Exhibit E Form 1098-E — Internal Revenue Bulletin 2023-40

.45 in

	8484	.33 in .50 in VOID CORRECTED e, street address, city or town, state or OMB No. 1545-1576 Student n postal code, and telephone number 2023 Loan Interest 1 in Statement Form 1098-E BORROWER’S TIN 1 Student loan interest received by lender Copy A $ 2.80 in For Internal Revenue Service Center 2.83 in 3.40 in File with Form 1096. o.) For Privacy Act and
RECIPIE province,	NT’S/LENDER’S nam country, ZIP or foreig 3.33 in	e, street address, city or town, state or n postal code, and telephone number 1 in	e, street address, city or town, state or n postal code, and telephone number 1 in	e, street address, city or town, state or n postal code, and telephone number 1 in	e, street address, city or town, state or n postal code, and telephone number 1 in	e, street address, city or town, state or n postal code, and telephone number 1 in
RECIPIEN	T’S TIN		BORROWER’S TIN	BORROWER’S TIN	BORROWER’S TIN	Inter Se File wi For Copy A For nal Revenue rvice Center th Form 1096. Privacy Act and
RECIPIEN	1.70 in	1.70 in	1.70 in	1.70 in	1.70 in	1.70 in
BORROW	ER’S name	3.40 in	3.40 in		2.83 in	2.83 in
BORROW
Street ad	dress (including apt. n	o.)	o.)	o.)	o.)	o.)
Street ad					~~7.30 in ~~	~~Paper~~ Act In Certa ~~work Reduction~~ Notice, see the 2023 General structions for in Information Returns.
City or to	wn, state or province,	country, and ZIP or foreign postal code	country, and ZIP or foreign postal code	country, and ZIP or foreign postal code	country, and ZIP or foreign postal code	country, and ZIP or foreign postal code
Account number (see instructio	Account number (see instructio	ns)	ns)	2 Check if box 1 doesnotinclude loan origination fees and/or capitalized interest, and the loan was made before September 1, 2004 . . . . . . .	2 Check if box 1 doesnotinclude loan origination fees and/or capitalized interest, and the loan was made before September 1, 2004 . . . . . . .	2 Check if box 1 doesnotinclude loan origination fees and/or capitalized interest, and the loan was made before September 1, 2004 . . . . . . .
Form1098-E Do Not Cut or Se	Form1098-E Do Not Cut or Se	Cat. No. 25088U www.irs.gov/Form1098E Department of the Treasury - Internal parate Forms on This Page —Do Not Cut or Separate Forms on T Revenue Service his Page	Cat. No. 25088U www.irs.gov/Form1098E Department of the Treasury - Internal parate Forms on This Page —Do Not Cut or Separate Forms on T Revenue Service his Page	Cat. No. 25088U www.irs.gov/Form1098E Department of the Treasury - Internal parate Forms on This Page —Do Not Cut or Separate Forms on T Revenue Service his Page	Cat. No. 25088U www.irs.gov/Form1098E Department of the Treasury - Internal parate Forms on This Page —Do Not Cut or Separate Forms on T Revenue Service his Page	Cat. No. 25088U www.irs.gov/Form1098E Department of the Treasury - Internal parate Forms on This Page —Do Not Cut or Separate Forms on T Revenue Service his Page
8484	8484	.85 in VOID CORRECTED 8.00 4.75 in e, street address, city or town, state or n postal code, and telephone number 11.0 in OMB No. 1545-1576 2023 Form1098-E Loa o.) BORROWER’S TIN 1 Student loan interest received by lender $ Inter Se File wi For Paper country, and ZIP or foreign postal code ns) 2 Check if box 1 doesnotinclude loan origination fees and/or capitalized interest, and the loan was made before September 1, 2004 . . . . . . . Act In Certa in Student n Interest Statement Copy A For nal Revenue rvice Center th Form 1096. Privacy Act and work Reduction Notice, see the 2023 General structions for in Information Returns.	.85 in VOID CORRECTED 8.00 4.75 in e, street address, city or town, state or n postal code, and telephone number 11.0 in OMB No. 1545-1576 2023 Form1098-E Loa o.) BORROWER’S TIN 1 Student loan interest received by lender $ Inter Se File wi For Paper country, and ZIP or foreign postal code ns) 2 Check if box 1 doesnotinclude loan origination fees and/or capitalized interest, and the loan was made before September 1, 2004 . . . . . . . Act In Certa in Student n Interest Statement Copy A For nal Revenue rvice Center th Form 1096. Privacy Act and work Reduction Notice, see the 2023 General structions for in Information Returns.	.85 in VOID CORRECTED 8.00 4.75 in e, street address, city or town, state or n postal code, and telephone number 11.0 in OMB No. 1545-1576 2023 Form1098-E Loa o.) BORROWER’S TIN 1 Student loan interest received by lender $ Inter Se File wi For Paper country, and ZIP or foreign postal code ns) 2 Check if box 1 doesnotinclude loan origination fees and/or capitalized interest, and the loan was made before September 1, 2004 . . . . . . . Act In Certa in Student n Interest Statement Copy A For nal Revenue rvice Center th Form 1096. Privacy Act and work Reduction Notice, see the 2023 General structions for in Information Returns.	.85 in VOID CORRECTED 8.00 4.75 in e, street address, city or town, state or n postal code, and telephone number 11.0 in OMB No. 1545-1576 2023 Form1098-E Loa o.) BORROWER’S TIN 1 Student loan interest received by lender $ Inter Se File wi For Paper country, and ZIP or foreign postal code ns) 2 Check if box 1 doesnotinclude loan origination fees and/or capitalized interest, and the loan was made before September 1, 2004 . . . . . . . Act In Certa in Student n Interest Statement Copy A For nal Revenue rvice Center th Form 1096. Privacy Act and work Reduction Notice, see the 2023 General structions for in Information Returns.	.85 in VOID CORRECTED 8.00 4.75 in e, street address, city or town, state or n postal code, and telephone number 11.0 in OMB No. 1545-1576 2023 Form1098-E Loa o.) BORROWER’S TIN 1 Student loan interest received by lender $ Inter Se File wi For Paper country, and ZIP or foreign postal code ns) 2 Check if box 1 doesnotinclude loan origination fees and/or capitalized interest, and the loan was made before September 1, 2004 . . . . . . . Act In Certa in Student n Interest Statement Copy A For nal Revenue rvice Center th Form 1096. Privacy Act and work Reduction Notice, see the 2023 General structions for in Information Returns.
RECIPIENT’S/LENDER’S nam province, country, ZIP or foreig	RECIPIENT’S/LENDER’S nam province, country, ZIP or foreig	e, street address, city or town, state or n postal code, and telephone number 11.0 in	e, street address, city or town, state or n postal code, and telephone number 11.0 in	e, street address, city or town, state or n postal code, and telephone number 11.0 in	e, street address, city or town, state or n postal code, and telephone number 11.0 in	e, street address, city or town, state or n postal code, and telephone number 11.0 in
RECIPIENT’S TIN	RECIPIENT’S TIN		BORROWER’S TIN	BORROWER’S TIN	BORROWER’S TIN	Inter Se File wi For Paper Act In Certa Copy A For nal Revenue rvice Center th Form 1096. Privacy Act and work Reduction Notice, see the 2023 General structions for in Information Returns.
