Form 1099-C Cancellation of Debt

Caution: DRAFT—NOT FOR FILING
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8585

VOID

CORRECTED

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

1 Date of identifiable event
2 Amount of debt discharged

$
3 Interest if included in box 2

$
CREDITOR'S federal identification number

DEBTOR'S identification number

OMB No. 1545-1424

2015

Cancellation
of Debt

Form 1099-C

4 Debt description

DRAFT AS OF
July 8, 2014
DO NOT FILE

For
Internal Revenue
Service Center

DEBTOR'S name

Street address (including apt. no.)

File with Form 1096.
For Privacy Act and
. ▶
Paperwork Reduction
Act Notice, see the
2015 General
Instructions for
7 Fair market value of property Certain Information
Returns.
$

5 Check here if the debtor was personally liable for
repayment of the debt . . . . . . .

City or town, state or province, country, and ZIP or foreign postal code
Account number (see instructions)

Copy A

6 Identifiable event code

1099-C
Cat. No. 26280W
www.irs.gov/form1099c
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

CORRECTED (if checked)
CREDITOR'S name, street address, city or town, state or province, country,
ZIP or foreign postal code, and telephone no.

1 Date of identifiable event
2 Amount of debt discharged

$
3 Interest if included in box 2

$
CREDITOR'S federal identification number

DEBTOR'S identification number

2015

Cancellation
of Debt

Form 1099-C

DRAFT AS OF
July 8, 2014
DO NOT FILE

DEBTOR'S name

Street address (including apt. no.)

City or town, state or province, country, and ZIP or foreign postal code
Account number (see instructions)
Form

4 Debt description

OMB No. 1545-1424

1099-C

(keep for your records)

Copy B
For Debtor

This is important tax
information and is being
furnished to the Internal
Revenue Service. If you
are required to file a
5 If checked, the debtor was personally liable for
return, a negligence
repayment of the debt . . . . . . . . ▶
penalty or other
sanction may be
imposed on you if
taxable income results
from this transaction
6 Identifiable event code
7 Fair market value of property and the IRS determines
that it has not been
reported.
$
www.irs.gov/form1099c

Department of the Treasury - Internal Revenue Service

Instructions for Debtor
You received this form because a Federal Government agency or an applicable
financial entity (a creditor) has discharged (canceled or forgiven) a debt you
owed, or because an identifiable event has occurred that either is or is deemed
to be a discharge of a debt of $600 or more. If a creditor has discharged a debt
you owed, you are required to include the discharged amount in your income,
even if it is less than $600, on the "Other income" line of your Form 1040.
However, you may not have to include all of the canceled debt in your income.
There are exceptions and exclusions, such as bankruptcy and insolvency. See
Pub. 4681, available at IRS.gov, for more details. If an identifiable event has
occurred but the debt has not actually been discharged, then include any
discharged debt in your income in the year that it is actually discharged, unless
an exception or exclusion applies to you in that year.
Debtor's identification number. For your protection, this form may show only
the last four digits of your social security number (SSN), individual taxpayer
identification number (ITIN), or adoption taxpayer identification number (ATIN).
However, the creditor has reported your complete identification number to the
IRS and, where applicable, to state and/or local governments.
Account number. May show an account or other unique number the creditor
assigned to distinguish your account.
Box 1. Shows the date the earliest identifiable event occurred or, at the
creditor's discretion, the date of an actual discharge that occurred before an
identifiable event. See the code in box 6.
Box 2. Shows the amount of debt either actually or deemed discharged. Note. If
you do not agree with the amount, contact your creditor.
Box 3. Shows interest if included in the debt reported in box 2. See Pub. 4681
to see if you must include the interest in gross income.

Box 4. Shows a description of the debt. If box 7 is completed, box 4 also shows
a description of the property.
Box 5. Shows whether you were personally liable for repayment of the debt
when the debt was created or, if modified, at the time of the last modification.
See Pub. 4681 for reporting instructions.
Box 6. Shows the reason your creditor has filed this form. The codes in this box
are described in more detail in Pub. 4681. A—Bankruptcy; B—Other judicial
debt relief; C—Statute of limitations or expiration of deficiency period; D—
Foreclosure election; E—Debt relief from probate or similar proceeding; F—By
agreement; G—Decision or policy to discontinue collection; H—Expiration of
nonpayment testing period; or I—Other actual discharge before identifiable
event.
Box 7. If, in the same calendar year, a foreclosure or abandonment of property
occurred in connection with the cancellation of the debt, the fair market value
(FMV) of the property will be shown, or you will receive a separate Form 1099-A.
Generally, the gross foreclosure bid price is considered to be the FMV. For an
abandonment or voluntary conveyance in lieu of foreclosure, the FMV is
generally the appraised value of the property. You may have income or loss
because of the acquisition or abandonment. See Pub. 4681 for information
about foreclosures and abandonments. If the property was your main home, see
Pub. 523 to figure any taxable gain or ordinary income.
Future developments. For the latest information about developments related to
Form 1099-C and its instructions, such as legislation enacted after they were
published, go to www.irs.gov/form1099c.

DRAFT AS OF
July 8, 2014
DO NOT FILE

VOID

CORRECTED

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

1 Date of identifiable event
2 Amount of debt discharged

$
3 Interest if included in box 2

OMB No. 1545-1424

2015
Form 1099-C

$
CREDITOR'S federal identification number

DEBTOR'S identification number

Cancellation
of Debt

4 Debt description

DRAFT AS OF
July 8, 2014
DO NOT FILE

Copy C
For Creditor

DEBTOR'S name

Street address (including apt. no.)

City or town, state or province, country, and ZIP or foreign postal code
Account number (see instructions)

For Privacy Act
and Paperwork
Reduction Act
5 Check here if the debtor was personally liable for
Notice, see the
repayment of the debt . . . . . . . . ▶
2015 General
Instructions for
Certain Information
Returns.
6 Identifiable event code
7 Fair market value of property

$

Form

1099-C

www.irs.gov/form1099c

Department of the Treasury - Internal Revenue Service

Instructions for Creditor
To complete Form 1099-C, use:
• the 2015 General Instructions for Certain Information
Returns, and
• the 2015 Instructions for Forms 1099-A and 1099-C.
To order these instructions and additional forms, go
to www.irs.gov/form1099c or call 1-800-TAX-FORM
(1-800-829-3676).
Caution. Because paper forms are scanned during
processing, you cannot file Forms 1096, 1097, 1098,
1099, 3921, 3922, or 5498 that you print from the IRS
website.
Due dates. Furnish Copy B of this form to the debtor by
February 1, 2016.

File Copy A of this form with the IRS by February 29,
2016. If you file electronically, the due date is March 31,
2016. To file electronically, you must have software that
generates a file according to the specifications in Pub.
1220, Specifications for Electronic Filing of Forms 1097,
1098, 1099, 3921, 3922, 5498, and W-2G. The IRS does
not provide a fill-in form option.
Need help? If you have questions about reporting on
Form 1099-C, call the information reporting customer
service site toll free at 1-866-455-7438 or 304-263-8700
(not toll free). Persons with a hearing or speech
disability with access to TTY/TDD equipment can call
304-579-4827 (not toll free).

DRAFT AS OF
July 8, 2014
DO NOT FILE