099K Instructions for Payee
You have received this form because you have either: (a) accepted payment cards for payments, or (b) received payments through a third party network that exceeded $20,000 in gross total reportable transactions and the aggregate number of those transactions exceeded 200 for the calendar year. Merchant acquirers and third party settlement organizations, as payment settlement entities
(PSE), must report the proceeds of payment card and third party network transactions made to you on Form 1099-K under Internal Revenue Code section 6050W. The PSE may have contracted with an electronic payment facilitator (EPF) or other third party payer to make payments to you.
If you have questions about the amounts reported on this form, contact the FILER whose information is shown in the upper left corner on the front of this form. If you do not recognize the FILER shown in the upper left corner of the form, contact the PSE whose name and phone number are shown in the lower left corner of the form above your account number.
See the separate instructions for your income tax return for using the information reported on this form.
If the Form 1099-K is related to your business, see Pub. 334 for more information. If the Form 1099-K is related to your work as part of the gig economy, see www.IRS.gov/GigEconomy.
Payee's identification number (TIN). For your protection, this form may show only the last four digits of your TIN (social security number (SSN), individual taxpayer identification number (ITIN), adoption taxpayer identification number (ATIN), or employer identification number (EIN)). However, the issuer has reported your complete TIN to the IRS.
Account number. May show an account number or other unique number the PSE assigned to distinguish your account. Box 1a. Shows the aggregate gross amount of payment card/third party network transactions made to you through the PSE during the calendar year.
Box 1b. Shows the aggregate gross amount of all reportable payment transactions made to you through the PSE during the calendar year where the card was not present at the time of the transaction or the card number was keyed into the terminal. Typically, this relates to online sales, phone sales, or catalogue sales. If the box for third party network is checked, or if these are third party network transactions, card not present transactions will not be reported.
Box 2. Shows the merchant category code used for payment card/third party network transactions (if available) reported on this form.
Box 3. Shows the number of payment transactions (not including refund transactions) processed through the payment card/third party network.
Box 4. Shows backup withholding. Generally, a payer must backup withhold if you did not furnish your taxpayer identification number
(TIN) or you did not furnish the correct TIN to the payer. See Form W-9, Request for Taxpayer Identification Number and Certification, and Publication 505, Tax Withholding and Estimated Tax, for information on backup withholding. Include this amount on your income tax return as tax withheld.
Box 5a-5l. Shows the gross amount of payment card/third party network transactions made to you for each month of the calendar year.
Box 6-8. Shows state and local income tax withheld from the payments.
Future developments. For the latest information about developments related to Form 1099-K and its instructions, such as legislation enacted after they were published, go to www.irs.gov/form1099k.
FreeFile. Go to www.irs.gov/FreeFile to see if you qualify for no- cost online federal tax preparation, e-filing, and direct deposit or payment options.