UBS FINANCIAL SERVICES INC.

5200 No. Palm, Suite 101 2022 Consolidated Form 1099

Fig Garden Financial Center
Fresno CA 93704-2225

Account Number: H8 00024

Your Financial Advisor:

BRENT FOLLAND
JOSHUA SOFFER
Phone: 559-226-2800/800-423-8797 5701 N SHERIDAN RD, APT. 29R
CHICAGO IL 60660-4720
Reporting for:
JOSHUA SOFFER

Our 1099 Guide at www.ubs.com/1099information provides access to supplemental tax information you may find useful when filing your income tax return.
This page intentionally left blank.
 Page 1 of 10

Tax Information Statement Date: 02/12/2023

UBS FINANCIAL SERVICES INC.
1000 HARBOR BLVD.
Account H8 00024 Document ID: T343 CGP 1767 2022
WEEHAWKEN, NJ 07086 JOSHUA SOFFER Your Financial Advisor:
5701 N SHERIDAN RD, APT. 29R BRENT FOLLAND
CHICAGO, IL 60660-4720 559-226-2800

Office Code: H8
Rep Code: H805

PAYER'S TIN: 13-2638166 RECIPIENT'S TIN: XXX-XX-4655

11 - [ ] FATCA filing requirement (see instructions) Summary Information 13 - [ ] FATCA filing requirement (see instructions)

DIVIDENDS AND DISTRIBUTIONS 2022 1099-DIV* OMB No. 1545-0110 MISCELLANEOUS INFORMATION 2022 1099-MISC* OMB No. 1545-0115
1a- Total ordinary dividends (includes lines 1b, 5, 2e) 1,207.83 2- Royalties 0.00
1b- Qualified dividends 495.53 3- Other income 0.00
2a- Total capital gain distributions (includes lines 2b, 2c, 2d, 2f) 10.14 4- Federal income tax withheld 0.00
2b- Unrecaptured Section 1250 gain 0.00 8- Substitute payments in lieu of dividends or interest 0.00
2c- Section 1202 gain 0.00
2d- Collectibles (28%) gain 0.00 SECTION 1256 CONTRACTS 2022 1099-B* OMB No. 1545-0715
2e- Section 897 ordinary dividends 0.00
2f- Section 897 capital gain 0.00 8- Profit or (loss) realized in 2022 on closed contracts 0.00
3- Nondividend distributions 0.00 9- Unrealized profit or (loss) on open contracts-12/31/2021 0.00
4- Federal income tax withheld 0.00 10- Unrealized profit or (loss) on open contracts-12/31/2022 0.00
5- Section 199A dividends 0.00 11- Aggregate profit or (loss) on contracts 0.00
6- Investment expenses 0.00
If applicable, proceeds from sale transactions appear summarized below and are
8- Foreign country or US possession: See detail 7- Foreign tax paid: 13.42
detailed in subsequent sections of this document.
9- Cash liquidation distributions 0.00
10- Noncash liquidation distributions 0.00 * This is important tax information and is being furnished to the Internal Revenue Service.
12- Exempt-interest dividends (includes line 13) 0.00 If you are required to file a return, a negligence penalty or other sanction may be imposed on
13- Specified private activity bond interest dividends (AMT) 0.00 you if this income is taxable and the IRS determines that it has not been reported.

SUMMARY OF PROCEEDS, GAINS & LOSSES, ADJUSTMENTS AND WITHHOLDING

Refer to the 1099-B and Proceeds not reported to the IRS pages to ensure that you consider all relevant items and to determine the correct gains and losses. The amounts shown below are for informational purposes.
Term Form 8949 type Proceeds Cost basis Market discount Wash sale loss disallowed Net gain or loss(-)

