This form contains 100 fields organized into 17 sections. Below is a complete list of every field, its type, and what information is expected.

Field Name Type Description
Additional Information
Text
Enter any additional information or amounts related to government payments that do not fit into other specified boxes.
topmostSubform[0].CopyA[0].RightColumn[0].f1_16[0 Text
Enter any other amounts that are not specified in other boxes but are required to be reported.
Text
Enter any other relevant information or amounts that do not fit into other specified boxes.
Text
Provide any additional information or notes related to the form, if applicable.
topmostSubform[0].CopyB[0].RightColumn[0].f2_21[0 Text
Enter any additional information or amounts related to the government payments.
topmostSubform[0].CopyB[0].RightColumn[0].f2_22[0 Text
Enter any additional information or amounts related to the government payments.
Checkbox Options
topmostSubform[0].CopyA[0].RightColumn[0].c1_3[0]_1 CheckBox
Check this box if the amount reported is for a refund, credit, or offset of state or local income taxes.
topmostSubform[0].Copy2[0].RightColumn[0].c2_3[0]_1 CheckBox
Check this box if applicable. This checkbox may relate to a specific condition or requirement on the form.
Financial Details
topmostSubform[0].Copy2[0].RightColumn[0].Box7_ReadOrder[0].f2_15[0 Text
Enter the amount or details related to Box 7. This field is a text input and may require specific financial information.
Form Copy Identification
topmostSubform[0].Copy2[0].CopyHeader[0].c2_1[0]_1 CheckBox
Indicate whether this copy is to be filed with the recipient's state income tax return.
topmostSubform[0].Copy2[0].CopyHeader[0].c2_1[1]_2 CheckBox
Indicate whether this copy is to be filed with the recipient's state income tax return.
Form Details
topmostSubform[0].CopyB[0].CopyHeader[0].CalendarYear[0].f2_1[0 Text
Enter the calendar year for which the government payments are being reported.
Max length: 4 characters
Form Information
For calendar year Text
Enter the calendar year for which the form is being filed. This should be a four-digit year.
Max length: 4 characters
Form Options
topmostSubform[0].Copy1[0].CopyHeader[0].c2_1[0]_1 CheckBox
Check this box if applicable for the specific condition or requirement stated in the form instructions.
topmostSubform[0].Copy1[0].CopyHeader[0].c2_1[1]_2 CheckBox
Check this box if applicable for the specific condition or requirement stated in the form instructions.
topmostSubform[0].CopyB[0].RightColumn[0].c2_3[0]_1 CheckBox
Check this box if the amount reported is for a tax year other than the current year.
General Information
For calendar year Text
Enter the calendar year for which the government payments are being reported.
Max length: 4 characters
topmostSubform[0].CopyA[0].CopyHeader[0].c1_1[0]_1 CheckBox
Check this box if applicable. Refer to the form instructions for specific conditions.
topmostSubform[0].CopyA[0].CopyHeader[0].c1_1[1]_2 CheckBox
Check this box if applicable. Refer to the form instructions for specific conditions.
topmostSubform[0].CopyA[0].LeftColumn[0].c1_2[0 CheckBox
Check this box if applicable. Refer to the form instructions for specific conditions.
For calendar year Text
Enter the calendar year for which the payments are being reported. This is typically a 4-digit year.
Max length: 4 characters
Text
Enter the relevant information as required by the form. This field is a text input and may require specific details related to government payments.
Text
Enter the relevant information as required by the form. This field is a text input and may require specific details related to government payments.
topmostSubform[0].Copy2[0].RightColumn[0].f2_21[0 Text
Enter the relevant information as required by the form. This field is a text input and may require specific details related to government payments.
topmostSubform[0].Copy2[0].RightColumn[0].f2_22[0 Text
Enter the relevant information as required by the form. This field is a text input and may require specific details related to government payments.
Government Payments
topmostSubform[0].CopyB[0].RightColumn[0].Box5_ReadOrder[0].f2_13[0 Number
Enter the amount of taxable grants received. This is typically reported in Box 5 of the 1099-G form.
Number
Enter the amount of state or local income tax refunds, credits, or offsets. This is typically reported in Box 6 of the 1099-G form.
Number
Enter any other amounts that are reportable on the 1099-G form, typically found in Box 7.
Number
Enter the amount of any other government payments not specified in other boxes.
Payer Information
PAYER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no Text
Enter the full name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone number of the payer.
PAYER'S TIN Text
Enter the Taxpayer Identification Number (TIN) of the payer. This should be a 9-digit number.
Max length: 11 characters
PAYER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no Text
Enter the payer's full name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone number.
