This form contains 123 fields organized into 10 sections. Below is a complete list of every field, its type, and what information is expected.

Field Name Type Description
Additional Information
topmostSubform[0].Copy1[0].RightColumn[0].f2_19[0 Text
Enter any additional information or amounts that do not fit into other categories.
Form Information
topmostSubform[0].CopyA[0].RightColumn[0].c1_4[0]_1 CheckBox
Check this box if the form is being corrected.
topmostSubform[0].CopyA[0].RightColumn[0].TagCorrectingSubform[0].c1_3[0]_1 CheckBox
Check this box if the form is being corrected.
topmostSubform[0].Copy1[0].RightColumn[0].TagCorrectingSubform[0].c2_3[0]_1 CheckBox
Check this box if the form is being corrected.
topmostSubform[0].CopyB[0].RightColumn[0].c2_4[0]_1 CheckBox
Check this box if the form is being corrected.
topmostSubform[0].CopyB[0].RightColumn[0].TagCorrectingSubform[0].c2_3[0]_1 CheckBox
Check this box if the form is being corrected.
topmostSubform[0].Copy2[0].RightColumn[0].c2_4[0]_1 CheckBox
Check this box if the form is a corrected version of a previously filed form.
topmostSubform[0].Copy2[0].RightColumn[0].TagCorrectingSubform[0].c2_3[0]_1 CheckBox
Check this box if the form is a corrected version of a previously filed form.
General Information
For calendar year Text
Enter the calendar year for which this form is being filed.
Max length: 4 characters
topmostSubform[0].CopyA[0].CopyAHeader[0].c1_1[0]_1 CheckBox
Check this box if applicable. Refer to the form instructions for specific conditions.
topmostSubform[0].CopyA[0].CopyAHeader[0].c1_1[1]_2 CheckBox
Check this box if applicable. Refer to the form instructions for specific conditions.
Account number (see instructions) Text
Enter the account number if applicable, as per the form instructions.
Max length: 42 characters
topmostSubform[0].CopyA[0].LeftColumn[0].c1_2[0]_1 CheckBox
Check this box if applicable. Refer to the form instructions for specific conditions.
Department of the Treasury - Internal Revenue Service Text
This field is for the Department of the Treasury - Internal Revenue Service. It is likely pre-filled and does not require user input.
topmostSubform[0].CopyA[0].f1_27[0 Text
This field appears to be a placeholder or an unused field. No input is required.
For calendar year Text
Enter the calendar year for which this form is being filed. Use a 4-digit year format (e.g., 2023).
Max length: 4 characters
topmostSubform[0].Copy1[0].Copy1Header[0].c2_1[0]_1 CheckBox
Check this box if applicable. The specific purpose of this checkbox is not clear from the field name.
topmostSubform[0].Copy1[0].Copy1Header[0].c2_1[1]_2 CheckBox
Check this box if applicable. The specific purpose of this checkbox is not clear from the field name.
Account number (see instructions) Text
Enter the account number associated with the income reported on this form, if applicable. Refer to the form instructions for more details.
Max length: 42 characters
For calendar year Text
Enter the calendar year for which this form is being filed. Use a 4-digit year format.
Max length: 4 characters
topmostSubform[0].CopyB[0].CopyBHeader[0].c2_1[0]_2 CheckBox
Check this box if the form is being corrected.
For calendar year Text
Enter the calendar year for which this form is being filed. This should be a 4-digit year.
Max length: 4 characters
topmostSubform[0].Copy2[0].Copy2Header[0].c2_1[0]_2 CheckBox
Check this box if applicable. Refer to the form instructions for specific conditions under which this box should be checked.
Account number (see instructions) Text
Enter the account number associated with this form, if applicable. Refer to the form instructions for more details. This can be up to 42 characters long.
Max length: 42 characters
Income Details
1 Rents Number
Enter the amount of rents paid.
2 Royalties Number
Enter the amount of royalties paid.