Short A (basis reported to the IRS) 0.00 0.00 0.00 0.00 0.00
Short B (basis not reported to the IRS) 0.00 0.00 0.00 0.00 0.00
Short C (Form 1099-B not received) 0.00 0.00 0.00 0.00 0.00
Total Short-term 0.00 0.00 0.00 0.00 0.00
Long D (basis reported to the IRS) 0.00 0.00 0.00 0.00 0.00
Long E (basis not reported to the IRS) 0.00 0.00 0.00 0.00 0.00
Long F (Form 1099-B not received) 0.00 0.00 0.00 0.00 0.00
Total Long-term 0.00 0.00 0.00 0.00 0.00
Undetermined B or E (basis not reported to the IRS) 0.00 0.00 0.00 0.00 0.00
Undetermined C or F (Form 1099-B not received) 0.00 0.00 0.00 0.00 0.00
Total Undetermined-term 0.00 0.00 0.00 0.00 0.00

Grand total 0.00 0.00 0.00 0.00 0.00

Withholding Amount
Federal income tax withheld 0.00

Changes to dividend tax classifications processed after your original tax form is issued for 2022 may require an amended tax form.
 Page 2 of 10

UBS FINANCIAL SERVICES INC. Account H8 00024

Summary Information
2022 (continued) 02/12/2023

INTEREST INCOME 2022 1099-INT OMB No. 1545-0112 ORIGINAL ISSUE DISCOUNT AND ADJUSTMENTS
This is important tax information and is being furnished to the Internal Revenue Service. Use bond-by-bond details from the Form 1099-OID page(s) to determine amounts of
If you are required to file a return, a negligence penalty or other sanction may be Original Issue Discount income for your income tax return(s). The amounts shown in this
imposed on you if this income is taxable and the IRS determines that it has not been section are for your reference when preparing your income tax return(s).
reported. Original issue discount for the year 0.00
1- Interest income (not included in line 3) 4.85 Acquisition premium (covered lots) 0.00
2- Early withdrawal penalty 0.00 Acquisition premium (noncovered lots) 0.00
3- Interest on US Savings Bonds & Treasury obligations 0.00 Original issue discount on Treasury obligations 0.00
4- Federal income tax withheld 0.00 Acquisition premium, Treasury obligations (covered lots) 0.00
5- Investment expenses 0.00 Acquisition premium, Treasury obligations (noncovered lots) 0.00
7- Foreign country or US possession: 6- Foreign tax paid: 0.00 Tax-exempt OID 0.00
8- Tax-exempt interest (includes line 9) 0.00 Tax-exempt OID (lots not reported) 0.00
9- Specified private activity bond interest (AMT) 0.00 Acquisition premium (covered) 0.00
10- Market discount (covered lots) 0.00 Acquisition premium (lots not reported) 0.00
11- Bond premium (covered lots) 0.00 Tax-exempt OID on private activity bonds 0.00
12- Bond premium on Treasury obligations (covered lots) 0.00 Tax-exempt OID on private activity bonds (lots not reported) 0.00
13- Bond premium on tax-exempt bonds (categorized below) 0.00 Acquisition premium (AMT, covered) 0.00
Tax-exempt obligations (covered lots) 0.00 Acquisition premium (AMT, lots not reported) 0.00
Tax-exempt private activity obligations (AMT, covered lots) 0.00 Market discount (all lots) 0.00
14- Tax-exempt and tax credit bond CUSIP number See detail Early withdrawal penalty 0.00
FATCA filing requirement [ ] Investment expenses 0.00

