This form contains 127 fields organized into 22 sections. Below is a complete list of every field, its type, and what information is expected.

Field Name Type Description
Account Information
Account number (see instructions) Text
Enter the account number associated with the interest income, if applicable. Refer to the form instructions for more details.
Account number (see instructions) Text
Enter the account number associated with the interest income, if applicable. Refer to the form's instructions for more details.
Max length: 44 characters
Account number (see instructions) Text
Enter the account number associated with the interest income, as per the instructions provided.
Max length: 44 characters
Account number (see instructions) Text
Enter the account number associated with the interest income, as per the instructions. Maximum length is 44 characters.
Max length: 44 characters
Bond Information
14 Tax-exempt and tax credit bond CUSIP no Text
Enter the CUSIP number for tax-exempt and tax credit bonds. This is a unique identifier for securities.
14 Tax-exempt and tax credit bond CUSIP no Text
Enter the CUSIP number for tax-exempt and tax credit bonds. This is a unique identifier for securities.
14 Tax-exempt and tax credit bond CUSIP no Text
Enter the CUSIP number for tax-exempt and tax credit bonds. The CUSIP number is a unique identifier for securities.
Bond Premium
Number
Enter the bond premium amount.
Number
Enter the amount of bond premium on tax-exempt bond.
Number
Enter the bond premium on tax-exempt bond interest. This is the amount reported in Box 11 of Form 1099-INT.
topmostSubform[0].CopyB[0].RghtColumn[0].Box12[0].f2_20[0 Number
Enter the bond premium on Treasury obligations. This is the amount reported in Box 12 of Form 1099-INT.
topmostSubform[0].CopyB[0].RghtColumn[0].Box13[0].f2_21[0 Number
Enter the bond premium on tax-exempt bonds. This is the amount reported in Box 13 of Form 1099-INT.
Expenses
Number
Enter the amount of investment expenses in Box 5, if applicable.
Number
Enter the investment expenses related to the interest income. This is the amount reported in Box 5 of Form 1099-INT.
topmostSubform[0].Copy2[0].RghtColumn[0].Box5[0].f2_13[0 Number
Enter the investment expenses in Box 5.
Filing Information
topmostSubform[0].Copy1[0].CopyHeader[0].c2_1[0]_1 CheckBox
Check this box if the form is being filed for the first time for the specified calendar year.
topmostSubform[0].Copy1[0].CopyHeader[0].c2_1[1]_2 CheckBox
Check this box if the form is a corrected version of a previously filed form.
Foreign Information
7 Foreign country or U.S. territory Text
Enter the name of the foreign country or U.S. territory where the interest was earned.
7 Foreign country or U.S. territory Text
Enter the name of the foreign country or U.S. territory where the interest income was earned, if applicable.
7 Foreign country or U.S. territory Text
Enter the name of the foreign country or U.S. territory in Box 7.
Foreign Tax
topmostSubform[0].CopyA[0].RightColumn[0].Box6[0].f1_14[0 Number
Enter the amount of foreign tax paid.
Number
Enter the foreign tax paid on the interest income. This is the amount reported in Box 6 of Form 1099-INT.
topmostSubform[0].Copy2[0].RghtColumn[0].Box6[0].f2_14[0 Number
Enter the foreign tax paid in Box 6.
Form Options
topmostSubform[0].Copy2[0].LeftColumn[0].c2_2[0]_1 CheckBox
Check this box if applicable. Refer to the form instructions for specific conditions.
General Information
For calendar year Text
Enter the calendar year for which the interest income is being reported. This should be a four-digit year, such as 2023.
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 under which this box should be checked.
topmostSubform[0].CopyA[0].CopyHeader[0].c1_1[1]_2 CheckBox
Check this box if applicable. Refer to the form instructions for specific conditions under which this box should be checked.
topmostSubform[0].CopyA[0].LeftColumn[0].c1_2[0]_1 CheckBox
Check this box if applicable. Refer to the form instructions for specific conditions under which this box should be checked.
topmostSubform[0].CopyA[0].LeftColumn[0].c1_3[0]_1 CheckBox
Check this box if applicable. Refer to the form instructions for specific conditions under which this box should be checked.