PAYER'S TIN Text
Enter the payer's Taxpayer Identification Number (TIN). This should be up to 11 characters long.
Max length: 11 characters
PAYER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no Text
Provide the name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone number of the payer.
PAYER'S TIN Text
Enter the Taxpayer Identification Number (TIN) of the payer. This can be a Social Security Number (SSN), Employer Identification Number (EIN), or Individual Taxpayer Identification Number (ITIN).
Max length: 11 characters
PAYER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no Text
Enter the full name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone number of the payer.
PAYER'S TIN Text
Enter the Taxpayer Identification Number (TIN) of the payer. This should be a 9-digit number.
Max length: 11 characters
Payment Amounts
topmostSubform[0].CopyA[0].RightColumn[0].f1_12[0 Number
Enter the amount of state or local income tax refunds, credits, or offsets. This is typically the amount reported in Box 2.
topmostSubform[0].CopyA[0].RightColumn[0].Box5_ReadOrder[0].f1_13[0 Number
Enter the amount of taxable grants received. This is typically the amount reported in Box 5.
Number
Enter the amount of any agricultural payments received. This is typically the amount reported in Box 7.
Payment Details
topmostSubform[0].CopyA[0].RightColumn[0].f1_22[0 Number
Enter the specific amount related to a government payment for Copy A of the form.
Account number (see instructions) Text
Enter the account number associated with the payment, if applicable. Refer to the form instructions for more details. This can be up to 45 characters long.
Max length: 45 characters
topmostSubform[0].Copy1[0].RightColumn[0].f2_9[0 Number
Enter the specific amount related to a government payment for Copy 1 of the form.
Number
Enter the specific amount related to a government payment for Copy 1 of the form.
Number
Enter the amount related to Box 4, which typically involves federal income tax withheld. Ensure the amount is accurate as per your records.
Number
Enter the amount related to Box 5, which may involve certain government payments or grants. Verify the amount with your records.
Number
Enter the amount related to Box 6, which may involve taxable grants or other government payments. Confirm the amount with your records.
Number
Enter the amount related to Box 7, which may involve agricultural payments or other specific government payments. Check the amount against your records.
Number
Enter the amount related to Box 8, which may involve other specific government payments. Ensure the amount is correct as per your records.
topmostSubform[0].Copy1[0].RightColumn[0].f2_21[0 Number
Enter the amount related to Box 9, which may involve other specific government payments. Verify the amount with your records.
topmostSubform[0].Copy1[0].RightColumn[0].f2_22[0 Number
Enter the amount related to Box 10, which may involve other specific government payments. Confirm the amount with your records.
topmostSubform[0].CopyB[0].RightColumn[0].f2_9[0 Text
Enter any additional information related to the government payment, if applicable.
3 Box 2 amount is for tax year Text
Enter the tax year for which the amount in Box 2 is applicable.
Max length: 4 characters
4 Federal income tax withheld Number
Enter the amount of federal income tax withheld from the payments reported on this form.
Account number (see instructions) Text
Enter the account number associated with the payment, if applicable. Refer to the instructions for more details.
Max length: 45 characters
topmostSubform[0].Copy2[0].RightColumn[0].f2_9[0 Number
Enter the amount related to the specific government payment or refund.
Text
Enter any additional information related to the payment or refund, if applicable.
Text
Enter any additional information related to the payment or refund, if applicable.
Text
Enter any additional information related to the payment or refund, if applicable.
Payment Information
Text
Enter the specific amount or information as required by the form instructions.
topmostSubform[0].CopyA[0].RightColumn[0].f1_10[0 Text
Enter the specific amount or information as required by the form instructions.
Payment Type
topmostSubform[0].Copy1[0].RightColumn[0].c2_3[0]_1 CheckBox
Check this box if the payment is related to a trade or business. This is typically used to indicate the nature of the payment.
Recipient Information
RECIPIENT'S TIN Text
Enter the Taxpayer Identification Number (TIN) of the recipient. This should be a 9-digit number.
Max length: 11 characters
RECIPIENT'S name Text
Enter the full name of the recipient.
Street address (including apt. no.) Text
Enter the street address of the recipient, including apartment number if applicable.
City or town, state or province, country, and ZIP or foreign postal code Text
Enter the city or town, state or province, country, and ZIP or foreign postal code of the recipient.
Account number (see instructions) Text
Enter the account number associated with the recipient, if applicable. Refer to the form instructions for more details.
RECIPIENT'S TIN Text
Enter the recipient's Taxpayer Identification Number (TIN). This should be up to 11 characters long.
Max length: 11 characters
RECIPIENT'S name Text
Enter the recipient's full name.
Street address (including apt. no.) Text
Enter the recipient's street address, including apartment number if applicable.