BORROWER’S name	BORROWER’S name
Street address (including apt. n	Street address (including apt. n	o.)	o.)	o.)	o.)	o.)
City or town, state or province,	City or town, state or province,	country, and ZIP or foreign postal code	country, and ZIP or foreign postal code	country, and ZIP or foreign postal code	country, and ZIP or foreign postal code	country, and ZIP or foreign postal code
Account number (see instructio	Account number (see instructio	ns)	ns)	2 Check if box 1 doesnotinclude loan origination fees and/or capitalized interest, and the loan was made before September 1, 2004 . . . . . . .	2 Check if box 1 doesnotinclude loan origination fees and/or capitalized interest, and the loan was made before September 1, 2004 . . . . . . .	2 Check if box 1 doesnotinclude loan origination fees and/or capitalized interest, and the loan was made before September 1, 2004 . . . . . . .
Form1098-E Do Not Cut or Se 8484	Form1098-E Do Not Cut or Se 8484	Cat. No. 25088U www.irs.gov/Form1098E Department of the Treasury - Internal parate Forms on This Page —Do Not Cut or Separate Forms on T VOID CORRECTED e, street address, city or town, state or n postal code, and telephone number OMB No. 1545-1576 2023 Loa Revenue Service his Page Form1098-E Student n Interest Statement o.) BORROWER’S TIN 1 Student loan interest received by lender $ Copy A For Internal Revenue Service Center File with Form 1096. For Privacy Act and Paperwork Reduction country, and ZIP or foreign postal code s) 2 Check if box 1 doesnotinclude loan origination fees and/or capitalized interest, and the loan was made before September 1, 2004 . . . . . . . Act Notice, see the 2023 General Instructions for Certain Information Returns.	Cat. No. 25088U www.irs.gov/Form1098E Department of the Treasury - Internal parate Forms on This Page —Do Not Cut or Separate Forms on T VOID CORRECTED e, street address, city or town, state or n postal code, and telephone number OMB No. 1545-1576 2023 Loa Revenue Service his Page Form1098-E Student n Interest Statement o.) BORROWER’S TIN 1 Student loan interest received by lender $ Copy A For Internal Revenue Service Center File with Form 1096. For Privacy Act and Paperwork Reduction country, and ZIP or foreign postal code s) 2 Check if box 1 doesnotinclude loan origination fees and/or capitalized interest, and the loan was made before September 1, 2004 . . . . . . . Act Notice, see the 2023 General Instructions for Certain Information Returns.	Cat. No. 25088U www.irs.gov/Form1098E Department of the Treasury - Internal parate Forms on This Page —Do Not Cut or Separate Forms on T VOID CORRECTED e, street address, city or town, state or n postal code, and telephone number OMB No. 1545-1576 2023 Loa Revenue Service his Page Form1098-E Student n Interest Statement o.) BORROWER’S TIN 1 Student loan interest received by lender $ Copy A For Internal Revenue Service Center File with Form 1096. For Privacy Act and Paperwork Reduction country, and ZIP or foreign postal code s) 2 Check if box 1 doesnotinclude loan origination fees and/or capitalized interest, and the loan was made before September 1, 2004 . . . . . . . Act Notice, see the 2023 General Instructions for Certain Information Returns.	Cat. No. 25088U www.irs.gov/Form1098E Department of the Treasury - Internal parate Forms on This Page —Do Not Cut or Separate Forms on T VOID CORRECTED e, street address, city or town, state or n postal code, and telephone number OMB No. 1545-1576 2023 Loa Revenue Service his Page Form1098-E Student n Interest Statement o.) BORROWER’S TIN 1 Student loan interest received by lender $ Copy A For Internal Revenue Service Center File with Form 1096. For Privacy Act and Paperwork Reduction country, and ZIP or foreign postal code s) 2 Check if box 1 doesnotinclude loan origination fees and/or capitalized interest, and the loan was made before September 1, 2004 . . . . . . . Act Notice, see the 2023 General Instructions for Certain Information Returns.	Cat. No. 25088U www.irs.gov/Form1098E Department of the Treasury - Internal parate Forms on This Page —Do Not Cut or Separate Forms on T VOID CORRECTED e, street address, city or town, state or n postal code, and telephone number OMB No. 1545-1576 2023 Loa Revenue Service his Page Form1098-E Student n Interest Statement o.) BORROWER’S TIN 1 Student loan interest received by lender $ Copy A For Internal Revenue Service Center File with Form 1096. For Privacy Act and Paperwork Reduction country, and ZIP or foreign postal code s) 2 Check if box 1 doesnotinclude loan origination fees and/or capitalized interest, and the loan was made before September 1, 2004 . . . . . . . Act Notice, see the 2023 General Instructions for Certain Information Returns.
RECIPIENT’S/LENDER’S nam province, country, ZIP or foreig	RECIPIENT’S/LENDER’S nam province, country, ZIP or foreig	e, street address, city or town, state or n postal code, and telephone number	e, street address, city or town, state or n postal code, and telephone number	e, street address, city or town, state or n postal code, and telephone number	e, street address, city or town, state or n postal code, and telephone number	e, street address, city or town, state or n postal code, and telephone number
RECIPIENT’S TIN	RECIPIENT’S TIN		BORROWER’S TIN	BORROWER’S TIN	BORROWER’S TIN	Copy A For Internal Revenue Service Center File with Form 1096. For Privacy Act and Paperwork Reduction Act Notice, see the 2023 General Instructions for Certain Information Returns.
BORROWER’Sname	BORROWER’Sname
Street address (including apt. n	Street address (including apt. n	o.)	o.)	o.)	o.)	o.)
City or town, state or province,	City or town, state or province,	country, and ZIP or foreign postal code	country, and ZIP or foreign postal code	country, and ZIP or foreign postal code	country, and ZIP or foreign postal code	country, and ZIP or foreign postal code
Account number (see instruction	Account number (see instruction	s)	s)	2 Check if box 1 doesnotinclude loan origination fees and/or capitalized interest, and the loan was made before September 1, 2004 . . . . . . .	2 Check if box 1 doesnotinclude loan origination fees and/or capitalized interest, and the loan was made before September 1, 2004 . . . . . . .	2 Check if box 1 doesnotinclude loan origination fees and/or capitalized interest, and the loan was made before September 1, 2004 . . . . . . .
Form1098-E	Form1098-E	Cat. No. 25088U www.irs.gov/Form1098E Department of the Treasury - Internal Revenue Service	Cat. No. 25088U www.irs.gov/Form1098E Department of the Treasury - Internal Revenue Service	Cat. No. 25088U www.irs.gov/Form1098E Department of the Treasury - Internal Revenue Service	Cat. No. 25088U www.irs.gov/Form1098E Department of the Treasury - Internal Revenue Service	Cat. No. 25088U www.irs.gov/Form1098E Department of the Treasury - Internal Revenue Service