For calendar year Text
Enter the calendar year for which the interest income is being reported.
Max length: 4 characters
topmostSubform[0].Copy1[0].LftColumn[0].c2_2[0]_1 CheckBox
Check this box if applicable, as per the form's instructions.
For calendar year Text
Enter the calendar year for which the interest income is being reported. Use a four-digit year format (e.g., 2023).
Max length: 4 characters
For calendar year Text
Enter the calendar year for which the interest income is being reported.
Max length: 4 characters
topmostSubform[0].Copy2[0].CopyHeader[0].c2_1[0]_2 CheckBox
Check this box if applicable to indicate a specific condition or requirement as per the form instructions.
Interest Income
topmostSubform[0].CopyA[0].RightColumn[0].Box2[0].f1_10[0 Number
Enter the amount of interest on U.S. Savings Bonds and Treasury obligations.
topmostSubform[0].CopyA[0].RightColumn[0].Box1[0].f1_9[0 Number
Enter the total amount of interest income paid to the recipient.
Number
Enter the amount of interest on U.S. Savings Bonds and Treasury obligations.
topmostSubform[0].Copy1[0].RghtCol[0].Box1[0].f2_9[0 Number
Enter the amount of interest income in Box 1. This is the total interest paid to the recipient.
Number
Enter the amount of interest on U.S. Savings Bonds and Treasury obligations in Box 3, if applicable.
Number
Enter the total interest income received during the tax year. This is the amount reported in Box 1 of Form 1099-INT.
topmostSubform[0].CopyB[0].RghtColumn[0].Box3[0].f2_11[0 Number
Enter the interest on U.S. Savings Bonds and Treasury obligations. This is the amount reported in Box 3 of Form 1099-INT.
S Number
Enter the amount of interest income in Box 1.
topmostSubform[0].Copy2[0].RghtColumn[0].Box3[0].f2_11[0 Number
Enter the amount of interest on U.S. Savings Bonds and Treasury obligations in Box 3.
8 Tax-exempt interest Number
Enter the amount of tax-exempt interest income received. This is interest income that is not subject to federal income tax.
topmostSubform[0].Copy2[0].RghtColumn[0].Box9[0].f2_17[0 Number
Enter the amount of specified private activity bond interest. This is typically interest from bonds issued for private activities.
Market discount Number
Enter the amount of market discount on bonds. Market discount is the difference between the purchase price of a bond and its face value.
Number
Enter the amount of bond premium on tax-exempt bonds. This is the amount paid over the face value of a bond.
topmostSubform[0].Copy2[0].RghtColumn[0].Box12[0].f2_20[0 Number
Enter the amount of bond premium on tax-exempt private activity bonds. This is the premium paid over the face value of such bonds.
Number
Enter the amount of interest on U.S. Savings Bonds and Treasury obligations. This is interest income from U.S. government securities.
Interest Income Details
topmostSubform[0].Copy1[0].RghtCol[0].Box6[0].f2_14[0 Number
Enter the amount of foreign tax paid on interest income, if applicable.
7 Foreign country or U.S. territory Text
Specify the foreign country or U.S. territory where the interest income was earned.
Number
Enter the tax-exempt interest amount, if applicable.
Number
Enter the specified private activity bond interest amount, if applicable.
topmostSubform[0].Copy1[0].RghtCol[0].Box10[0].f2_18[0 Number
Enter the market discount amount, if applicable.
Number
Enter the bond premium amount on tax-exempt bond, if applicable.
Number
Enter the bond premium amount on tax credit bond, if applicable.
Number
Enter the amount of U.S. savings bond interest, if applicable.
14 Tax-exempt and tax credit bond CUSIP no Text
Enter the CUSIP number for tax-exempt and tax credit bonds, if applicable.
Investment Expenses
topmostSubform[0].CopyA[0].RightColumn[0].Box5[0].f1_13[0 Number
Enter the amount of investment expenses.
