Customer Service Postal
Resume:
Form ****-NEC
Cat. No. *****N
Nonemployee
Compensation
Copy A
For Internal Revenue
Service Center
Department of the Treasury - Internal Revenue Service File with Form 1096.
OMB No. 1545-0116
For Privacy Act and
Paperwork Reduction Act
Notice, see the 2021
General Instructions for
Certain Information
Returns.
7171 VOID CORRECTED
PAYER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.
PAYER’S TIN RECIPIENT’S TIN
RECIPIENT’S name
Street address (including apt. no.)
City or town, state or province, country, and ZIP or foreign postal code Account number (see instructions) 2nd TIN not.
1 Nonemployee compensation
$
2 Payer made direct sales totaling $5,000 or more of consumer products to recipient for resale
3
4 Federal income tax withheld
$
5 State tax withheld
$
$
6 State/Payer’s state no. 7 State income
$
$
Form 1099-NEC www.irs.gov/Form1099NEC
Do Not Cut or Separate Forms on This Page — Do Not Cut or Separate Forms on This Page Tend Exchange, Inc.
516 N Sepulveda Blvd
Manhattan Beach CA 90266
84-3326789 ***-**-****
Susan Roman
1103 Buckingham Drive A
Costa Mesa CA 92626
1889.31
0.00
Form 1099-NEC
2021 Nonemployee
Compensation
Copy 1
For State Tax
Department
Department of the Treasury - Internal Revenue Service OMB No. 1545-0116
VOID CORRECTED
PAYER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.
PAYER’S TIN RECIPIENT’S TIN
RECIPIENT’S name
Street address (including apt. no.)
City or town, state or province, country, and ZIP or foreign postal code Account number (see instructions)
1 Nonemployee compensation
$
2 Payer made direct sales totaling $5,000 or more of consumer products to recipient for resale
3
4 Federal income tax withheld
$
5 State tax withheld
$
$
6 State/Payer’s state no. 7 State income
$
$
Form 1099-NEC www.irs.gov/Form1099NEC
Tend Exchange, Inc.
516 N Sepulveda Blvd
Manhattan Beach CA 90266
84-3326789 ***-**-****
Susan Roman
1103 Buckingham Drive A
Costa Mesa CA 92626
1889.31
0.00
Form 1099-NEC
2021 Nonemployee
Compensation
Copy B
For Recipient
Department of the Treasury - Internal Revenue Service This is important tax
information and is being
furnished to the IRS. If you are
required to file a return, a
negligence penalty or other
sanction may be imposed on
you if this income is taxable
and the IRS determines that it
has not been reported.
OMB No. 1545-0116
CORRECTED (if checked)
PAYER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.
PAYER’S TIN RECIPIENT’S TIN
RECIPIENT’S name
Street address (including apt. no.)
City or town, state or province, country, and ZIP or foreign postal code Account number (see instructions)
1 Nonemployee compensation
$
2 Payer made direct sales totaling $5,000 or more of consumer products to recipient for resale
3
4 Federal income tax withheld
$
5 State tax withheld
$
$
6 State/Payer’s state no. 7 State income
$
$
Form 1099-NEC (keep for your records) www.irs.gov/Form1099NEC Tend Exchange, Inc.
516 N Sepulveda Blvd
Manhattan Beach CA 90266
84-3326789 ***-**-****
Susan Roman
1103 Buckingham Drive A
Costa Mesa CA 92626
1889.31
0.00
Instructions for Recipient
You received this form instead of Form W-2 because the payer did not consider you an employee and did not withhold income tax or social security and Medicare tax.
If you believe you are an employee and cannot get the payer to correct this form, report this amount on the line for “Wages, salaries, tips, etc.” of Form 1040, 1040-SR, or 1040-NR. You must also complete Form 8919 and attach it to your return. For more information, see Pub. 1779, Independent Contractor or Employee.
If you are not an employee but the amount in this box is not self- employment (SE) income (for example, it is income from a sporadic activity or a hobby), report this amount on the “Other income” line (on Schedule 1
(Form 1040)).
Recipient’s taxpayer 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 or other unique number the payer assigned to distinguish your account.