October 2, 2023 1032 Bulletin No. 2023–40

Bulletin No. 2023–40 1033 October 2, 2023

October 2, 2023 1034 Bulletin No. 2023–40

ISSUER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.		ISSUER’S TIN		OMB No. 1545-2234 1098-Q Form (Rev. December 2019)
ISSUER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.	ISSUER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.	PARTICIPANT’S TIN	PARTICIPANT’S TIN	PARTICIPANT’S TIN	PARTICIPANT’S TIN
ISSUER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.	ISSUER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.	1aAnnuity amount on start date $	1aAnnuity amount on start date $	For calendar year 20	For calendar year 20
ISSUER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.	ISSUER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.	1bAnnuity start date	1bAnnuity start date	2 Check if start date may be accelerated	2 Check if start date may be accelerated

		3 Total premiums $	3 Total premiums $	4 FMV of QLAC $	4 FMV of QLAC $
PARTICIPANT’S name	PARTICIPANT’S name	5aJanuary $	dd	5bFebruary $	dd
PARTICIPANT’S name	PARTICIPANT’S name	5cMarch $	dd	5dApril $	dd
Street address (including apt. no.)	Street address (including apt. no.)	Street address (including apt. no.)	Street address (including apt. no.)	Street address (including apt. no.)	Street address (including apt. no.)
Street address (including apt. no.)	Street address (including apt. no.)	5eMay $	dd	5fJune $	dd
Street address (including apt. no.)	Street address (including apt. no.)	5gJuly $	dd	5hAugust $	dd
City or town, state or province, country, and ZIP or foreign postal code
City or town, state or province, country, and ZIP or foreign postal code	City or town, state or province, country, and ZIP or foreign postal code	5iSeptember $	dd	5jOctober $	dd
Account number (see instructions)	Plan number	Plan number	Plan number	Plan number	Plan number
Account number (see instructions)	Plan number	5kNovember $	dd	5lDecember $	dd
Name of plan	Plansponsor’s EIN	Plansponsor’s EIN	Plansponsor’s EIN	Plansponsor’s EIN	Plansponsor’s EIN

Bulletin No. 2023–40 1035 October 2, 2023

FILER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone number			1 Payments received for qualified tuition and related expenses $	OMB No. 1545-1574 2023 Form 1098-T
FILER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone number	FILER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone number	FILER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone number	2	2
FILER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone number	FILER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone number	FILER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone number
FILER’S employer identification no.	STUDENT’S TIN	STUDENT’S TIN	3	3
FILER’S employer identification no.	STUDENT’S TIN	STUDENT’S TIN
STUDENT’S name	STUDENT’S name	STUDENT’S name	4 Adjustments made for a prior year $	5 Scholarships or grants $
Street address (including apt. no.)	Street address (including apt. no.)	Street address (including apt. no.)	6 Adjustments to scholarships or grants for a prior year $	7 Checked if the amount in box 1 includes amounts for an academic period beginning January– March 2024
City or town, state or province, country, and ZIP or foreign postal code
Service Provider/Acct. No. (see instr.)	Service Provider/Acct. No. (see instr.)	8 Checked if at least half-time student	9 Checked if a graduate student	10Ins. contract reimb./refund $

8383 VOID CORRE				ECTED
FILER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone number	FILER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone number	FILER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone number	FILER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone number	1 Payments received for qualified tuition and related expenses $	OMB No. 1545-1574 2023 Form1098-T	OMB No. 1545-1574 2023 Form1098-T
FILER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone number	FILER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone number	FILER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone number	FILER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone number	2	2	2
FILER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone number	FILER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone number	FILER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone number	FILER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone number
FILER’S employer identification no.	STUDENT’S TIN	STUDENT’S TIN	STUDENT’S TIN	3	3	3
FILER’S employer identification no.	STUDENT’S TIN	STUDENT’S TIN
STUDENT’S name	STUDENT’S name	STUDENT’S name	STUDENT’S name	4 Adjustments made for a prior year $	5 Scholarships or grants $	5 Scholarships or grants $
Street address (including apt. no.)	Street address (including apt. no.)	Street address (including apt. no.)	Street address (including apt. no.)	6 Adjustments to scholarships or grants for a prior year $	7 Checked if the amount in box 1 includes amounts for an academic period beginning January– March 2024	7 Checked if the amount in box 1 includes amounts for an academic period beginning January– March 2024
City or town, state or province, country, and ZIP or foreign postal code
City or town, state or province, country, and ZIP or foreign postal code
Service Provider/Acct. No. (see instr.)	Service Provider/Acct. No. (see instr.)	8 Checked if at least half-time student	8 Checked if at least half-time student	9 Checked if a graduate student	10Ins. contract reimb./refund $	10Ins. contract reimb./refund $

FILER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone number			1 Payments received for qualified tuition and related expenses $	OMB No. 1545-1574 2023 Form 1098-T
FILER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone number	FILER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone number	FILER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone number	2	2	2
FILER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone number	FILER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone number	FILER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone number
FILER’S employer identification no.	STUDENT’S TIN	STUDENT’S TIN	3	3	3
FILER’S employer identification no.	STUDENT’S TIN	STUDENT’S TIN
STUDENT’S name	STUDENT’S name	STUDENT’S name	4 Adjustments made for a prior year $	5 Scholarships or grants $	5 Scholarships or grants $
Street address (including apt. no.)	Street address (including apt. no.)	Street address (including apt. no.)	6 Adjustments to scholarships or grants for a prior year $	7 Checked if the amount in box 1 includes amounts for an academic period beginning January– March 2024	7 Checked if the amount in box 1 includes amounts for an academic period beginning January– March 2024
City or town, state or province, country, and ZIP or foreign postal code
City or town, state or province, country, and ZIP or foreign postal code
Service Provider/Acct. No. (see instr.)	Service Provider/Acct. No. (see instr.)	8 Checked if at least half-time student	9 Checked if a graduate student	10Ins. contract reimb./refund $	10Ins. contract reimb./refund $

