Page 142 - 5D.Charlotte.Sydney

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Action
FORM 1099-B*
SILVERGATE CAP CORP CL A,
100.000
5.000
100.000
100.000
200.000
Quantity
311.000
200.000
100.000
132.000
20.000
200.000
30.000
100.000
102.000
300.000
492.000
500.000
100.000
660.000
100.000
100.000
100.000
100.000
SI,
Transactions for which basis
1b Date
Acquired
Unknown
Unknown
Unknown
Unknown
Unknown
Unknown
Unknown
Unknown
Unknown
Unknown
Unknown
Unknown
Unknown
Unknown
Unknown
Unknown
Unknown
Unknown
Unknown
Unknown
Unknown
Unknown
Unknown
82837P408
1a Description of property, Stock or Other Symbol, CUSIP
or Disposed
1c Date Sold
12/31/19
12/31/19
12/31/19
12/31/19
12/31/19
12/31/19
12/31/19
12/31/19
12/31/19
12/31/19
12/31/19
12/31/19
12/31/19
12/31/19
12/31/19
12/31/19
12/31/19
12/31/19
12/31/19
12/31/19
12/31/19
12/31/19
12/31/19
0 0 0
02/09/2020 9001572465
if this income is taxable and the IRS determines that it has not been reported.
3,172.93
7,921.83
317.39
1,571.46
1,571.64
3,172.93
2,089.51
1,618.70
4,935.46
3,161.93
1,570.94
1,579.96
1d Proceeds
1,573.96
1,571.22
4,739.90
10,427.78
1,585.27
1,571.08
475.19
1,575.80
1,573.96
79.27
7,783.27
Unknown
1e Cost or
Unknown
Unknown
Unknown
Unknown
Unknown
Unknown
Unknown
Unknown
Unknown
Unknown
Unknown
Unknown
Unknown
Unknown
Unknown
Unknown
Unknown
Unknown
Unknown
Unknown
Unknown
Unknown
Other Basis (b)
JEFFREY AND KAREN BLOCK REV TR
Discount
1f Accrued
Market
(IRS Form 1099-B box numbers are shown below in bold type)
Proceeds are reported as gross proceeds unless otherwise indicated (a).(This Label is a Substitute for Boxes 2, 5, 6 & 12)
Account No.
2019 Proceeds from Broker and Barter Exchange Transactions
1g Wash Sale
Disallowed
Loss
Recipient ID No.
649-690260
***-**-1895
Gain/Loss (-)
Pages 3 of 12
Customer Service:
4 Federal
Income Tax
Withheld
Payer's Fed ID Number:
2019 TAX REPORTING STATEMENT
04-3523567
415-326-7650
is not reported to the IRS and Term is Unknown--report on Form 8949 with Box B or E checked and/or Schedule D, Part I or II
* This is important tax information and is being furnished to the Internal Revenue Service. If you are required to file a return, a negligence penalty or other sanction may be imposed on you
Copy B for Recipient OMB No. 1545-0715
16 State Tax
Withheld
14 State