Form 1099-C Cancellation of Debt

Tax Forms & Publications

Work Request Notification
Title: Form 1099-C, Cancellation of Debt
Tax Year: 2009

Processing Year: 2010

Route to:

Approved:

Section Chief:

Ellen Fingerman

Reviewer:

Dave Needle

Date:

Ellen
Fingerman

Digitally signed by 62PDB
DN: cn=62PDB, [email protected]
Date: 2008.05.12 15:34:28 -04'00'

05/15/08
Digitally signed by B50DB
DN: cn=B50DB, [email protected]
Date: 2008.05.21 14:57:44 -04'00'

Senior Technical Advisor: Bob Erickson
Review Chief:

05/12/08

Marilyn Ward

Marilyn Ward

I have reviewed this document
2008.05.15 16:44:30 -04'00'

Branch Chief:
Initiator (Tax Law Specialist): Melody

DeVoe

The information in this document can be used to develop any necessary Work Requests.
This notification is for changes due to:
Legislation or Chief Counsel guidance:
✔ A Program change initiated by: Suggestions from National Taxpayer Advocate and IRPAC

The major changes are as follows:
The CREDITOR's name box has been changed for the addition of a central telephone number for debtors to use to communicate
with the creditor for problems and concerns with the canceled debt. NTA, IRPAC, and Sr. Tech Advisor
Boxes 1, 2, and 3 have been repositioned and box 4 has been renamed "Debt description" and moved to the former box 1
placement. The lines for the old boxes 2, 3, and 4 have been removed to allow adequate space for the debt description.
The new box 5 has 2 check boxes to indicate whether or not the borrower was personally liable for the debt. NTA, IRPAC, and
Sr. Tech Advisor

We may need to make further changes that would require a work request.
✔ We do not anticipate the need for any further changes that would require a Work Request.

If you have any questions, please contact:
Name: Melody G. DeVoe

Name: Dave Needle

Title:

Title:

Tax Law Specialist

Tax Law Specialist (Reviewer)

Symbols: SE:W:CAR:MP:T:I:P

Symbols: SE:W:CAR:MP:T:I:R

Phone: 202-283-7635

Phone: 202-622-4009

Email: [email protected]

Email: [email protected]

Room: C7-143 NCFB

Room: 6429

TLS, have you
transmitted all R
text files for this
cycle update?

Date

Page 1 of 6 of Form 1099-C (Page 2 is blank)

Action

1

The type and rule above prints on all proofs including departmental
reproduction proofs. MUST be removed before printing.

8585

VOID

Revised proofs
requested

1 Date canceled

0.3 in

2 Amount of debt canceled
$
3 Interest if included in box 2
$

0.3 in

0.4 in

CORRECTED

CREDITOR’S name, street address, city, state, and ZIP code

OMB No. 1545-1424

2009

unshade

Form
CREDITOR’S federal identification number

Signature

O.K. to print
Responsible
scan organization

Separation 1 for page 1 of Form 1099-C (2005). Prints in
Red (J-6983) Ink.
Separation 2 for page 1 of Form 1099-C (2005). Prints in Black Ink.

ZIP code, and telephone no.

Date

O.K. to print
T:FP:F

DEBTOR’S identification number

DEBTOR’S name

1099-C

1 Date canceled

2 Amount of debt canceled

4 Debt description

$

3 Interest if included in box 2 4

unshade

Cancellation
of Debt
remove lines
Copy A
For
Internal Revenue
Service Center

File with Form 1096.
For Privacy Act
5 Debt description
and Paperwork
Was borrower personally liable for repayment of the debt?
Reduction Act
Notice, see the
2009 General
Yes
No
Instructions for
Forms 1099, 1098,
6 Check for bankruptcy
7 Fair market value of property
5498, and W-2G.
$

$

Street address (including apt. no.)

City, state, and ZIP code

new inserts

Account number (see instructions)

Form

1099-C

Cat. No. 26280W

Do Not Cut or Separate Forms on This Page

—

Department of the Treasury - Internal Revenue Service

Do Not Cut or Separate Forms on This Page

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