October 2, 2023 1036 Bulletin No. 2023–40

Bulletin No. 2023–40 1037 October 2, 2023

PAYER’S name, street address, city or town, state or pro vince, country, ZIP or foreign postal code, and telephone no.						Applicable checkbox on Form 8949		OMB No. 1545-0715 2023 Form 1099-B
PAYER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.	PAYER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.	PAYER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.	PAYER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.	PAYER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.	PAYER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.	1bDate acquired	1cDate sold or disposed	1cDate sold or disposed	1cDate sold or disposed	1cDate sold or disposed
PAYER’S TIN	PAYER’S TIN	RECIPIENT’S TIN	RECIPIENT’S TIN	RECIPIENT’S TIN	RECIPIENT’S TIN	1dProceeds $	1eCost or other basis $	1eCost or other basis $	1eCost or other basis $	1eCost or other basis $
PAYER’S TIN	PAYER’S TIN	RECIPIENT’S TIN	RECIPIENT’S TIN	RECIPIENT’S TIN	RECIPIENT’S TIN	1fAccrued market discount $	1gWash sale loss disallowed $	1gWash sale loss disallowed $	1gWash sale loss disallowed $	1gWash sale loss disallowed $
RECIPIENT’S name	RECIPIENT’S name	RECIPIENT’S name	RECIPIENT’S name	RECIPIENT’S name	RECIPIENT’S name	2 Short-term gain or loss Long-term gain or loss Ordinary	3 Check if proceeds from: Collectibles QOF	3 Check if proceeds from: Collectibles QOF	3 Check if proceeds from: Collectibles QOF	3 Check if proceeds from: Collectibles QOF
Street address (including apt. no.)	Street address (including apt. no.)	Street address (including apt. no.)	Street address (including apt. no.)	Street address (including apt. no.)	Street address (including apt. no.)	4 Federal income tax withheld $	5 Check if noncovered security	5 Check if noncovered security	5 Check if noncovered security	5 Check if noncovered security
Street address (including apt. no.)	Street address (including apt. no.)	Street address (including apt. no.)	Street address (including apt. no.)	Street address (including apt. no.)	Street address (including apt. no.)	6 Reported to IRS: Gross proceeds Net proceeds	7 Check if loss is not allowed based on amount in 1d 2.60 in	7 Check if loss is not allowed based on amount in 1d 2.60 in	7 Check if loss is not allowed based on amount in 1d 2.60 in	7 Check if loss is not allowed based on amount in 1d 2.60 in
City or town, state or province, country, and ZIP or foreign postal code 0.60 in
City or town, state or province, country, and ZIP or foreign postal code 0.60 in
City or town, state or province, country, and ZIP or foreign postal code 0.60 in	City or town, state or province, country, and ZIP or foreign postal code 0.60 in	City or town, state or province, country, and ZIP or foreign postal code 0.60 in	City or town, state or province, country, and ZIP or foreign postal code 0.60 in	City or town, state or province, country, and ZIP or foreign postal code 0.60 in	City or town, state or province, country, and ZIP or foreign postal code 0.60 in	8 Profit or (loss) realized in 2023 on closed contracts $	9 Unrealized profit or (loss) on open contracts—12/31/2022 $	9 Unrealized profit or (loss) on open contracts—12/31/2022 $	9 Unrealized profit or (loss) on open contracts—12/31/2022 $	9 Unrealized profit or (loss) on open contracts—12/31/2022 $
Account number (see instructions)	Account number (see instructions)	Account number (see instructions)	Account number (see instructions)	Account number (see instructions)	2nd TIN not.	2nd TIN not.	2nd TIN not.	2nd TIN not.	2nd TIN not.	2nd TIN not.
CUSIP number	CUSIP number	CUSIP number	CUSIP number	FATCA filing requirement	FATCA filing requirement	10Unrealized profit or (loss) on open contracts—12/31/2023	11Aggregate profit or (loss) on contracts	11Aggregate profit or (loss) on contracts	11Aggregate profit or (loss) on contracts	11Aggregate profit or (loss) on contracts
CUSIP number	CUSIP number	CUSIP number	CUSIP number	FATCA filing requirement	FATCA filing requirement	$	4.20 in $	4.20 in $	4.20 in $	4.20 in $
14State name	15 State identification no.	15 State identification no.	16State tax withheld $	16State tax withheld $	16State tax withheld $	16State tax withheld $	16State tax withheld $	16State tax withheld $	16State tax withheld $	16State tax withheld $
14State name	15 State identification no.	15 State identification no.	16State tax withheld $	16State tax withheld $	16State tax withheld $	12Check if basis reported to IRS	13Bartering $ 1.56 in	13Bartering $ 1.56 in	13Bartering $ 1.56 in	13Bartering $ 1.56 in
			$	$	$	$	$	$	$	$

PAYER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.						Applicable checkbox on Form 8949				OMB No. 1545-0715 2023 Form 1099-B
PAYER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.	PAYER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.	PAYER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.	PAYER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.	PAYER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.	PAYER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.	1bDate acquired	1bDate acquired	1bDate acquired	1cDate sold or disposed	1cDate sold or disposed
PAYER’S TIN	PAYER’S TIN	RECIPIENT’S TIN	RECIPIENT’S TIN	RECIPIENT’S TIN	RECIPIENT’S TIN	1dProceeds $	1dProceeds $	1dProceeds $	1eCost or other basis $	1eCost or other basis $

						1fAccrued market discount $	1fAccrued market discount $	1fAccrued market discount $	1gWash sale loss disallowed $	1gWash sale loss disallowed $
RECIPIENT’S name	RECIPIENT’S name	RECIPIENT’S name	RECIPIENT’S name	RECIPIENT’S name	RECIPIENT’S name	2 Short-term gain or loss Long-term gain or loss Ordinary			3 Check if proceeds from: Collectibles QOF	3 Check if proceeds from: Collectibles QOF
RECIPIENT’S name	RECIPIENT’S name	RECIPIENT’S name	RECIPIENT’S name	RECIPIENT’S name	RECIPIENT’S name	2 Short-term gain or loss Long-term gain or loss Ordinary
RECIPIENT’S name	RECIPIENT’S name	RECIPIENT’S name	RECIPIENT’S name	RECIPIENT’S name	RECIPIENT’S name	2 Short-term gain or loss Long-term gain or loss Ordinary
Street address (including apt. no.)	Street address (including apt. no.)	Street address (including apt. no.)	Street address (including apt. no.)	Street address (including apt. no.)	Street address (including apt. no.)	4 Federal income tax withheld $	4 Federal income tax withheld $	4 Federal income tax withheld $	5 Check if noncovered security	5 Check if noncovered security
Street address (including apt. no.)	Street address (including apt. no.)	Street address (including apt. no.)	Street address (including apt. no.)	Street address (including apt. no.)	Street address (including apt. no.)	6 Reported to IRS: Gross proceeds Net proceeds	6 Reported to IRS: Gross proceeds Net proceeds	6 Reported to IRS: Gross proceeds Net proceeds	7 Check if loss is not allowed based on amount in 1d	7 Check if loss is not allowed based on amount in 1d

PAYER’S name, street address, city or town, state or pro vince, country, ZIP or foreign postal code, and telephone no.						Applicable checkbox on Form 8949		OMB No. 1545-0715 2023 Form 1099-B
City or town, state or province, country, and ZIP or foreign postal code
City or town, state or province, country, and ZIP or foreign postal code	City or town, state or province, country, and ZIP or foreign postal code	City or town, state or province, country, and ZIP or foreign postal code	City or town, state or province, country, and ZIP or foreign postal code	City or town, state or province, country, and ZIP or foreign postal code	City or town, state or province, country, and ZIP or foreign postal code	8 Profit or (loss) realized in 2023 on closed contracts $	8 Profit or (loss) realized in 2023 on closed contracts $	8 Profit or (loss) realized in 2023 on closed contracts $	9 Unrealized profit or (loss) on open contracts—12/31/2022 $	9 Unrealized profit or (loss) on open contracts—12/31/2022 $
Account number (see instructions)	Account number (see instructions)	Account number (see instructions)	Account number (see instructions)	Account number (see instructions)	2nd TIN not.	2nd TIN not.	2nd TIN not.	2nd TIN not.	2nd TIN not.	2nd TIN not.
CUSIP number	CUSIP number	CUSIP number	CUSIP number	FATCA filing requirement	FATCA filing requirement	10Unrealized profit or (loss) on open contracts—12/31/2023 $	10Unrealized profit or (loss) on open contracts—12/31/2023 $	10Unrealized profit or (loss) on open contracts—12/31/2023 $	11Aggregate profit or (loss) on contracts $	11Aggregate profit or (loss) on contracts $
14State name	15State identification no.	15State identification no.	16State tax withheld $ $	16State tax withheld $ $	16State tax withheld $ $	16State tax withheld $ $	16State tax withheld $ $	16State tax withheld $ $	16State tax withheld $ $	16State tax withheld $ $
14State name	15State identification no.	15State identification no.	16State tax withheld $ $	16State tax withheld $ $	16State tax withheld $ $	12Check if basis reported to IRS	12Check if basis reported to IRS	12Check if basis reported to IRS	13Bartering $	13Bartering $

