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1099-C Form
1099-C
Step
1
of
2
50%
Email
*
Tax Year
2022
2021
2020
Creditor's Information
Creditor's name, street address, city or town, state or province, country, ZIP, Phone number
Creditor's TIN
Debtor's Information
Debtor's Name
Debtor's TIN
Debtor's Address
Address (Number and Street)
City or town, state or province, country, and ZIP or foreign postal code
Cancellation of Debt
Account Number
1. Date of identifiable event
MM slash DD slash YYYY
2. Amount of Debt Discharged
3. Interest if Included in Box 2
4. Debt Description
5. Check Here if the Debtor Was Personally Liable for Repayment of the Debt
6. Identifiable Event Code
7. Fair Market Value (FMV) of Property
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1099-C Form
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Payment Method
PayPal Checkout
American Express
Discover
MasterCard
Visa
Supported Credit Cards: American Express, Discover, MasterCard, Visa
Card Number
Expiration Date
Security Code
Cardholder Name
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