Market Discount
Number
Enter the market discount amount.
topmostSubform[0].CopyB[0].RghtColumn[0].Box10[0].f2_18[0 Number
Enter the market discount accrued on the interest income. This is the amount reported in Box 10 of Form 1099-INT.
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 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 a 9-digit number.
Max length: 11 characters
Payer's RTN (optional) Text
Enter the payer's Routing Transit Number (RTN), if applicable. This is optional.
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, address, and contact information including telephone number.
PAYER'S TIN Text
Enter the Taxpayer Identification Number (TIN) of the payer. This is typically an Employer Identification Number (EIN) or Social Security Number (SSN).
Max length: 11 characters
Payer's RTN (optional) Text
Enter the payer's Routing Transit Number (RTN), if applicable. This is optional.
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 a 9-digit number.
Max length: 11 characters
Payer's RTN (optional) Text
Enter the payer's Routing Transit Number (RTN), if applicable. This is optional.
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, address, and contact information including street, city, state, ZIP code, and phone number.
PAYER'S TIN Text
Enter the payer's Taxpayer Identification Number (TIN), which can be a Social Security Number (SSN) or Employer Identification Number (EIN).
Max length: 11 characters
Payer's RTN (optional) Text
Enter the Payer's Routing Transit Number (RTN) if applicable. This is optional.
Penalties
topmostSubform[0].Copy1[0].RghtCol[0].Box2[0].f2_10[0 Number
Enter the amount of early withdrawal penalty in Box 2, if applicable.
Number
Enter any early withdrawal penalties incurred during the tax year. This is the amount reported in Box 2 of Form 1099-INT.
topmostSubform[0].Copy2[0].RghtColumn[0].Box2[0].f2_10[0 Number
Enter the amount of early withdrawal penalty in Box 2.
Private Activity Bond Interest
Number
Enter the specified private activity bond interest.
Recipient Information
RECIPIENT'S TIN Number
Enter the recipient's Taxpayer Identification Number (TIN). This should be a 9-digit number.
Max length: 11 characters
RECIPIENT'S name Text
Enter the full name of the recipient of the interest income.
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.
RECIPIENT'S TIN Text
Enter the Taxpayer Identification Number (TIN) of the recipient. This is typically a Social Security Number (SSN) or Employer Identification Number (EIN).
Max length: 11 characters
RECIPIENT'S name Text
Enter the full name of the recipient of the interest income.
Street address (including apt. no.) Text
Enter the street address of the recipient, including apartment number if applicable.
e7e8 City or town, state or province, country, and ZIP or foreign postal code Text
Enter the city, state or province, country, and ZIP or foreign postal code of the recipient's address.
topmostSubform[0].CopyB[0].CopyBHeader[0].c2_1[0]_2 CheckBox
Check this box if the recipient is a corporation.
RECIPIENT'S TIN Number
Enter the recipient's Taxpayer Identification Number (TIN). This should be a 9-digit number.
Max length: 11 characters
RECIPIENT'S name Text
Enter the full name of the recipient of the interest income.
Street address (including apt. no.) Text
Enter the street address of the recipient, including apartment number if applicable.
98eb 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.
topmostSubform[0].CopyB[0].LeftColumn[0].c2_2[0]_1 CheckBox
Check this box if the recipient is a nonresident alien.
RECIPIENT'S TIN Text
Enter the recipient's Taxpayer Identification Number (TIN), which can be a Social Security Number (SSN) or Employer Identification Number (EIN).
Max length: 11 characters
RECIPIENT'S name Text
Enter the full name of the recipient of the interest income.
Street address (including apt. no.) Text
Enter the street address of the recipient, including apartment number if applicable.
82ef Text
Enter the city, state, and ZIP code of the recipient's address.
State Information
15 State Text
Enter the two-letter state abbreviation where the interest income is being reported.
Max length: 2 characters
topmostSubform[0].CopyA[0].RightColumn[0].Boxes15_16_17[0].f1_24[0 Text
Enter the two-letter state abbreviation for the state related to the interest income.