October 2, 2023 1038 Bulletin No. 2023–40

Bulletin No. 2023–40 1039 October 2, 2023

9191 VOID CORREC			CTED
PAYER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.	PAYER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.	PAYER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.	1aTotal ordinary dividends $	1aTotal ordinary dividends $	OMB No. 1545-0110 Form1099-DIV (Rev. January 2022)
PAYER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.	PAYER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.	PAYER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.	1bQualified dividends $	1bQualified dividends $	1bQualified dividends $
PAYER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.	PAYER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.	PAYER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.	1bQualified dividends $	1bQualified dividends $	For calendar year 20
PAYER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.	PAYER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.	PAYER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.	2aTotal capital gain distr. $	2aTotal capital gain distr. $	2bUnrecap. Sec. 1250 gain $
PAYER’S TIN	RECIPIENT’S TIN	RECIPIENT’S TIN	2cSection 1202 gain $	2cSection 1202 gain $	2dCollectibles (28%) gain $

			2e Section 897 ordinary dividends $	2e Section 897 ordinary dividends $	2fSection 897 capital gain $
RECIPIENT’S name	RECIPIENT’S name	RECIPIENT’S name	3Nondividend distributions $	3Nondividend distributions $	4 Federal income tax withheld $
RECIPIENT’S name	RECIPIENT’S name	RECIPIENT’S name	5 Section 199A dividends $	5 Section 199A dividends $	6Investment expenses $
Street address (including apt. no.)	Street address (including apt. no.)	Street address (including apt. no.)	Street address (including apt. no.)	Street address (including apt. no.)	Street address (including apt. no.)
Street address (including apt. no.)	Street address (including apt. no.)	Street address (including apt. no.)	7 Foreign tax paid $	7 Foreign tax paid $	8 Foreign country or U.S. possession
City or town, state or province, country, and ZIP or foreign postal code
City or town, state or province, country, and ZIP or foreign postal code	City or town, state or province, country, and ZIP or foreign postal code	City or town, state or province, country, and ZIP or foreign postal code	9 Cash liquidation distributions $	9 Cash liquidation distributions $	10 Noncash liquidation distributions $
		11FATCA filing requirement	12Exempt-interest dividends $	12Exempt-interest dividends $	13Specified private activity bond interest dividends $
Account number (see instructions)	Account number (see instructions)	2nd TIN not.	14State	15 State identification no.	16State tax withheld $ $
PAYER’S name, street address, city or town, stateor province, country, ZIP or foreign postal code, and telephone no.	PAYER’S name, street address, city or town, stateor province, country, ZIP or foreign postal code, and telephone no.	PAYER’S name, street address, city or town, stateor province, country, ZIP or foreign postal code, and telephone no.	1aTotal ordinary dividends $	1aTotal ordinary dividends $	OMB No. 1545-0110 Form1099-DIV (Rev. January 2022)
PAYER’S name, street address, city or town, stateor province, country, ZIP or foreign postal code, and telephone no.	PAYER’S name, street address, city or town, stateor province, country, ZIP or foreign postal code, and telephone no.	PAYER’S name, street address, city or town, stateor province, country, ZIP or foreign postal code, and telephone no.	1bQualified dividends $	1bQualified dividends $	1bQualified dividends $
PAYER’S name, street address, city or town, stateor province, country, ZIP or foreign postal code, and telephone no.	PAYER’S name, street address, city or town, stateor province, country, ZIP or foreign postal code, and telephone no.	PAYER’S name, street address, city or town, stateor province, country, ZIP or foreign postal code, and telephone no.	1bQualified dividends $	1bQualified dividends $	For calendar year 20
PAYER’S name, street address, city or town, stateor province, country, ZIP or foreign postal code, and telephone no.	PAYER’S name, street address, city or town, stateor province, country, ZIP or foreign postal code, and telephone no.	PAYER’S name, street address, city or town, stateor province, country, ZIP or foreign postal code, and telephone no.	2aTotal capital gain distr. $	2aTotal capital gain distr. $	2bUnrecap. Sec. 1250 gain $
PAYER’S TIN	RECIPIENT’S TIN	RECIPIENT’S TIN	2cSection 1202 gain $	2cSection 1202 gain $	2dCollectibles (28%) gain $

			2e Section 897 ordinary dividends $	2e Section 897 ordinary dividends $	2fSection 897 capital gain $
RECIPIENT’S name	RECIPIENT’S name	RECIPIENT’S name	3Nondividend distributions $	3Nondividend distributions $	4 Federal income tax withheld $
RECIPIENT’S name	RECIPIENT’S name	RECIPIENT’S name	5 Section 199A dividends $	5 Section 199A dividends $	6Investment expenses $
Street address (including apt. no.)	Street address (including apt. no.)	Street address (including apt. no.)	Street address (including apt. no.)	Street address (including apt. no.)	Street address (including apt. no.)
Street address (including apt. no.)	Street address (including apt. no.)	Street address (including apt. no.)	7 Foreign tax paid $	7 Foreign tax paid $	8 Foreign country or U.S. possession
City or town, state or province, country, and ZIP or foreign postal code
City or town, state or province, country, and ZIP or foreign postal code	City or town, state or province, country, and ZIP or foreign postal code	City or town, state or province, country, and ZIP or foreign postal code	9 Cash liquidation distributions $	9 Cash liquidation distributions $	10 Noncash liquidation distributions $
		11FATCA filing requirement	12Exempt-interest dividends $	12Exempt-interest dividends $	13Specified private activity bond interest dividends $
Account number (see instructions)	Account number (see instructions)	2nd TIN not.	14State	15 State identification no.	16State tax withheld $ $