The following amounts are not reported to the IRS. They are presented here for your reference RECONCILIATIONS, FEES, EXPENSES AND EXPENDITURES
when preparing your tax return(s). The amounts in this section are not reported to the IRS. They are presented here for your
reference when preparing your income tax return(s).
Taxable accrued interest paid 0.00
Taxable accrued Treasury interest paid 0.00 Other Receipts & Reconciliations- Partnership distributions 0.00
Tax-exempt accrued interest paid 0.00 Other Receipts & Reconciliations- Foreign tax paid- partnership 0.00
Tax-exempt accrued interest paid (AMT) 0.00 Other Receipts & Reconciliations- Return of principal 0.00
Taxable accrued nonqualified interest paid 0.00 Other Receipts & Reconciliations- Deferred income payment 0.00
Tax-exempt accrued nonqualified interest paid 0.00 Other Receipts & Reconciliations- Deemed premium 0.00
Tax-exempt accrued nonqualified interest paid (AMT) 0.00 Other Receipts & Reconciliations- Income accrual- UIT 0.00
Nonqualified interest 0.00 Other Receipts & Reconciliations- Basis adjustments 0.00
Tax-exempt nonqualified interest 0.00 Other Receipts & Reconciliations- Foreign tax pd beyond treaty 0.00
Tax-exempt nonqualified interest (AMT) 0.00 Fees & Expenses- Margin interest 0.00
Interest shortfall on contingent payment debt 0.00 Fees & Expenses- Dividends paid on short position 0.00
Bond premium- Non Treasury obligations (noncovered lots) 0.00 Fees & Expenses- Interest paid on short position 0.00
Bond premium- Treasury obligations (noncovered lots) 0.00 Fees & Expenses- Non reportable distribution expense 0.00
Bond premium- Tax-exempt obligations (noncovered lots) 0.00 Fees & Expenses- Other expenses 0.00
Bond premium- Tax-exempt obligations (AMT, noncovered lots) 0.00 Fees & Expenses- Severance tax 0.00
Market discount (noncovered lots) 0.00 Fees & Expenses- Organizational expense 0.00
Fees & Expenses- Miscellaneous fees 175.00
STATE TAX WITHHELD Fees & Expenses- Tax-exempt investment expense 0.00
Use the details of the State Tax Withholding page(s) to determine the appropriate amounts for Foreign Exchange Gains & Losses- Foreign currency gain/loss 0.00
your income tax return(s). The amounts shown in this section are for your reference.
1099-DIV total withheld 0.00
1099-INT total withheld 0.00
1099-OID total withheld 0.00
1099-MISC total withheld 0.00
1099-B total withheld 0.00
 Page 3 of 10

UBS FINANCIAL SERVICES INC. Account H8 00024

Detail for Dividends and Distributions
2022 02/12/2023
This section of your tax information statement contains the payment level detail of your taxable dividends, capital gains distributions, Section 199A dividends, exempt-interest dividends, nondividend
distributions and liquidation distributions. Also shown are the fair market values of any taxable stock dividends or noncash liquidation distributions.

Federal, state and foreign tax withheld and investment expenses are presented as negative amounts but do not net against the reportable income totals. All amounts are grouped by security, with the
transactions listed in chronological order. Subtotals for each security are provided. For situations in which the tax character of a distribution (or part thereof) is different than at the time it was paid,
endnotes are provided for further explanation.

Note that a payment characterized as a “Qualified dividend” is only issuer-qualified. There is also a holder level criteria for a dividend to be treated as Qualified. If the payment is from a common stock
you are required to have held it for more than 60 days during the 121-day period that begins 60 days before the ex-dividend date of the dividend. If the dividend is from preferred shares and covers a
period greater than 366 days, you must have held the preferred stock for more than 90 days during the 181-day period that begins 90 days before the ex-dividend date of the dividend.

Amounts presented in Box 2e as Section 897 Ordinary Dividends or Box 2f as Section 897 Capital Gains apply only to foreign persons and entities whose income maintains its character when passed
through or distributed to its direct or indirect foreign owners or beneficiaries. If you are a US citizen, you should disregard this.

Security description CUSIP and/or symbol State Date Amount Transaction type Notes Ex-Date
ISHARES CORE S&P 500 ETF 464287200 IVV 03/30/22 85.91 Qualified dividend 03 03/24/2022
06/15/22 74.40 Qualified dividend 03 06/09/2022
09/30/22 110.54 Qualified dividend 03 09/26/2022
12/19/22 99.97 Qualified dividend 03 12/13/2022
370.82 Total Dividends & distributions

