Form 1099-S - Proceeds From Real Estate Transactions

Form 1099-S - Proceeds From Real Estate Transactions - 2016 Page 2

VOID

CORRECTED

7575

FILER'S name, street address, city or town, state or province, country, ZIP

1 Date of closing

OMB No. 1545-0997

or foreign postal code, and telephone number

Proceeds From Real

2016

Estate Transactions

2 Gross proceeds

1099-S

Form

Copy A

FILER'S federal identification number

TRANSFEROR'S identification number

Address or legal description (including city, state, and ZIP code)

For

Internal Revenue

TRANSFEROR'S name

Service Center

File with Form 1096.

For Privacy Act

and Paperwork

Street address (including apt. no.)

Reduction Act

Notice, see the

2016 General

4 Check here if the transferor received or will receive

City or town, state or province, country, and ZIP or foreign postal code

Instructions for

property or services as part of the consideration

▶

Certain

Account or escrow number (see instructions)

5 Buyer's part of real estate tax

Information

Returns.

1099-S

Form

Cat. No. 64292E

Department of the Treasury - Internal Revenue Service

Do Not Cut or Separate Forms on This Page — Do Not Cut or Separate Forms on This Page

Form 1099-S - Proceeds From Real Estate Transactions - 2016 Page 2