Attention:

Copy A of this form is provided for informational purposes only. Copy A appears in red, similar to the official IR
version of Copy A of this IRS form is scannable, but the online version of it, printed from this website, is not. Do
downloaded from this website; a penalty may be imposed for filing with the IRS information return forms that ca
in the current General Instructions for Certain Information Returns, available at www.irs.gov/form1099, for more
penalties.
Please note that Copy B and other copies of this form, which appear in black, may be downloaded and printed
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See IRS Publications 1141, 1167, and 1179 for more information about printing these tax forms.

8080
VOID CORRECTED
OMB No. 1545-0877
and telephone no.
Form 1099-A
(Rev. January 2022)
For calendar year
20
1 2 Balance of principal outstanding
knowledge of abandonment $

3 4 Fair market value of property

$
Street address (including apt. no.) 5 Check if the borrower was personally liable for repayment of the debt

City or town, state or province, country, and ZIP or foreign postal code 6 Description of property

Account number (see instructions)

Form 1099-A (Rev. 1-2022) Cat. No. 14412G www.irs.gov/Form1099A Department of the Treasury - Internal Revenu
 CORRECTED (if checked)
OMB No. 1545-0877
and telephone no.
Form 1099-A
(Rev. January 2022)
For calendar year
20
1 2 Balance of principal outstanding
knowledge of abandonment $

3 4 Fair market value of property

$
Street address (including apt. no.) 5 If checked, the borrower was personally liable for repayment of the debt

City or town, state or province, country, and ZIP or foreign postal code 6 Description of property

Account number (see instructions)

(keep for your records)

Form 1099-A (Rev. 1-2022) www.irs.gov/Form1099A Department of the Treasury - Internal Revenu
or the date possession and the burdens and benefits of ownership were transferred to
Instructions for Borrower date of a foreclosure or execution sale or the date your right of redemption or objecti
Certain lenders who acquire an interest in property that was security for a loan or who have reason abandonment, the date shown is the date on which the lender first knew or had reaso
to know that such property has been abandoned must provide you with this statement. You may was abandoned or the date of a foreclosure, execution, or similar sale.
have reportable income or loss because of such acquisition or abandonment. Gain or loss from an Box 2. Shows the debt (principal only) owed to the lender on the loan when the intere
acquisition is generally measured by the difference between your adjusted basis in the property acquired by the lender or on the date the lender first knew or had reason to know tha
and the amount of your debt canceled in exchange for the property or, if greater, the sale proceeds. abandoned.
If you abandoned the property, you may have income from the discharge of indebtedness in the Box 3. Reserved for future use.
amount of the unpaid balance of your canceled debt. The tax consequences of abandoning
Box 4. Shows the fair market value of the property. If the amount in box 4 is less than
property depend on whether or not you were personally liable for the debt. Losses on acquisitions
debt is canceled, you may have cancellation of debt income. If the property was your
or abandonments of property held for personal use are not deductible. See Pub. 4681 for
figure any taxable gain or ordinary income.
information about your tax consequences.
Box 5. Shows whether you were personally liable for repayment of the debt when the
Property means any real property (such as a personal residence), any intangible property, and
modified, when it was last modified.
tangible personal property that is held for investment or used in a trade or business.
Box 6.
If you borrowed money on this property with someone else, each of you should receive this
form indicates the amount of any Commodity Credit Corporation loan outstanding w
statement.
commodity.
For your protection, this form may show only
Future developments. For the latest information about developments related to For
the last four digits of your TIN (social security number (SSN), individual taxpayer identification
such as legislation enacted after they were published, go to www.irs.gov/Form1099A .
number (ITIN), adoption taxpayer identification number (ATIN), or employer identification number
Free File Program. Go to www.irs.gov/FreeFile to see if you qualify for no-cost online
(EIN)). However, the issuer has reported your complete TIN to the IRS.
filing, and direct deposit or payment options.
Account number. May show an account or other unique number the lender assigned to
distinguish your account.
Box 1.
the earlier of the date title was transferred to the lender

VOID CORRECTED
OMB No. 1545-0877
and telephone no.
Form 1099-A
(Rev. January 2022)
For calendar year
20
1 2 Balance of principal outstanding
knowledge of abandonment $

3 4 Fair market value of property

Street address (including apt. no.) $
City or town, state or province, country, and ZIP or foreign postal code

5 Check if the borrower was personally liable for repayment of the debt
Street address (including apt. no.)
City or town, state or province, country, and ZIP or foreign postal code

6 Description of property

Account number (see instructions)

Form 1099-A (Rev. 1-2022) www.irs.gov/Form1099A Department of the Treasury - Internal Revenu

Instructions for Lender

To complete Form 1099-A, use:
Filing and furnishing. For filing and furnishing instructions, inclu
request filing or furnishing extensions, see the current General Ins
To order these instructions and additional forms, go to
Information Returns.
www.irs.gov/EmployerForms .
Need help? If you have questions about reporting on Form 1099-A
Caution: Because paper forms are scanned during processing, you cannot
reporting customer service site toll free at
file certain Forms 1096, 1097, 1098, 1099, 3921, or 5498 that you print from
866-455-7438 or 304-263-8700 (not toll free). Persons with a hearin
the IRS website.
with access to TTY/TDD equipment can call 304-579-4827 (not toll
 d, similar to the official IRS form. The official printed
om this website, is not. Do not print and file copy A
mation return forms that can’t be scanned. See part O
rs.gov/form1099, for more information about

downloaded and printed and used to satisfy the

with the IRS and all other applicable copies of the

we’ll mail you the forms you request and their

eturns Electronically (FIRE) system (visit

m (visit www.IRS.gov/AIR).
tax forms.

Acquisition or
Abandonment of
Secured Property

f principal outstanding Copy A

For Internal Revenue
Service Center
et value of property File with Form 1096.
For Privacy Act and
Paperwork Reduction Act
Notice, see the current
payment of the debt
General Instructions for
Certain Information
Returns.

epartment of the Treasury - Internal Revenue Service

 Acquisition or
Abandonment of
Secured Property

f principal outstanding Copy B

For Borrower
This is important tax
et value of property 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
repayment of the debt
you if taxable income
results from this transaction
and the IRS determines that it
has not been
reported.

epartment of the Treasury - Internal Revenue Service

nd benefits of ownership were transferred to the lender. This may be the
he date your right of redemption or objection expired. For an
on which the lender first knew or had reason to know that the property
re, execution, or similar sale.
ed to the lender on the loan when the interest in the property was
lender first knew or had reason to know that the property was

property. If the amount in box 4 is less than the amount in box 2, and your
on of debt income. If the property was your main home, see Pub. 523 to
e.
ly liable for repayment of the debt when the debt was created or, if

dity Credit Corporation loan outstanding when you forfeited your

rmation about developments related to Form 1099-A and its instructions,

e published, go to www.irs.gov/Form1099A .
eFile to see if you qualify for no-cost online federal tax preparation, e-
ons.

Acquisition or
Abandonment of
Secured Property

f principal outstanding Copy C

For Lender
For Privacy Act and
et value of property Paperwork Reduction Act
Notice, see the current
General Instructions for
payment of the debt Certain Information
Returns.
 Paperwork Reduction Act
Notice, see the current
General Instructions for
Certain Information
Returns.

epartment of the Treasury - Internal Revenue Service

g and furnishing instructions, including due dates, and to

nsions, see the current General Instructions for Certain

ns about reporting on Form 1099-A, call the information

toll free at
not toll free). Persons with a hearing or speech disability
ent can call 304-579-4827 (not toll free).