Max length: 2 characters
topmostSubform[0].CopyA[0].RightColumn[0].Boxes15_16_17[0].f1_25[0 Text
Enter the state identification number for the payer, if applicable.
topmostSubform[0].CopyA[0].RightColumn[0].Boxes15_16_17[0].f1_27[0 Text
Enter any additional state-specific information required for reporting.
topmostSubform[0].CopyA[0].RightColumn[0].Boxes15_16_17[0].f1_28[0 Text
Enter any additional state-specific information required for reporting.
15 State Text
Enter the two-letter abbreviation for the state where the interest income is being reported.
Max length: 2 characters
ef 15 Text
Enter the two-letter abbreviation for the state where the interest income is being reported.
Max length: 2 characters
topmostSubform[0].CopyB[0].RghtColumn[0].Boxes15_16_17[0].f2_25[0 Text
Enter the state identification number or other relevant state-specific information.
topmostSubform[0].CopyB[0].RghtColumn[0].Boxes15_16_17[0].f2_26[0 Text
Enter the state identification number or other relevant state-specific information.
17 State Text
Enter the two-letter abbreviation for the state where the interest income is being reported.
topmostSubform[0].CopyB[0].RghtColumn[0].Boxes15_16_17[0].f2_28[0 Text
Enter the state identification number or other relevant state-specific information.
0efb 82564 Text
Enter the state code for the state where the interest income is taxable. This is a two-letter state abbreviation.
Max length: 2 characters
0efb 82564 d2 Text
Enter the state identification number for the payer. This is a two-digit number assigned by the state.
Max length: 2 characters
State Text
Enter the name of the state where the interest income is taxable.
17 State Text
Enter the name of the state where the interest income is taxable.
State Tax Information
topmostSubform[0].CopyA[0].RightColumn[0].Boxes15_16_17[0].f1_26[0 Number
Enter the amount of state tax withheld, if any.
15 State Text
Enter the two-letter state abbreviation for the state where the interest income is reported.
Max length: 2 characters
bc 66 Text
Enter the two-letter state abbreviation for the state where the interest income is reported.
Max length: 2 characters
topmostSubform[0].Copy1[0].RghtCol[0].Boxes15_16_17[0].f2_25[0 Text
Enter the state identification number, if applicable.
topmostSubform[0].Copy1[0].RghtCol[0].Boxes15_16_17[0].f2_26[0 Number
Enter the state tax withheld amount, if applicable.
17 State Text
Enter the state abbreviation where the interest income is being reported for state tax purposes.
topmostSubform[0].Copy1[0].RghtCol[0].Boxes15_16_17[0].f2_28[0 Text
Enter the state identification number for the payer, if applicable.
topmostSubform[0].Copy2[0].RghtColumn[0].Boxes15_16_17[0].f2_25[0 Number
Enter the amount of state tax withheld from the interest income. This is the tax amount withheld by the state.
17 State tax withheld $ 94ec Number
Enter the amount of state tax withheld from the interest income. This is the tax amount withheld by the state.
Tax-Exempt Bond Information
topmostSubform[0].CopyA[0].RightColumn[0].Box12[0].f1_20[0 Text
Enter the amount of tax-exempt bond CUSIP number.
Tax-Exempt Interest
topmostSubform[0].CopyA[0].RightColumn[0].Box8[0].f1_16[0 Number
Enter the tax-exempt interest amount.
Number
Enter the tax-exempt interest income received during the tax year. This is the amount reported in Box 8 of Form 1099-INT.
Number
Enter the specified private activity bond interest, which is a subset of tax-exempt interest. This is the amount reported in Box 9 of Form 1099-INT.
Taxes Withheld
topmostSubform[0].CopyA[0].RightColumn[0].Box4[0].f1_12[0 Number
Enter the amount of federal income tax withheld from the interest income.
topmostSubform[0].Copy1[0].RghtCol[0].Box4[0].f2_12[0 Number
Enter the amount of federal income tax withheld in Box 4, if applicable.
topmostSubform[0].CopyB[0].RghtColumn[0].Box4[0].f2_12[0 Number
Enter the federal income tax withheld from the interest income. This is the amount reported in Box 4 of Form 1099-INT.
Number
Enter the federal income tax withheld in Box 4.