October 2, 2023 1040 Bulletin No. 2023–40

Bulletin No. 2023–40 1041 October 2, 2023

9292 VOID CORREC			CTE D
PAYER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.	PAYER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.	PAYER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.	Paye r’s RTN (optional)	OMB No. 1545-0112 Form1099-INT (Rev. January 2022)	OMB No. 1545-0112 Form1099-INT (Rev. January 2022)
PAYER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.	PAYER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.	PAYER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.	1 Int $ erest income	1 Int $ erest income	1 Int $ erest income
PAYER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.	PAYER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.	PAYER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.	1 Int $ erest income	For calendar year 20	For calendar year 20
PAYER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.	PAYER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.	PAYER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.	2 Ea $ rly withdrawal penalty	2 Ea $ rly withdrawal penalty	2 Ea $ rly withdrawal penalty
PAYER’S TIN	RECIPIENT’S TIN	RECIPIENT’S TIN	RECIPIENT’S TIN	RECIPIENT’S TIN	RECIPIENT’S TIN
			3 Int $ erest on U.S. Savings Bonds and Treasury obligations	3 Int $ erest on U.S. Savings Bonds and Treasury obligations	3 Int $ erest on U.S. Savings Bonds and Treasury obligations
RECIPIENT’S name	RECIPIENT’S name	RECIPIENT’S name	4 Fe $ deral income tax withheld	5 Investment expenses $	5 Investment expenses $
RECIPIENT’S name	RECIPIENT’S name	RECIPIENT’S name	6 Fo $ reign tax paid	7 Foreign country or U.S. possession	7 Foreign country or U.S. possession
Street address (including apt. no.)	Street address (including apt. no.)	Street address (including apt. no.)	Street address (including apt. no.)	Street address (including apt. no.)	Street address (including apt. no.)
Street address (including apt. no.)	Street address (including apt. no.)	Street address (including apt. no.)	8 Ta $ x-exempt interest	9 Specifed private activity bond interest $	9 Specifed private activity bond interest $
City or town, state or province, country, and ZIP or foreign postal code
City or town, state or province, country, and ZIP or foreign postal code	City or town, state or province, country, and ZIP or foreign postal code	City or town, state or province, country, and ZIP or foreign postal code	10M $ arket discount	11Bond premium $	11Bond premium $
		FATCA fling requirement	FATCA fling requirement	FATCA fling requirement	FATCA fling requirement
		FATCA fling requirement	12 Bond $ premium on Treasury obligations	13 Bond premium on tax-exempt bond $	13 Bond premium on tax-exempt bond $
Account number (see instructions)	Account number (see instructions)	2nd TIN not.	14Tax bo -exempt and tax credit nd CUSIP no.	15State	16 State identifcation no.
PAYER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.	PAYER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.	PAYER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.	Paye r’s RTN (optional)	OMB No. 1545-0112 Form1099-INT (Rev. January 2022)	OMB No. 1545-0112 Form1099-INT (Rev. January 2022)
PAYER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.	PAYER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.	PAYER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.	1 Int $ erest income	1 Int $ erest income	1 Int $ erest income
PAYER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.	PAYER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.	PAYER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.	1 Int $ erest income	For calendar year 20	For calendar year 20
PAYER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.	PAYER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.	PAYER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.	2 Ea $ rly withdrawal penalty	2 Ea $ rly withdrawal penalty	2 Ea $ rly withdrawal penalty
PAYER’S TIN	RECIPIENT’S TIN	RECIPIENT’S TIN	RECIPIENT’S TIN	RECIPIENT’S TIN	RECIPIENT’S TIN
			3 Int $ erest on U.S. Savings Bonds and Treasury obligations	3 Int $ erest on U.S. Savings Bonds and Treasury obligations	3 Int $ erest on U.S. Savings Bonds and Treasury obligations
RECIPIENT’S name	RECIPIENT’S name	RECIPIENT’S name	4 Fe $ deral income tax withheld	5 Investment expenses $	5 Investment expenses $
RECIPIENT’S name	RECIPIENT’S name	RECIPIENT’S name	6 Foreign tax paid $	7 Foreign country or U.S. possession	7 Foreign country or U.S. possession
Street address (including apt. no.)	Street address (including apt. no.)	Street address (including apt. no.)	Street address (including apt. no.)	Street address (including apt. no.)	Street address (including apt. no.)
Street address (including apt. no.)	Street address (including apt. no.)	Street address (including apt. no.)	8 Tax-exempt interest $	9 Specifed private activity bond interest $	9 Specifed private activity bond interest $
City or town, state or province, country, and ZIP or foreign postal code
City or town, state or province, country, and ZIP or foreign postal code	City or town, state or province, country, and ZIP or foreign postal code	City or town, state or province, country, and ZIP or foreign postal code	10Market discount $	11Bond premium $	11Bond premium $
		FATCA fling requirement	FATCA fling requirement	FATCA fling requirement	FATCA fling requirement
		FATCA fling requirement	12 Bond premium on Treasury obligations $	13 Bond premium on tax-exempt bond $	13 Bond premium on tax-exempt bond $
Account number (see instructions)	Account number (see instructions)	2nd TIN not.	14Tax-exempt and tax credit bond CUSIP no.	15State	16 State identifcation no.

October 2, 2023 1042 Bulletin No. 2023–40

Bulletin No. 2023–40 1043 October 2, 2023

ACQUIRER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.		1 Amount paid to payment recipient $	OMB No. 1545-2281 1099-LS Form (Rev. December 2019)
ACQUIRER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.	ACQUIRER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.	2 Date of sale	2 Date of sale
ACQUIRER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.	ACQUIRER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.	2 Date of sale	For calendar year 20
ACQUIRER’S TIN	PAYMENTRECIPIENT’S TIN	Issuer’s name	Issuer’s name
PAYMENTRECIPIENT’S name	PAYMENTRECIPIENT’S name	Acquirer’s information contact name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no. (if different from ACQUIRER)	Acquirer’s information contact name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no. (if different from ACQUIRER)
Street address (including apt. no.)
City or town, state or province, country, and ZIP or foreign postal code
Policy number
ACQUIRER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.	ACQUIRER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.	2 Date of sale	2 Date of sale
ACQUIRER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.	ACQUIRER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.	2 Date of sale	For calendar year 20
ACQUIRER’S TIN	PAYMENTRECIPIENT’S TIN	Issuer’s name	Issuer’s name
PAYMENTRECIPIENT’S name	PAYMENTRECIPIENT’S name	Acquirer’s information contact name, street address,city or town, state or province, country, ZIP or foreign postal code, and telephone no. (if different from ACQUIRER)	Acquirer’s information contact name, street address,city or town, state or province, country, ZIP or foreign postal code, and telephone no. (if different from ACQUIRER)
Street address (including apt. no.)
City or town, state or province, country, and ZIP or foreign postal code
Policy number
ACQUIRER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.	ACQUIRER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.	2 Date of sale	2 Date of sale
ACQUIRER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.	ACQUIRER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.	2 Date of sale	For calendar year 20
ACQUIRER’S TIN	PAYMENTRECIPIENT’S TIN	Issuer’s name	Issuer’s name
PAYMENTRECIPIENT’S name	PAYMENTRECIPIENT’S name	Acquirer’s information contact name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no. (if different from ACQUIRER)	Acquirer’s information contact name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no. (if different from ACQUIRER)
Street address (including apt. no.)
City or town, state or province, country, and ZIP or foreign postal code
Policy number