VANGUARD TOTAL BOND MARKET ETF 921937835 BND 02/04/22 23.35 Nonqualified dividend 02/01/2022
03/04/22 22.08 Nonqualified dividend 03/01/2022
04/06/22 23.72 Nonqualified dividend 04/01/2022
04/06/22 10.14 Long-term capital gain 04/01/2022
05/05/22 24.08 Nonqualified dividend 05/02/2022
06/06/22 25.32 Nonqualified dividend 06/01/2022
07/07/22 25.43 Nonqualified dividend 07/01/2022
08/04/22 26.21 Nonqualified dividend 08/01/2022
09/07/22 26.76 Nonqualified dividend 09/01/2022
10/06/22 26.70 Nonqualified dividend 10/03/2022
11/04/22 27.85 Nonqualified dividend 11/01/2022
12/06/22 28.15 Nonqualified dividend 12/01/2022
12/29/22 29.47 Nonqualified dividend 12/23/2022
319.26 Total Dividends & distributions

VANGUARD FTSE ALL WORLD EX-US ETF 922042775 VEU 03/24/22 8.46 Qualified dividend 03 03/21/2022
03/24/22 2.63 Nonqualified dividend 03 03/21/2022
03/24/22 -0.91 Foreign tax withheld-Various 03 03/21/2022
06/24/22 46.09 Qualified dividend 03 06/21/2022
06/24/22 14.36 Nonqualified dividend 03 06/21/2022
06/24/22 -4.96 Foreign tax withheld-Various 03 06/21/2022
 Page 4 of 10

UBS FINANCIAL SERVICES INC. Account H8 00024

Detail for Dividends and Distributions
2022 (continued) 02/12/2023

Security description CUSIP and/or symbol State Date Amount Transaction type Notes Ex-Date
VANGUARD FTSE ALL WORLD EX-US ETF 09/22/22 20.83 Qualified dividend 03 09/19/2022
(cont'd) 09/22/22 6.49 Nonqualified dividend 03 09/19/2022
09/22/22 -2.24 Foreign tax withheld-Various 03 09/19/2022
12/22/22 49.33 Qualified dividend 03 12/19/2022
12/22/22 15.37 Nonqualified dividend 03 12/19/2022
12/22/22 -5.31 Foreign tax withheld-Various 03 12/19/2022
163.56 Total Dividends & distributions
-13.42 Total Foreign tax withheld

VANGUARD INTERMEDIATE TERM 92206C870 VCIT 02/04/22 27.20 Nonqualified dividend 02/01/2022
CORPORATEBD BOND ETF 03/04/22 24.58 Nonqualified dividend 03/01/2022
04/06/22 28.07 Nonqualified dividend 04/01/2022
05/05/22 28.75 Nonqualified dividend 05/02/2022
06/06/22 29.81 Nonqualified dividend 06/01/2022
07/07/22 29.12 Nonqualified dividend 07/01/2022
08/04/22 30.47 Nonqualified dividend 08/01/2022
09/07/22 32.04 Nonqualified dividend 09/01/2022
10/06/22 32.64 Nonqualified dividend 10/03/2022
11/04/22 32.35 Nonqualified dividend 11/01/2022
12/06/22 33.60 Nonqualified dividend 12/01/2022
12/29/22 35.70 Nonqualified dividend 12/23/2022
364.33 Total Dividends & distributions

1,217.97 Total Dividends & distributions

-13.42 Total Foreign tax withheld
 Page 5 of 10

UBS FINANCIAL SERVICES INC. Account H8 00024

Detail for Interest Income
2022 02/12/2023
This section of your tax information statement contains the payment level detail of taxable interest and associated bond premium. Market discount will be shown here only if you have elected to
recognize it currently rather than at the time of sale or maturity. Bond premium and market discount for covered tax lots are totaled on Form 1099-INT and reported to the IRS. For noncovered tax lots,
they are totaled and presented beneath the 1099-INT for informational purposes and are not reported to the IRS.

To provide a complete picture of activity for each investment, we also include here nonreportable transactions such as accrued interest paid on purchases and payment or receipt of nonqualified
interest. Other amounts, such as federal, state and foreign tax withheld and investment expenses are shown as negative amounts but do not net against the reportable income totals.

