Page 223 - Fontaine Oaks Handbook Directors 062923
P. 223

VOID        CORRECTED
            PAYER’S name, street address, city or town, state or province, country, ZIP   1 Rents  OMB No. 1545-0115
            or foreign postal code, and telephone no.
            Fontaine Oaks Unit  Owners Association                                2016              Miscellaneous
                                                             $
            Fontaine Oaks Unit Owners Association                                                           Income
                                                             2 Royalties
            P.O. Box 8007
            Winslow ME 04901                                 $                   Form 1099-MISC
                                                             3 Other income      4 Federal income tax withheld  Copy C
            207-872-2373                                     $                   $                          For Payer
            PAYER’S federal identification number RECIPIENT’S identification number  5 Fishing boat proceeds  6 Medical and health care payments


                01-0455327              007-92-5570          $                   $
            RECIPIENT’S name                                 7 Nonemployee compensation  8 Substitute payments in lieu of
            Alex Duong                                                             dividends or interest  For Privacy Act
                                                                                                       and Paperwork
                                                                                                       Reduction Act
            Street address (including apt. no.)              $       2480.00     $                     Notice, see the
            2 Central Avenue                                 9 Payer made direct sales of   10 Crop insurance proceeds  2016 General
            Apt. 1                                            $5,000 or more of consumer              Instructions for
                                                              products to a buyer
            City or town, state or province, country, and ZIP or foreign postal code  (recipient) for resale  a  $  Certain
            Waterville ME 04901                             11                   12                      Information
                                                                                                            Returns.
            Account number (see instructions)  FATCA filing  2nd TIN not. 13 Excess golden parachute   14 Gross proceeds paid to an
                                           requirement        payments             attorney
                                                             $                   $
           15a Section 409A deferrals  15b Section 409A income  16 State tax withheld  17 State/Payer’s state no.  18 State income
                                                             $                                       $
            $                       $                        $                                       $
           Form 1099-MISC                    www.irs.gov/form1099misc             Department of the Treasury - Internal Revenue Service
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