Form 1099-A Acquisition or Abondonment of Secured Property

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 downloaded from this website. The official printed
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is not. A penalty may be imposed for filing forms that can’t be scanned. See part O in the
current General Instructions for Certain Information Returns for more information about
penalties.
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See IRS Publications 1141, 1167, 1179 and other IRS resources for information about
printing these tax forms.

8080

VOID

CORRECTED
OMB No. 1545-0877

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

2012

Acquisition or
Abandonment of
Secured Property

Form 1099-A
LENDER’S federal identification number

BORROWER’S identification number

1 Date of lender's acquisition or
knowledge of abandonment

2 Balance of principal
outstanding

$
BORROWER’S name

3

4 Fair market value of property

Copy A
For
Internal Revenue
Service Center
File with Form 1096.

$
Street address (including apt. no.)

5 Check here if the borrower was personally liable for
repayment of the debt
. . . . . . . .▶

City, state, and ZIP code

6 Description of property

Account number (see instructions)

For Privacy Act
and Paperwork
Reduction Act
Notice, see the
2012 General
Instructions for
Certain
Information
Returns.

1099-A
Cat. No. 14412G
Department of the Treasury - Internal Revenue Service
Do Not Cut or Separate Forms on This Page — Do Not Cut or Separate Forms on This Page

Form

CORRECTED (if checked)
OMB No. 1545-0877

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

2012

Acquisition or
Abandonment of
Secured Property

Form 1099-A
LENDER’S federal identification number

BORROWER’S name

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

1099-A

BORROWER’S identification number

1 Date of lender's acquisition or
knowledge of abandonment

2 Balance of principal
outstanding

Copy B
For Borrower

This is important tax
$
information and is being
4 Fair market value of property furnished to the Internal
Revenue Service. If you
are required to file a
$
return, a negligence
5 If checked, the borrower was personally liable for
penalty or other
repayment of the debt
. . . . . . . .▶
sanction may be
imposed on you if
6 Description of property
taxable income results
from this transaction
and the IRS determines
that it has not been
reported.
3

(keep for your records)

Department of the Treasury - Internal Revenue Service

Instructions for Borrower
Certain lenders who acquire an interest in property that was security for a
loan or who have reason to know that such property has been abandoned
must provide you with this statement. You may have reportable income or
loss because of such acquisition or abandonment. Gain or loss from an
acquisition generally is measured by the difference between your adjusted
basis in the property and the amount of your debt canceled in exchange
for the property, or, if greater, the sale proceeds. If you abandoned the
property, you may have income from the discharge of indebtedness in the
amount of the unpaid balance of your canceled debt. The tax
consequences of abandoning property depend on whether or not you were
personally liable for the debt. Losses on acquisitions or abandonments of
property held for personal use are not deductible. See Pub. 4681 for
information about your tax consequences.
Property means any real property (such as a personal residence); any
intangible property; and tangible personal property that is held for
investment or used in a trade or business.
If you borrowed money on this property with someone else, each of you
should receive this statement.
Borrower’s identification number. For your protection, this form may
show only the last four digits of your social security number (SSN),
individual taxpayer identification number (ITIN), or adoption taxpayer
identification number (ATIN). However, the issuer has reported your
complete identification number to the IRS and, where applicable, to state
and/or local governments.

Account number. May show an account or other unique number the
lender assigned to distinguish your account.
Box 1. For a lender’s acquisition of property that was security for a loan,
the date shown is generally the earlier of the date title was transferred to
the lender or the date possession and the burdens and benefits of
ownership were transferred to the lender. This may be the date of a
foreclosure or execution sale or the date your right of redemption or
objection expired. For an abandonment, the date shown is the date on
which the lender first knew or had reason to know that the property was
abandoned or the date of a foreclosure, execution, or similar sale.
Box 2. Shows the debt (principal only) owed to the lender on the loan
when the interest in the property was acquired by the lender or on the date
the lender first knew or had reason to know that the property was
abandoned.
Box 4. Shows the fair market value of the property. If the amount in box 4
is less than the amount in box 2, and your debt is canceled, you may have
cancellation of debt income. If the property was your main home, see Pub.
523 to figure any taxable gain or ordinary income.
Box 5. Shows whether you were personally liable for repayment of the
debt when the debt was created or, if modified, when it was last modified.
Box 6. Shows the description of the property acquired by the lender or
abandoned by you. If “CCC” is shown, the form indicates the amount of
any Commodity Credit Corporation loan outstanding when you forfeited
your commodity.

VOID

CORRECTED
OMB No. 1545-0877

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

2012

Acquisition or
Abandonment of
Secured Property

Form 1099-A

1 Date of lender's acquisition or
knowledge of abandonment

2 Balance of principal
outstanding

BORROWER’S name

3

4 Fair market value of property

Street address (including apt. no.)

5 Check here if the borrower was personally liable for
repayment of the debt
. . . . . . . .▶

City, state, and ZIP code

6 Description of property

LENDER’S federal identification number

BORROWER’S identification number

Copy C
For Lender

$
$

Account number (see instructions)
Form

1099-A

For Privacy Act
and Paperwork
Reduction Act
Notice, see the
2012 General
Instructions for
Certain
Information
Returns.

Department of the Treasury - Internal Revenue Service

Instructions for Lender
General and specific form instructions are provided as
separate products. The products you should use to complete
Form 1099-A are the 2012 General Instructions for Certain
Information Returns and the 2012 Instructions for Forms 1099A and 1099-C. 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 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, 1097, 1098, 1099,
3921, 3922, or 5498 that you print from the IRS website.
Due dates. Furnish Copy B of this form to the borrower by
January 31, 2013.
File Copy A of this form with the IRS by February 28, 2013.
If you file electronically, the due date is April 1, 2013. To file
electronically, you must have software that generates a file

according to the specifications in Pub. 1220, Specifications for
Filing Forms 1097, 1098, 1099, 3921, 3922, 5498, 8935, and
W-2G Electronically. IRS does not provide a fill-in form option.
Need help? If you have questions about reporting on Form
1099-A, 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). The
hours of operation are Monday through Friday from 8:30 a.m.
to 4:30 p.m. Eastern time.
Future developments. The IRS has created a page on
IRS.gov for information about Form 1099-A and its instructions,
at www.irs.gov/form1099a. Information about any future
developments affecting Form 1099-A (such as legislation
enacted after we release it) will be posted on that page.