Security description CUSIP and/or symbol Date Amount Transaction type Notes
UBS INSURED SWEEP PROGRAM 90499A981 01/06/22 0.02 Interest
02/04/22 0.02 Interest
03/04/22 0.01 Interest
04/06/22 0.02 Interest
05/05/22 0.10 Interest
06/06/22 0.19 Interest
07/07/22 0.19 Interest
08/04/22 0.35 Interest
09/07/22 1.08 Interest
10/06/22 0.92 Interest
11/04/22 0.99 Interest
12/06/22 0.96 Interest
4.85 Total Interest

4.85 Total Interest

 Page 6 of 10

UBS FINANCIAL SERVICES INC. Account H8 00024

Fees and Expenses
2022 02/12/2023
This section of your tax information statement may contain the detail of fees, investment expenses, and interest that are not reported with the associated items of income in other sections of the
statement. You may wish to consult with your tax advisor, the IRS or your state tax authority regarding the proper treatment.

These amounts are provided here to facilitate an accounting of all amounts received during the year and are totaled in the Reconciliations, Fees, Expenses and Expenditures found in the Summary
Information at the beginning of the statement.

Description CUSIP and/or symbol Date Amount Transaction type Notes

ANNUAL FEE-H8 00024 12/06/22 -175.00 Management fee

-175.00 Total Management fee

 Page 7 of 10

UBS FINANCIAL SERVICES INC. Account H8 00024

Mutual Fund and UIT Supplemental Information
2022 02/12/2023
The following information may be useful in the preparation of your federal and state income tax return(s). This information represents what was available at the time your tax statement was prepared. It
may not be all inclusive and is subject to change. Please contact your mutual fund or UIT directly if you need to verify or supplement this information. Note that depending on your state of residence not
all Federal Source income is exempt from state taxation. You may wish to consult with your tax advisor, the IRS or your state tax authority regarding the proper treatment.

VANGUARD TOTAL BOND MARKET ETF / 921937835 / BND

PERCENTAGE OF INCOME FROM US GOVERNMENT SECURITIES
Fed Source Total 34.75% (A detailed breakdown is shown below when available)
Agency % Agency % Agency %
U.S. Treasury 34.32 Fed Farm Credit 0.08 TN Valley Auth 0.13
Fed Home Loan 0.22 Student Loan 0.00 Other Dir. Fed 0.00

VANGUARD FTSE ALL WORLD EX-US ETF / 922042775 / VEU

FOREIGN SOURCE INCOME PERCENTAGES
Fgn Source Inc Tot 100.00% Fgn Source Inc Qual 76.24% Fgn Source Inc Adj 0.00%
PERCENTAGE OF INCOME FROM US GOVERNMENT SECURITIES
Fed Source Total 0.04% (A detailed breakdown is shown below when available)
Agency % Agency % Agency %
U.S. Treasury 0.03 Fed Farm Credit 0.00 TN Valley Auth 0.00
Fed Home Loan 0.01 Student Loan 0.00 Other Dir. Fed 0.00

VANGUARD INTERMEDIATE TERM CORPORATEBD BOND ETF / 92206C870 / VCIT

PERCENTAGE OF INCOME FROM US GOVERNMENT SECURITIES
Fed Source Total 0.39% (A detailed breakdown is shown below when available)
Agency % Agency % Agency %
U.S. Treasury 0.38 Fed Farm Credit 0.00 TN Valley Auth 0.00
Fed Home Loan 0.01 Student Loan 0.00 Other Dir. Fed 0.00
 Page 8 of 10

UBS FINANCIAL SERVICES INC. Account H8 00024

Foreign Income and Taxes Summary
2022 02/12/2023

This schedule lists all income and foreign tax by country. Mutual Funds and Unit Investment Trusts (UITs) structured as Regulated Investment Companies (RICs) are listed separately with a country
designation of “RIC.”
Dividends
Country Security Description CUSIP Nonqualified Qualified Interest Total Income Tax

