Form 1099-G Certain Government Payments

Attention:
This form is provided for informational purposes only. Copy A appears in red,
similar to the official IRS form. Do not file copy A with the IRS. The official printed
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See IRS Publications 1141, 1167, 1179 and other IRS resources for information
about printing these tax forms.

8686

VOID

CORRECTED

PAYER’S name, street address, city, state, ZIP code, and telephone no.

1 Unemployment compensation

OMB No. 1545-0120

$

2008

2 State or local income tax
refunds, credits, or offsets

$
PAYER’S federal identification number

RECIPIENT’S identification number

Form

3 Box 2 amount is for tax year

Certain
Government
Payments

1099-G

4 Federal income tax withheld

$
RECIPIENT’S name

5 ATAA payments

6 Taxable grants

$

$

Street address (including apt. no.)

7 Agriculture payments

8 Check if box 2 is
trade or business
income

$
City, state, and ZIP code

Account number (see instructions)

Form

1099-G

Cat. No. 14438M

Do Not Cut or Separate Forms on This Page

—

Copy A
For
Internal Revenue
Service Center

䊳

File with Form 1096.
For Privacy Act
and Paperwork
Reduction Act
Notice, see the
2008 General
Instructions for
Forms 1099, 1098,
5498, and W-2G.

Department of the Treasury - Internal Revenue Service

Do Not Cut or Separate Forms on This Page

CORRECTED (if checked)
PAYER’S name, street address, city, state, ZIP code, and telephone no.

1 Unemployment compensation

OMB No. 1545-0120

$

2008

2 State or local income tax
refunds, credits, or offsets

$
PAYER’S federal identification number

RECIPIENT’S identification number

3 Box 2 amount is for tax year

Certain
Government
Payments

Form

1099-G

4 Federal income tax withheld

$
RECIPIENT’S name

5 ATAA payments

6 Taxable grants

$

$

Street address (including apt. no.)

7 Agriculture payments

8 Box 2 is trade or
business income

$
City, state, and ZIP code

Account number (see instructions)

Form

1099-G

(keep for your records)

Copy B
For Recipient

䊳

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 if this
income is taxable and
the IRS determines that
it has not been
reported.

Department of the Treasury - Internal Revenue Service

Instructions for Recipient
Account number. May show an account or other unique number the payer
has assigned to distinguish your account.
Box 1. Shows the total unemployment compensation paid to you this year. If
you expect to receive these benefits in the future, you can ask the payer to
withhold federal income tax from each payment. Or, you can make estimated
tax payments using Form 1040-ES, Estimated Tax for Individuals. If you made
contributions to a governmental unemployment compensation program and
received a payment from that program, the payor must issue a separate Form
1099-G to report this amount to you. Include the entire amount in income. If
you itemize deductions, you may deduct your contributions on Schedule A
(Form 1040) as taxes paid. If you do not itemize, you only need to include the
amount in income that is in excess of your contributions. Combine the box 1
taxable amounts from all Forms 1099-G, and report it as income on the
unemployment compensation line of your tax return.
Box 2. Shows refunds, credits, or offsets of state or local income tax you
received. It may be taxable to you if you deducted the state or local income
tax paid on Schedule A (Form 1040). Even if you did not receive the amount
shown, for example, because it was credited to your state or local estimated
tax, it is still taxable if it was deducted. If you received interest on this amount,
you should receive Form 1099-INT for the interest. However, the payer may
include interest of less than $600 in the blank box on Form 1099-G.
Regardless of whether the interest is reported to you, report it as interest
income on your tax return. See your tax return instructions.
Box 3. Identifies the tax year for which the refunds, credits, or offsets shown
in box 2 were made. If there is no entry in this box, the refund is for 2007
taxes.

Box 4. Shows backup withholding or withholding you requested on
unemployment compensation, Commodity Credit Corporation loans, or
certain crop disaster payments. Generally, a payer must backup withhold
on certain payments at a 28% rate if you did not give your taxpayer
identification number to the payer. See Form W-9, Request for Taxpayer
Identification Number and Certification, for information on backup
withholding. Include this amount on your income tax return as tax
withheld.
Box 5. Shows alternative trade adjustment assistance (ATAA) payments
you received. Include on Form 1040 on the “Other income” line. See the
Form 1040 instructions.
Box 6. Shows taxable grants you received from a federal, state, or local
government.
Box 7. Shows Department of Agriculture payments that are taxable to
you. If the payer shown is anyone other than the Department of
Agriculture, it means the payer has received a payment, as a nominee,
that is taxable to you. This may represent the entire agricultural subsidy
payment received on your behalf by the nominee, or it may be your pro
rata share of the original payment. See Pub. 225, Farmer’s Tax Guide,
and the Instructions for Schedule F, Profit or Loss From Farming, for
information about where to report this income. Partnerships, see Form
8825, Rental Real Estate Income and Expenses of a Partnership or an
S Corporation, for how to report.
Box 8. If this box is checked, the amount in box 2 is attributable to an
income tax that applies exclusively to income from a trade or business
and is not a tax of general application. If taxable, report the amount in
box 2 on Schedule C, C-EZ, or F (Form 1040), as appropriate.

VOID

CORRECTED

PAYER’S name, street address, city, state, ZIP code, and telephone no.

1 Unemployment compensation

OMB No. 1545-0120

$

2008

2 State or local income tax
refunds, credits, or offsets

$
PAYER’S federal identification number

RECIPIENT’S identification number

Certain
Government
Payments

Form

1099-G

3 Box 2 amount is for tax year

4 Federal income tax withheld

5 ATAA payments

6 Taxable grants

$

$

7 Agriculture payments

8 Check if box 2 is
trade or business
income

Copy C

$
RECIPIENT’S name

Street address (including apt. no.)

$
City, state, and ZIP code

Account number (see instructions)

Form

1099-G

For Payer

䊳

For Privacy Act
and Paperwork
Reduction Act
Notice, see the
2008 General
Instructions for
Forms 1099,
1098, 5498,
and W-2G.

Department of the Treasury - Internal Revenue Service

Instructions for Payers
General and specific form instructions are provided as
separate products. The products you should use to
complete Form 1099-G are the 2008 General
Instructions for Forms 1099, 1098, 5498, and W-2G,
and the 2008 Instructions for Form 1099-G. A chart in
the general instructions gives a quick guide to which
form must be filed to report a particular payment. To
order these instructions and additional forms, visit the
IRS website at www.irs.gov or call 1-800-TAX-FORM
(1-800-829-3676).
Caution: Because paper forms are scanned during
processing, you cannot file Forms 1096, 1098, 1099, or
5498 that you download and print from the IRS
website.
Due dates. Furnish Copy B of this form to the
recipient by February 2, 2009.

File Copy A of this form with the IRS by March 2,
2009. If you file electronically, the due date is
March 31, 2009. To file electronically, you must have
software that generates a file according to the
specifications in Pub. 1220, Specifications for Filing
Forms 1098, 1099, 5498, and W-2G Electronically. IRS
does not provide a fill-in form option.
Need help? If you have questions about reporting on
Form 1099-G, call the information reporting customer
service site toll free at 1-866-455-7438 or
304-263-8700 (not toll free). For TTY/TDD equipment,
call 304-267-3367 (not toll free). The hours of operation
are Monday through Friday from 8:30 a.m. to 4:30
p.m., Eastern time.