Form 1098-MA Mortgage Assistance Payments

Version A, Cycle 2

VOID

CORRECTED

Filer's name, street address, city, state, ZIP code, and telephone no.

OMB No. 1545-xxxx

2011
Form
Filer's federal identification no.
Homeowner's name

DRAFT AS OF
August 1, 2011
Homeowner's federal identification number

1. Total State HFA/HUD and homeowner mortgage payments
$
2. State HFA/HUD mortgage assistance payments
$
3. Homeowner mortgage payments
$

Street address (including apt. no.)
City, state, and ZIP code
Account number

Form 1098-MA

1098-MA

Cat. No. 58017D

Do Not Cut or Separate Forms on This Page

Mortgage
Assistance
Payments
Copy A
For
Internal Revenue
Service Center
For Privacy Act
and Paperwork
Reduction Act
Notice, see
the 2011 General
Instructions for
Certain Information
Returns.

Department of the Treasury - Internal Revenue Service

—

Do Not Cut or Separate Forms on This Page

Version A, Cycle 2

CORRECTED (if checked)
Filer's name, street address, city, state, ZIP code, and telephone no.

OMB No. 1545-xxxx

2011
Form
Filer's federal identification no.
Homeowner's name

DRAFT AS OF
August 1, 2011
Homeowner's federal identification number

1. Total State HFA/HUD and homeowner mortgage payments
$
2. State HFA/HUD mortgage assistance payments
$
3. Homeowner mortgage payments
$

Street address (including apt. no.)
City, state, and ZIP code

1098-MA

Mortgage
Assistance
Payments
Copy B
For Homeowner
This is important
tax information
and is being
furnished to the
Internal Revenue
Service.

Account number

Form 1098-MA

(keep for your records)

Department of the Treasury - Internal Revenue Service

Version A, Cycle 2

Instructions for Homeowner
The information on this statement is submitted to the
Internal Revenue Service by State Housing Finance
Agencies (HFAs), the Department of Housing and Urban
Development's (HUD) Emergency Homeowner's Loan
Program (EHLP), or any existing state program receiving
funding from the EHLP to report payment(s) made by you
(homeowner mortgage payments) and with funds
allocated from the Housing Finance Agency Innovative
Fund for the Hardest-Hit Housing Markets (HFA Hardest
Hit Fund).
You can deduct only the amount equal to the sum of all
payments you actually made during the year to your
mortgage servicer, the State HFA, or HUD on the home

mortgage (including the amount shown in box 3), but not
in excess of the sum of the amounts shown on Form
1098, Mortgage Interest Statement, in boxes 1 (Mortgage
interest received), 4 (Mortgage insurance premiums), and
5 (Real property taxes).

DRAFT AS OF
August 1, 2011

Box 1. Shows the total amount of State HFA/HUD
mortgage assistance payments and homeowner
mortgage payments.
Boxes 2. Shows the amount of State HFA/HUD mortgage
assistance payments.
Box 3. Shows the amount of homeowner mortgage
payments.

Version A, Cycle 2

VOID

CORRECTED

Filer's name, street address, city, state, ZIP code, and telephone no.

OMB No. 1545-xxxx

2011
Form
Filer's federal identification no.
Homeowner's name

DRAFT AS OF
August 1, 2011
Homeowner's federal identification number

1. Total State HFA/HUD and homeowner mortgage payments
$
2. State HFA/HUD mortgage assistance payments
$
3. Homeowner mortgage payments
$

Street address (including apt. no.)
City, state, and ZIP code

1098-MA

Mortgage
Assistance
Payments
Copy C
For Filer
For Privacy Act
and Paperwork
Reduction Act
Notice, see
the 2011 General
Instructions for
Certain Information
Returns.

Account number

Form 1098-MA

Department of the Treasury - Internal Revenue Service

Version A, Cycle 2

Instructions for Filers
This form is used to provide information to the IRS and to
homeowners regarding mortgage payments made by the
homeowners and mortgage assistance payments made
by you with funds allocated from the Housing Finance
Agency Innovative Fund for the Hardest-Hit Housing
Markets (HFA Hardest Hit Fund).
Due dates. Furnish Copy B of this form to the recipient
homeowner by January 31, 2012.

DRAFT AS OF
August 1, 2011

Form 1098-MA may not be filed electronically
with the IRS. File Copy A of this form with the
Internal Revenue Service by February 28, 2012.
CAUTION
Send Copy A (or a paper listing in lieu of
Copy A) to the following address.
Internal Revenue Service
XXXXXXX Service Center
Mail Stop ####
City, State, ZIP Code
[INDENT]

!
▲

In lieu of filing Copy A, you may file a paper listing that
contains the tax year; form name and number (2011 Form
1098-MA); filer name and homeowner names (listed
alphabetically); taxpayer identification numbers; and
corresponding reportable amounts in boxes 1, 2, and 3
for each reportable record. You may request an extension
of time for filing Copy A (or a paper listing in lieu of Copy
A) with the IRS by filing Form 8809, Application for
Extension of Time To File Information Returns, available
on IRS.gov.
Need help? If you have questions about reporting on
Form 1098-MA, 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 304-579-4827
(not toll free).

Department of the Treasury
Internal Revenue Service Center
Stop 6728AUSC
Austin, TX 73301