VANGUARD FTSE ALL WORLD EX-US 922042775 38.85 124.71 0.00 163.56 -13.42
ETF

Total 38.85 124.71 0.00 163.56 -13.42

Grand Total Total Foreign Source Income* 163.56

Qualified Foreign Source Income** 124.71
Foreign Tax -13.42

* Total Foreign Source Income utilizes the "Total" column for RICs which may not always be supplied.
** Qualified Foreign Source Income utilizes the "Qualified" column for RICs which may not always be supplied.
 Page 9 of 10

UBS FINANCIAL SERVICES INC. 2022 End Notes for Account H8 00024

03 The tax character of the distribution has been allocated based on information provided by the security issuer.
 Page 10 of 10
Instructions for Recipient
Common Instructions for Recipient Line 4. See "Backup Withholding" section in the Common Instructions for Recipient constant yield election for market discount under section 1276(b). Report the accrued
Recipient's taxpayer identification number (TIN). For your protection, this form may instructions above. market discount on your income tax return as directed in the Instructions for Forms
show only the last four digits of your TIN (social security number (SSN), individual Line 5. Shows the portion of the amount on line 1a that may be eligible for the 20% 1040 and 1040-SR. Market discount on a tax-exempt security is includible in taxable
taxpayer identification number (ITIN), adoption taxpayer identification number (ATIN), or qualified business income deduction under section 199A. See the Instructions for Form income as interest income.
employer identification number (EIN)). However, the issuer has reported your complete 8995 and Form 8995-A. Line 11. For a taxable covered security (other than a U.S. Treasury obligation), shows
TIN to the IRS. Line 6. Shows your share of expenses of a nonpublicly offered RIC, generally a the amount of premium amortization allocable to the interest payment(s), unless you
Account number. May show an account or other unique number the payer assigned to nonpublicly offered mutual fund. This amount is included on line 1a. notified the payer in writing in accordance with Regulations section 1.6045-1(n)(5) that
distinguish your account. Line 7. Shows the foreign tax that you may be able to claim as a deduction or a credit you did not want to amortize bond premium under section 171. If an amount is reported
Backup Withholding. Shows backup withholding. Generally, a payer must backup on Form 1040 or 1040-SR. See the Instructions for Forms 1040 and 1040-SR. on this line, see the Instructions for Schedule B (Form 1040) to determine the net
withhold if you did not furnish your TIN or you did not furnish the correct TIN to the Line 8. This line should be left blank if a RIC reported the foreign tax shown on line 7. amount of interest includible in income on Form 1040 or 1040-SR with respect to the
payer. See Form W-9 and Pub. 505 for more information. Include this amount on your Lines 9 and 10. Shows cash and noncash liquidation distributions. security. If an amount is not reported on this line for a taxable covered security acquired
income tax return as tax withheld. Line 11. Shows exempt-interest dividends from a mutual fund or other RIC paid to you at a premium and the payer is reporting premium amortization, the payer has reported a
Nominees. If this 1099 form includes amounts belonging to another person, you are during the calendar year. See the Instructions for Form 1040 and 1040-SR for where to net amount of interest on line 1. If the amount on line 11 is greater than the amount of
considered a nominee recipient. You must file as the “payer” the respective Form 1099 report. This amount may be subject to backup withholding. See Line 4 above. interest paid on the covered security, see Regulations section 1.171-2(a)(4).
(DIV, INT, or OID) Copy A (with a Form 1096) to the IRS for each of the other owners Line 12. Shows exempt-interest dividends subject to the alternative minimum tax. This Line 12. For a U.S. Treasury obligation that is a covered security, shows the amount of
as recipient(s) to show their allocable share of the income and you must furnish the amount is included on line 11. See the Instructions for Form 6251. premium amortization allocable to the interest payment(s), unless you notified the payer
respective Copy B Form(s) and amounts to each owner. A spouse is not required to file Lines 13-15. State income tax withheld reporting lines. in writing in accordance with Regulations section 1.6045-1(n)(5) that you did not want to
a nominee return to show amounts owned by the other spouse. See the 2022 General amortize bond premium under section 171. If an amount is reported on this line, see the