October 2, 2023 1044 Bulletin No. 2023–40

Bulletin No. 2023–40 1045 October 2, 2023

PAYER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.					OMB No. 1545-0116 Form 1099-NEC (Rev. January 2022)
PAYER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.	PAYER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.	PAYER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.			For calendar year 20
PAYER’S TIN	RECIPIENT’S TIN	RECIPIENT’S TIN	1 Nonemployee compensation $	1 Nonemployee compensation $	1 Nonemployee compensation $
RECIPIENT’S name	RECIPIENT’S name	RECIPIENT’S name	2 Payer made direct sales totaling $5,000 or more of consumer products to recipient for resale	2 Payer made direct sales totaling $5,000 or more of consumer products to recipient for resale	2 Payer made direct sales totaling $5,000 or more of consumer products to recipient for resale
RECIPIENT’S name	RECIPIENT’S name	RECIPIENT’S name	3	3	3
Street address (including apt. no.)	Street address (including apt. no.)	Street address (including apt. no.)	Street address (including apt. no.)	Street address (including apt. no.)	Street address (including apt. no.)
Street address (including apt. no.)	Street address (including apt. no.)	Street address (including apt. no.)	4 Federal income tax withheld $	4 Federal income tax withheld $	4 Federal income tax withheld $
City or town, state or province, country, and ZIP or foreign postal code
City or town, state or province, country, and ZIP or foreign postal code	City or town, state or province, country, and ZIP or foreign postal code	City or town, state or province, country, and ZIP or foreign postal code	5 State tax withheld $ $	6 State/Payer’s state no.	6 State/Payer’s state no.
Account number (see instructions)	Account number (see instructions)	2nd TIN not.	2nd TIN not.	2nd TIN not.	2nd TIN not.
PAYER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.	PAYER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.	PAYER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.			For calendar year 20
PAYER’S TIN	RECIPIENT’S TIN	RECIPIENT’S TIN	1 Nonemployee compensation $	1 Nonemployee compensation $	1 Nonemployee compensation $
RECIPIENT’S name	RECIPIENT’S name	RECIPIENT’S name	2 Payer made direct sales totaling $5,000 or more of consumer products to recipient for resale	2 Payer made direct sales totaling $5,000 or more of consumer products to recipient for resale	2 Payer made direct sales totaling $5,000 or more of consumer products to recipient for resale
RECIPIENT’S name	RECIPIENT’S name	RECIPIENT’S name	3	3	3
Street address (including apt. no.)	Street address (including apt. no.)	Street address (including apt. no.)	Street address (including apt. no.)	Street address (including apt. no.)	Street address (including apt. no.)
Street address (including apt. no.)	Street address (including apt. no.)	Street address (including apt. no.)	4 Federal income tax withheld $	4 Federal income tax withheld $	4 Federal income tax withheld $
City or town, state or province, country, and ZIP or foreign postal code
City or town, state or province, country, and ZIP or foreign postal code	City or town, state or province, country, and ZIP or foreign postal code	City or town, state or province, country, and ZIP or foreign postal code	5 State tax withheld $ $	6 State/Payer’s state no.	6 State/Payer’s state no.
Account number (see instructions)	Account number (see instructions)	2nd TIN not.	2nd TIN not.	2nd TIN not.	2nd TIN not.
PAYER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.	PAYER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.	PAYER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.			For calendar year 20
PAYER’S TIN	RECIPIENT’S TIN	RECIPIENT’S TIN	1 Nonemployee compensation $	1 Nonemployee compensation $	1 Nonemployee compensation $
RECIPIENT’S name	RECIPIENT’S name	RECIPIENT’S name	2 Payer made direct sales totaling $5,000 or more of consumer products to recipient for resale	2 Payer made direct sales totaling $5,000 or more of consumer products to recipient for resale	2 Payer made direct sales totaling $5,000 or more of consumer products to recipient for resale
RECIPIENT’S name	RECIPIENT’S name	RECIPIENT’S name	3	3	3
Street address (including apt. no.)	Street address (including apt. no.)	Street address (including apt. no.)	Street address (including apt. no.)	Street address (including apt. no.)	Street address (including apt. no.)
Street address (including apt. no.)	Street address (including apt. no.)	Street address (including apt. no.)	4 Federal income tax withheld $	4 Federal income tax withheld $	4 Federal income tax withheld $
City or town, state or province, country, and ZIP or foreign postal code
City or town, state or province, country, and ZIP or foreign postal code	City or town, state or province, country, and ZIP or foreign postal code	City or town, state or province, country, and ZIP or foreign postal code	5 State tax withheld $ $	6 State/Payer’s state no.	6 State/Payer’s state no.
Account number (see instructions)	Account number (see instructions)	2nd TIN not.	2nd TIN not.	2nd TIN not.	2nd TIN not.

October 2, 2023 1046 Bulletin No. 2023–40

Bulletin No. 2023–40 1047 October 2, 2023

October 2, 2023 1048 Bulletin No. 2023–40

PAYER’S/TRUSTEE’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.		1 Gross distribution $		OMB No. 1545-1760 1099-Q Form (Rev. November 2019)
PAYER’S/TRUSTEE’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.	PAYER’S/TRUSTEE’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.	2 Earnings $	2 Earnings $	2 Earnings $
PAYER’S/TRUSTEE’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.	PAYER’S/TRUSTEE’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.	2 Earnings $	2 Earnings $	For calendar year 20
PAYER’S/TRUSTEE’S TIN	RECIPIENT’S TIN	3 Basis $	3 Basis $	4 Trustee-to-trustee transfer
RECIPIENT’S name	RECIPIENT’S name	5 Distribution is from: • Qualifed tuition program— Private ~~orState ~~ • Coverdell ESA	5 Distribution is from: • Qualifed tuition program— Private ~~orState ~~ • Coverdell ESA	benefciary 6 Check if the recipient is not the designated 3.30 in
RECIPIENT’S name	RECIPIENT’S name	5 Distribution is from: • Qualifed tuition program— Private ~~orState ~~ • Coverdell ESA		2.55 in
Street address (including apt. no.)
Street address (including apt. no.)
City or town, state or province, country, and ZIP or foreign postal code
Account number (see instructions)
PAYER’S/TRUSTEE’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.	PAYER’S/TRUSTEE’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.	2 Earnings $	2 Earnings $	2 Earnings $
PAYER’S/TRUSTEE’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.	PAYER’S/TRUSTEE’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.	2 Earnings $	2 Earnings $	For calendar year 20
PAYER’S/TRUSTEE’S TIN	RECIPIENT’S TIN	3 Basis $	3 Basis $	4 Trustee-to-trustee transfer
RECIPIENT’S name	RECIPIENT’S name	5 Distribution is from: • Qualifed tuition program— Private orState • Coverdell ESA	5 Distribution is from: • Qualifed tuition program— Private orState • Coverdell ESA	6 Check if the recipient is not the designated benefciary
RECIPIENT’S name	RECIPIENT’S name	5 Distribution is from: • Qualifed tuition program— Private orState • Coverdell ESA
Street address (including apt. no.)	Street address (including apt. no.)	Street address (including apt. no.)
Street address (including apt. no.)	Street address (including apt. no.)
City or town, state or province, country, and ZIP or foreign postal code
Account number (see instructions)	Account number (see instructions)	Account number (see instructions)	Account number (see instructions)	Account number (see instructions)
PAYER’S/TRUSTEE’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.	PAYER’S/TRUSTEE’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.	2 Earnings $	2 Earnings $	2 Earnings $
PAYER’S/TRUSTEE’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.	PAYER’S/TRUSTEE’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.	2 Earnings $	2 Earnings $	For calendar year 20
PAYER’S/TRUSTEE’S TIN	RECIPIENT’S TIN	3 Basis $	3 Basis $	4 Trustee-to-trustee transfer
RECIPIENT’S name	RECIPIENT’S name	5 Distribution is from: • Qualifed tuition program— Private orState • Coverdell ESA	5 Distribution is from: • Qualifed tuition program— Private orState • Coverdell ESA	6 Check if the recipient is not the designated benefciary
RECIPIENT’S name	RECIPIENT’S name	5 Distribution is from: • Qualifed tuition program— Private orState • Coverdell ESA
Street address (including apt. no.)	Street address (including apt. no.)	Street address (including apt. no.)
Street address (including apt. no.)	Street address (including apt. no.)
City or town, state or province, country, and ZIP or foreign postal code
Account number (see instructions)	Account number (see instructions)	Account number (see instructions)	Account number (see instructions)	Account number (see instructions)

