draft-watermark
checkbox
, , , ,
1   Date of identifiable event
2   Amount of debt discharged
$
3 Interest, if included in box 2
$

Form 1099-C
(Rev. January 2022)
For calendar year
2024

Cancellation
of Debt



, , , ,
4  Debt description
5  If checked, the debtor was personally liable for repayment of the debt . . checkbox   
6  Identifiable event code
7   Fair market value of property
$

Copy B
For Debtor

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 taxable income results from this transaction and the IRS determines that it has not been reported.

Form 1099-C (Rev. 1-2022) (keep for your records) www.irs.gov/Form1099C Department of the Treasury - Internal Revenue Service