3 Other income Number
Enter the amount of other income paid.
4 Federal income tax withheld Number
Enter the amount of federal income tax withheld.
5 Fishing boat proceeds Number
Enter the total proceeds from the sale of fish caught by a fishing boat.
6 Medical and health care payments Number
Enter the total amount of medical and health care payments made.
8 Substitute payments in lieu of dividends or interest Number
Enter the total amount of substitute payments in lieu of dividends or interest.
11 Fish purchased for resale Number
Enter the total amount paid for fish purchased for resale.
10 Gross proceeds paid to an attorney Number
Enter the total gross proceeds paid to an attorney.
topmostSubform[0].CopyA[0].RightColumn[0].f1_18[0 Number
Enter any other income not reported in the previous fields.
topmostSubform[0].CopyA[0].RightColumn[0].f1_19[0 Number
Enter any other income not reported in the previous fields.
14 Excess golden parachute payments Number
Enter the total amount of excess golden parachute payments.
topmostSubform[0].CopyA[0].RightColumn[0].f1_21[0 Number
Enter any other income not reported in the previous fields.
topmostSubform[0].CopyA[0].Box16_ReadOrder[0].f1_22[0 Number
Enter any other income not reported in the previous fields.
topmostSubform[0].CopyA[0].Box16_ReadOrder[0].f1_23[0 Number
Enter any other income not reported in the previous fields.
topmostSubform[0].CopyA[0].Box17_ReadOrder[0].f1_24[0 Number
Enter any other income not reported in the previous fields.
5 Fishing boat proceeds Number
Enter the total proceeds from the sale of fish caught by a fishing boat.
6 Medical and health care payments Number
Enter the total amount of payments made for medical and health care services.
8 Substitute payments in lieu of dividends or interest Number
Enter the total amount of substitute payments in lieu of dividends or interest.
for resale 12 Section Number
Enter the total amount of Section 12 payments for resale.
10 Gross proceeds paid to an attorney Number
Enter the total gross proceeds paid to an attorney.
11 Fish purchased for resale Number
Enter the total amount paid for fish purchased for resale.
14 Excess golden parachute payments Number
Enter the total amount of excess golden parachute payments.
15 Nonqualified deferred compensation Number
Enter the total amount of nonqualified deferred compensation.
5 Fishing boat proceeds Number
Enter the total proceeds from the sale of fish caught by a fishing boat.
6 Medical and health care payments Number
Enter the total amount of medical and health care payments made.
8 Substitute payments in lieu of dividends or interest Number
Enter the total amount of substitute payments in lieu of dividends or interest.
11 Fish purchased for resale Number
Enter the total amount paid for fish purchased for resale.
10 Gross proceeds paid to an attorney Number
Enter the gross proceeds paid to an attorney.
14 Excess golden parachute payments Number
Enter the total amount of excess golden parachute payments.
15 Nonqualified deferred compensation Number
Enter the total amount of nonqualified deferred compensation.
6 Medical and health care payments Number
Enter the total amount of medical and health care payments made during the year.
8 Substitute payments in lieu of dividends or interest Number
Enter the total amount of substitute payments in lieu of dividends or interest received.
9 Crop insurance proceeds Number
Enter the total amount of crop insurance proceeds received.
10 Gross proceeds paid to an attorney Number
Enter the total gross proceeds paid to an attorney.
11 Fish purchased for resale Number
Enter the total amount paid for fish purchased for resale.
topmostSubform[0].Copy2[0].RightColumn[0].f2_19[0 Number
Enter any other miscellaneous income not covered by other fields.
14 Excess golden parachute payments Number
Enter the total amount of excess golden parachute payments made.
15 Nonqualified deferred compensation Number
Enter the total amount of nonqualified deferred compensation.
Income Information
1 Rents Number
Enter the amount of rent income reported on this form.
2 Royalties Number
Enter the amount of royalty income reported on this form.