City or town, state or province, country, and ZIP or foreign postal code Text
Enter the recipient's city or town, state or province, country, and ZIP or foreign postal code.
topmostSubform[0].CopyB[0].CopyHeader[0].c2_1[0]_2 CheckBox
Check this box if the recipient is a nonresident alien.
RECIPIENT'S TIN Text
Enter the Taxpayer Identification Number (TIN) of the recipient. This can be a Social Security Number (SSN), Employer Identification Number (EIN), or Individual Taxpayer Identification Number (ITIN).
Max length: 11 characters
RECIPIENT'S name Text
Provide the full name of the recipient.
topmostSubform[0].CopyB[0].LeftColumn[0].f2_6[0 Text
Enter the street address of the recipient.
City or town, state or province, country, and ZIP or foreign postal code Text
Provide the city or town, state or province, country, and ZIP or foreign postal code of the recipient.
Account number (see instructions) Text
Enter the account number associated with the recipient, if applicable. Refer to the instructions for more details.
Max length: 45 characters
RECIPIENT'S TIN Text
Enter the Taxpayer Identification Number (TIN) of the recipient. This should be a 9-digit number.
Max length: 11 characters
RECIPIENT'S name Text
Enter the full name of the recipient.
Street address (including apt. no.) Text
Enter the street address of the recipient, including apartment number if applicable.
City or town, state or province, country, and ZIP or foreign postal code Text
Enter the city or town, state or province, country, and ZIP or foreign postal code of the recipient.
State Information
topmostSubform[0].CopyA[0].RightColumn[0].Box10a_ReadOrder[0].f1_17[0 Text
Enter the state code for the state that issued the payment. This should be a two-letter state abbreviation.
Max length: 2 characters
topmostSubform[0].CopyA[0].RightColumn[0].Box10a_ReadOrder[0].f1_18[0 Text
Enter the state code for the state that issued the payment. This should be a two-letter state abbreviation.
Max length: 2 characters
10b State identification no Text
Enter the state identification number assigned by the state that issued the payment.
topmostSubform[0].CopyA[0].RightColumn[0].Box10b_ReadOrder[0].f1_20[0 Text
Enter any additional state identification numbers if applicable.
10a State Text
Enter the two-letter abbreviation for the state related to the payment. This is used for state tax reporting purposes.
Max length: 2 characters
topmostSubform[0].Copy1[0].RightColumn[0].Box10a_ReadOrder[0].f2_18[0 Text
Enter the two-letter abbreviation for the state related to the payment. This is used for state tax reporting purposes.
Max length: 2 characters
10b State identification no Text
Enter the state identification number associated with the payment. This number is used for state tax reporting purposes.
84b1 Text
Enter the state identification number associated with the payment. This number is used for state tax reporting purposes.
topmostSubform[0].CopyB[0].RightColumn[0].Box10a_ReadOrder[0].f2_17[0 Text
Enter the state code for the state that issued the payment. This is typically a 2-letter abbreviation.
Max length: 2 characters
topmostSubform[0].CopyB[0].RightColumn[0].Box10a_ReadOrder[0].f2_18[0 Text
Enter the state code for the state that issued the payment. This is typically a 2-letter abbreviation.
Max length: 2 characters
10b State identification no Text
Enter the state identification number assigned by the state that issued the payment.
topmostSubform[0].CopyB[0].RightColumn[0].Box10b_ReadOrder[0].f2_20[0 Text
Enter the state identification number assigned by the state that issued the payment.
10a State Text
Enter the two-letter state abbreviation for the state related to the payment or refund. This field has a maximum length of 2 characters.
Max length: 2 characters
topmostSubform[0].Copy2[0].RightColumn[0].Box10a_ReadOrder[0].f2_18[0 Text
Enter the two-letter state abbreviation for the state related to the payment or refund. This field has a maximum length of 2 characters.
Max length: 2 characters
10b State identification no Text
Enter the state identification number associated with the payment or refund. This field is a text input.
topmostSubform[0].Copy2[0].RightColumn[0].Box10b_ReadOrder[0].f2_20[0 Text
Enter the state identification number associated with the payment or refund. This field is a text input.
Tax Year Information
3 Box 2 amount is for tax year Text
Enter the tax year for which the amount in Box 2 applies. This should be a four-digit year, such as 2022.
Max length: 4 characters
3 Box 2 amount is for tax year Text
Enter the tax year for which the Box 2 amount is applicable. This should be a four-digit year, such as 2022.
Max length: 4 characters
3 Box 2 amount is for tax year Text
Enter the tax year for which the Box 2 amount is applicable. This should be a 4-digit year.
Max length: 4 characters