1099-oid_form | Document Preview

VOID

CORRECTED

PAYER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.

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1	Original issue discount for the year
$

2	Other periodic interest
$

OMB No. 1545-0117 Form 1099-OID (Rev. January 2024)

For calendar year

2024

Original Issue Discount

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

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11 FATCA filing requirement checkbox

7	Description

8	Original issue discount on U.S. Treasury obligations
$

9	Investment expenses
$

10	Bond premium
$

11	Tax-exempt OID
$

Account number (see instructions)

12	State

13	State identification no

14	State tax withheld
$