Instructions for Certain Information Returns Instructions for Schedule B (Form 1040) to determine the net amount of interest
Disclosure regarding corrected IRS Consolidated Forms 1099. UBS will send you includible in income on Form 1040 or 1040-SR with respect to the U.S. Treasury
corrected Forms 1099 only: a) if revisions to amounts indicated herein exceed a total obligation. If an amount is not reported on this line for a U.S. Treasury obligation that is
value of $100.00 or the tax withheld is $25 or more or b) upon your request with respect 1099-INT Instructions for Recipient a covered security acquired at a premium and the payer is reporting premium
to your personal information (for example, to correct your name and or tax identification The information provided may be different for covered and noncovered securities. For a amortization, the payer has reported a net amount of interest on line 3. If the amount on
number). Alternatively, if you wish to have UBS automatically send you corrected Forms description of covered securities, see the Instructions for Form 8949. For a taxable line 12 is greater than the amount of interest paid on the U.S. Treasury obligation, see
for revised amounts of less than $100 or $25 or less with respect to any amount of tax covered security acquired at a premium, unless you notified the payer in writing in Regulations section 1.171-2(a)(4).
withheld, then please send your written election to your Financial Advisor at the UBS accordance with Regulations section 1.6045-1(n)(5) that you did not want to amortize Line 13. For a tax-exempt covered security, shows the amount of premium amortization
address listed on the cover page of this Form. the premium under section 171, or for a tax-exempt covered security acquired at a allocable to the interest payment(s). If an amount is reported on this line, see Pub. 550
FATCA filing requirement. If the FATCA filing requirement box is checked, the payer premium, your payer generally must report either (1) a net amount of interest that to determine the net amount of tax-exempt interest reportable on Form 1040 or
is reporting on Form 1099 to satisfy its account reporting requirement under chapter 4 of reflects the offset of the amount of interest paid to you by the amount of premium 1040-SR. If an amount is not reported on this line for a tax-exempt covered security
the Internal Revenue Code. You also may have a filing requirement. See the amortization allocable to the payment(s), or (2) a gross amount for both the interest paid acquired at a premium, the payer has reported a net amount of interest on line 8 or 9,
Instructions for Form 8938. to you and the premium amortization allocable to the payment(s). If you did notify your whichever is applicable. If the amount on line 13 is greater than the amount of interest
payer that you did not want to amortize the premium on a taxable covered security, then paid on the tax-exempt covered security, the excess is a nondeductible loss. See
Keep tax documents for your records. your payer will only report the gross amount of interest paid to you. For a noncovered Regulations section 1.171-2(a)(4)(ii).
security acquired at a premium, your payer is only required to report the gross amount Line 14. Shows CUSIP number(s) for tax-exempt bond(s) on which tax-exempt interest
of interest paid to you. was paid, or tax credit bond(s) on which taxable interest was paid or tax credit was
1099-DIV Instructions for Recipient Line 1. Shows taxable interest paid to you during the calendar year by the payer. This allowed, to you during the calendar year. If blank, no CUSIP number was issued for the
Line 1a. Shows total ordinary dividends that are taxable. Include this amount on the does not include interest shown on line 3. May also show the total amount of the credits bond(s).
“Ordinary dividends” line of Form 1040 or 1040-SR. Also, report it on Schedule B (Form from clean renewable energy bonds, new clean renewable energy bonds, qualified Line 15-17. State tax withheld reporting lines.
1040), if required. energy conservation bonds, qualified zone academy bonds, qualified school
Line 1b. Shows the portion of the amount on line 1a that may be eligible for reduced construction bonds, and build America bonds that must be included in your interest
capital gains rates. See the Instructions for Forms 1040 and 1040-SR for how to income. These amounts were treated as paid to you during 20221 on the credit
determine this amount and where to report. allowance dates (March 15, June 15, September 15, and December 15). For more
information, see Form 8912. See the instructions above for a taxable covered security