3 Other income Number
Enter the amount of other income reported on this form.
1 Rents Number
Enter the amount of rents paid to the recipient.
2 Royalties Number
Enter the amount of royalties paid to the recipient.
3 Other income Number
Enter any other income paid to the recipient.
4 Federal income tax withheld Number
Enter the amount of federal income tax withheld from the recipient's payments.
1 Rents Number
Enter the amount of rents received.
2 Royalties Number
Enter the amount of royalties received.
3 Other income Number
Enter the amount of other income received.
5 Fishing boat proceeds Number
Enter the amount of fishing boat proceeds received.
Miscellaneous
topmostSubform[0].CopyB[0].RightColumn[0].f2_18[0 Text
Enter the appropriate information for this field.
topmostSubform[0].CopyB[0].RightColumn[0].f2_19[0 Text
Enter the appropriate information for this field.
topmostSubform[0].CopyB[0].Box17_ReadOrder[0].f2_24[0 Text
Enter the appropriate information for this field.
topmostSubform[0].CopyB[0].Box17_ReadOrder[0].f2_25[0 Text
Enter the appropriate information for this field.
topmostSubform[0].CopyB[0].f2_27[0 Text
This field appears to be a placeholder or an unnamed field. Please refer to the form instructions for more details.
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).
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 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 name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no Text
Enter the payer's 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).
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 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
Recipient Information
RECIPIENT'S TIN Text
Enter the recipient's Taxpayer Identification Number (TIN).
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.
RECIPIENT'S TIN Text
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 recipient's full name.
Street address (including apt. no.) Text
Enter the recipient's street address, including apartment number if applicable.
Street address (including apt. no.) Text
Enter the recipient's street address, including apartment number if applicable.
RECIPIENT'S TIN Text
Enter the recipient's Taxpayer Identification Number (TIN).
Max length: 11 characters
RECIPIENT'S name Text
Enter the recipient's name.
Street address (including apt. no.) Text
Enter the recipient's street address, including apartment number if applicable.
Street address (including apt. no.) Text
Enter the recipient's street address, including apartment number if applicable.
Account number (see instructions) Text
Enter the account number associated with the recipient, if applicable. Refer to the instructions for more details.
Max length: 42 characters
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 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.
State Tax Information
18 State income Number
Enter the amount of state income reported on this form.
topmostSubform[0].Copy1[0].Box17_ReadOrder[0].f2_25[0 Number
Enter the state tax amount withheld for the recipient.
18 State income Number
Enter the state income amount for the recipient.
18 State income Number
Enter the state income amount for the recipient.
16 State tax withheld Number
Enter the amount of state tax withheld.
16 State tax withheld Number
Enter the amount of state tax withheld.
18 State income Number
Enter the amount of state income reported.
16 State tax withheld Number
Enter the total amount of state tax withheld.
16 State tax withheld Number
Enter the total amount of state tax withheld.
17 State/Payer's state no Text
Enter the state or payer's state number.
topmostSubform[0].Copy2[0].Box17_ReadOrder[0].f2_25[0 Text
Enter the state or payer's state number.
18 State income Number
Enter the total amount of state income.
topmostSubform[0].Copy2[0].f2_27[0 Number
Enter the total amount of state income.
Tax Information
4 Federal income tax withheld Number
Enter the total amount of federal income tax withheld from the payments reported on this form.
topmostSubform[0].Copy1[0].RightColumn[0].c2_4[0]_1 CheckBox
Check this box if the payments reported are subject to backup withholding.
16 State tax withheld Number
Enter the total amount of state tax withheld from the payments reported on this form.
topmostSubform[0].Copy1[0].Box16_ReadOrder[0].f2_23[0 Text
Enter any additional state tax information.
topmostSubform[0].Copy1[0].Box17_ReadOrder[0].f2_24[0 Text
Enter any additional state tax information.
4 Federal income tax withheld Number
Enter the amount of federal income tax withheld.