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Form 1099 Sa 2010
Employer Returns Online, and we’ll mail you the
scannable forms and other products.
See IRS Publications 1141, 1167, 1179 and other IRS resources for information
about printing these tax forms.
9494
VOID
CORRECTED
TRUSTEE’S/PAYER’S name, street address, city, state, and ZIP code
OMB No. 1545-1517
2010
Form 1099-SA
PAYER’S federal identification number
RECIPIENT’S identification number
1
Gross distribution
$
2 Earnings on excess cont.
$
RECIPIENT’S name
3
Distribution...
Show details
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