The amount shown may be dividends a corporation paid directly to you as a participant acquired at a premium.
(or beneficiary of a participant) in an employee stock ownership plan (ESOP). Report it Line 2. Shows interest or principal forfeited because of early withdrawal of time savings.
as a dividend on your Form 1040 or 1040-SR but treat it as a plan distribution, not as You may deduct this amount to figure your adjusted gross income on your income tax
investment income, for any other purpose. return. See the Instructions for Form 1040 and 1040-SR to see where to take the
Line 2a. Shows total capital gain distributions from a regulated investment company deduction.
(RIC) or real estate investment trust (REIT). See How To Report in the Instructions for Line 3. Shows interest on U.S. Savings Bonds, Treasury bills, Treasury bonds, and
Schedule D (Form 1040). But, if no amount is shown on lines 2b, 2c, 2d and 2f and your Treasury notes. This may or may not all be taxable. See Pub. 550. This interest is
only capital gains and losses are capital gain distributions, you may be able to report the exempt from state and local income taxes. This interest is not included on line 1. See
amounts shown on line 2a on your Form 1040 or 1040-SR rather than Schedule D. See the instructions above for a taxable covered security acquired at a premium.
the Instructions for Forms 1040 and 1040-SR. Line 4. See "Backup Withholding" section in the Common Instructions for Recipient
Line 2b. Shows the portion of the amount on line 2a that is unrecaptured section 1250 instructions above.
gain from certain depreciable real property. See the Unrecaptured Section 1250 Gain Line 5. Any amount shown is your share of investment expenses of a single-class
Worksheet in the Instructions for Schedule D (Form 1040). REMIC. This amount is included on line 1. Note: This amount is not deductible.
Line 2c. Shows the portion of the amount on line 2a that is section 1202 gain from Line 6. Shows foreign tax paid. You may be able to claim this tax as a deduction or a
certain small business stock that may be subject to an exclusion. See the Schedule D credit on your Form 1040 or 1040-SR. See your tax return instructions.
(Form 1040) instructions. Line 7. Shows the country or U.S. possession to which the foreign tax was paid.
Line 2d. Shows the portion of the amount in box 2a that is 28% rate gain from sales or Line 8. Shows tax-exempt interest paid to you during the calendar year by the payer.
exchanges of collectibles. If required, use this amount when completing the 28% Rate See how to report this amount in the Instructions for Form 1040 and 1040-SR. This
Gain Worksheet in the Instructions for Schedule D (Form 1040). amount may be subject to backup withholding. See line 4 above. See the instructions
Line 2e. Shows the portion of the amount in box 1a that is section 897 gain attributable above for a tax-exempt covered security acquired at a premium.
to disposition of U.S. real property interests (USRPI). Line 9. Shows tax-exempt interest subject to the alternative minimum tax. This amount
Line 2f. Shows the portion of the amount in box 2a that is section 897 gain attributable is included on line 8. See the Instructions for Form 6251. See the instructions above for
to disposition of USRPI. a tax-exempt covered security acquired at a premium.
Note: Boxes 2e and 2f apply only to foreign persons and entities whose income Line 10. For a taxable or tax-exempt covered security, if you made an election under
maintains its character when passed through or distributed to its direct or indirect section 1278(b) to include market discount in income as it accrues and you notified your
foreign owners or beneficiaries. It is generally treated as effectively connected to a trade payer of the election in writing in accordance with Regulations section 1.6045-1(n)(5),
or business within the United States. See the instructions for your tax return. shows the market discount that accrued on the debt instrument during the year while
Line 3. Shows a return of capital. To the extent of your cost (or other basis) in the held by you, unless it was reported on Form 1099-OID. For a taxable or tax-exempt
stock, the distribution reduces your basis and is not taxable. Any amount received in covered security acquired on or after January 1, 2015, accrued market discount will be
excess of your basis is taxable to you as capital gain. See Pub. 550. calculated on a constant yield basis unless you notified your payer in writing in
accordance with Regulations section 1.6045-1(n)(5) that you did not want to make a