Box 1. Shows nonemployee compensation. If the amount in this box is SE income, report it on Schedule C or F (Form 1040) if a sole proprietor, or on Form 1065 and Schedule K-1 (Form 1065) if a partnership, and the recipient/partner completes Schedule SE (Form 1040). Note: If you are receiving payments on which no income, social security, and Medicare taxes are withheld, you should make estimated tax payments. See Form 1040-ES (or Form 1040-ES (NR)). Individuals must report these amounts as explained in these box 1 instructions. Corporations, fiduciaries, and partnerships must report these amounts on the appropriate line of their tax returns.
Box 2. If checked, consumer products totaling $5,000 or more were sold to you for resale, on a buy-sell, a deposit-commission, or other basis. Generally, report any income from your sale of these products on Schedule C (Form 1040).
Box 3. Reserved for future use.
Box 4. Shows backup withholding. A payer must backup withhold on certain payments if you did not give your TIN to the payer. See Form W-9, Request for Taxpayer Identification Number and Certification, for information on backup withholding. Include this amount on your income tax return as tax withheld.
Boxes 5–7. State income tax withheld reporting boxes. Future developments. For the latest information about developments related to Form 1099-NEC and its instructions, such as legislation enacted after they were published, go to www.irs.gov/Form1099NEC. Free File. 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.
Form 1099-NEC
2021 Nonemployee
Compensation
Copy 2
To be filed with
recipient’s state
income tax
return, when
required.
Department of the Treasury - Internal Revenue Service OMB No. 1545-0116
VOID CORRECTED
PAYER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.
PAYER’S TIN RECIPIENT’S TIN
RECIPIENT’S name
Street address (including apt. no.)
City or town, state or province, country, and ZIP or foreign postal code Account number (see instructions)
1 Nonemployee compensation
$
2 Payer made direct sales totaling $5,000 or more of consumer products to recipient for resale
3
4 Federal income tax withheld
$
5 State tax withheld
$
$
6 State/Payer’s state no. 7 State income
$
$
Form 1099-NEC www.irs.gov/Form1099NEC
Tend Exchange, Inc.
516 N Sepulveda Blvd
Manhattan Beach CA 90266
84-3326789 ***-**-****
Susan Roman
1103 Buckingham Drive A
Costa Mesa CA 92626
1889.31
0.00
Form 1099-NEC
2021 Nonemployee
Compensation
Copy C
For Payer
Department of the Treasury - Internal Revenue Service OMB No. 1545-0116
VOID CORRECTED
For Privacy Act and
Paperwork Reduction
Act Notice, see the 2021
General Instructions for
Certain Information
Returns.
PAYER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.
PAYER’S TIN RECIPIENT’S TIN
RECIPIENT’S name
Street address (including apt. no.)
City or town, state or province, country, and ZIP or foreign postal code Account number (see instructions) 2nd TIN not.
1 Nonemployee compensation
$
2 Payer made direct sales totaling $5,000 or more of consumer products to recipient for resale
3
4 Federal income tax withheld
$
5 State tax withheld
$
$
6 State/Payer’s state no. 7 State income
$
$
Form 1099-NEC www.irs.gov/Form1099NEC
Tend Exchange, Inc.
516 N Sepulveda Blvd
Manhattan Beach CA 90266
84-3326789 ***-**-****
Susan Roman
1103 Buckingham Drive A
Costa Mesa CA 92626
1889.31
0.00
Instructions for Payer
To complete Form 1099-NEC, use:
• The 2021 General Instructions for Certain Information Returns, and
• The 2021 Instructions for Forms 1099-MISC and
1099-NEC.
To order these instructions and additional forms, go to www.irs.gov/Form1099NEC.
Caution: Because paper forms are scanned during
processing, you cannot file Forms 1096, 1097, 1098, 1099, 3921, or 5498 that you print from the IRS website. Due dates. Furnish Copy B of this form to the recipient by January 31, 2022. File Copy A of this form with the IRS by January 31, 2022.
To file electronically, you must have software that generates a file according to the specifications in Pub. 1220. The IRS does not provide a fill-in form option for Copy A.
Need help? If you have questions about reporting on Form 1099-NEC, call the information reporting customer service site toll free at 866-***-**** or 304-***-****
(not toll free). Persons with a hearing or speech
disability with access to TTY/TDD equipment can call 304-***-**** (not toll free).
Contact this candidate