Bulletin No. 2023–40 1049 October 2, 2023

9898 VOID CORREC				CTED
PAYER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.	PAYER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.	PAYER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.	PAYER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.	1 Gross distribution $	1 Gross distribution $	OMB No. 1545-0119 2023 Form1099-R	OMB No. 1545-0119 2023 Form1099-R
PAYER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.	PAYER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.	PAYER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.	PAYER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.	2aTaxable amount $	2aTaxable amount $	2aTaxable amount $	2aTaxable amount $
PAYER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.	PAYER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.	PAYER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.	PAYER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.	2bTaxable amount Total not determined distribution	2bTaxable amount Total not determined distribution	2bTaxable amount Total not determined distribution	2bTaxable amount Total not determined distribution
PAYER’S TIN	PAYER’S TIN	RECIPIENT’S TIN	RECIPIENT’S TIN	3 Capital gain (included in box 2a) $	3 Capital gain (included in box 2a) $	4 Federal income tax withheld $	4 Federal income tax withheld $
RECIPIENT’S name	RECIPIENT’S name	RECIPIENT’S name	RECIPIENT’S name	5 Employee contributions/ Designated Roth contributions or insurance premiums $	5 Employee contributions/ Designated Roth contributions or insurance premiums $	6 Net unrealized appreciation in employer’s securities $	6 Net unrealized appreciation in employer’s securities $
Street address (including apt. no.)	Street address (including apt. no.)	Street address (including apt. no.)	Street address (including apt. no.)	7 Distribution code(s)	IRA/ SEP/ SIMPLE	8 Other $	%
City or town, state or province, country, and ZIP or foreign postal code	City or town, state or province, country, and ZIP or foreign postal code	City or town, state or province, country, and ZIP or foreign postal code	City or town, state or province, country, and ZIP or foreign postal code	9aYour percentage of total distribution %	9aYour percentage of total distribution %	9b Total employee contributions $	9b Total employee contributions $
10Amount allocable to IRR within 5 years $	111st year of desig. Roth contrib.	111st year of desig. Roth contrib.	12FATCA filing requirement	14State tax withheld $ $	14State tax withheld $ $	15State/Payer’s state no.	15State/Payer’s state no.
Account number (see instructions)	Account number (see instructions)	Account number (see instructions)	13Date of payment	17Local tax withheld $ $	17Local tax withheld $ $	18Name of locality	18Name of locality
PAYER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.	PAYER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.	PAYER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.	PAYER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.	1 Gross distribution $	1 Gross distribution $	OMB No. 1545-0119 2023 Form1099-R	OMB No. 1545-0119 2023 Form1099-R
PAYER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.	PAYER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.	PAYER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.	PAYER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.	2aTaxable amount $	2aTaxable amount $	2aTaxable amount $	2aTaxable amount $
PAYER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.	PAYER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.	PAYER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.	PAYER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.	2bTaxable amount Total not determined distribution	2bTaxable amount Total not determined distribution	2bTaxable amount Total not determined distribution	2bTaxable amount Total not determined distribution
PAYER’S TIN	PAYER’S TIN	RECIPIENT’S TIN	RECIPIENT’S TIN	3 Capital gain (included in box 2a) $	3 Capital gain (included in box 2a) $	4 Federal income tax withheld $	4 Federal income tax withheld $
RECIPIENT’S name	RECIPIENT’S name	RECIPIENT’S name	RECIPIENT’S name	5 Employee contributions/ Designated Roth contributions or insurance premiums $	5 Employee contributions/ Designated Roth contributions or insurance premiums $	6 Net unrealized appreciation in employer’s securities $	6 Net unrealized appreciation in employer’s securities $
Street address (including apt. no.)	Street address (including apt. no.)	Street address (including apt. no.)	Street address (including apt. no.)	7 Distribution code(s)	IRA/ SEP/ SIMPLE	8 Other $	%
City or town, state or province, country, and ZIP or foreign postal code	City or town, state or province, country, and ZIP or foreign postal code	City or town, state or province, country, and ZIP or foreign postal code	City or town, state or province, country, and ZIP or foreign postal code	9aYour percentage of total distribution %	9aYour percentage of total distribution %	9b Total employee contributions $	9b Total employee contributions $
10Amount allocable to IRR within 5 years $	111st year of desig. Roth contrib.	111st year of desig. Roth contrib.	12FATCA filing requirement	14State tax withheld $ $	14State tax withheld $ $	15State/Payer’s state no.	15State/Payer’s state no.
Account number (see instructions)	Account number (see instructions)	Account number (see instructions)	13Date of payment	17Local tax withheld $ $	17Local tax withheld $ $	18Name of locality	18Name of locality

October 2, 2023 1050 Bulletin No. 2023–40

Bulletin No. 2023–40 1051 October 2, 2023

October 2, 2023 1052 Bulletin No. 2023–40

Bulletin No. 2023–40 1053 October 2, 2023

2828 VOID CORREC		CTED
TRUSTEE’S orISSUER’S name, street address, city or town, state or province, country, and ZIP or foreign postal code	TRUSTEE’S orISSUER’S name, street address, city or town, state or province, country, and ZIP or foreign postal code	1 $ IRA contributions (other than amounts in boxes 2–4, 8–10, 13a, and 14a)	1 $ IRA contributions (other than amounts in boxes 2–4, 8–10, 13a, and 14a)	1 $ IRA contributions (other than amounts in boxes 2–4, 8–10, 13a, and 14a)	1 $ IRA contributions (other than amounts in boxes 2–4, 8–10, 13a, and 14a)	1 $ IRA contributions (other than amounts in boxes 2–4, 8–10, 13a, and 14a)	OMB No. 1545-0747 2023 Form5498	OMB No. 1545-0747 2023 Form5498	OMB No. 1545-0747 2023 Form5498	OMB No. 1545-0747 2023 Form5498
TRUSTEE’S orISSUER’S name, street address, city or town, state or province, country, and ZIP or foreign postal code	TRUSTEE’S orISSUER’S name, street address, city or town, state or province, country, and ZIP or foreign postal code	2 Rollover contributions $	2 Rollover contributions $	2 Rollover contributions $	2 Rollover contributions $	2 Rollover contributions $	2 Rollover contributions $	2 Rollover contributions $	2 Rollover contributions $	2 Rollover contributions $
TRUSTEE’S orISSUER’S name, street address, city or town, state or province, country, and ZIP or foreign postal code	TRUSTEE’S orISSUER’S name, street address, city or town, state or province, country, and ZIP or foreign postal code	3 Roth IRA conversion amount $	3 Roth IRA conversion amount $	3 Roth IRA conversion amount $	3 Roth IRA conversion amount $	3 Roth IRA conversion amount $	4 Recharacterized contributions $	4 Recharacterized contributions $	4 Recharacterized contributions $	4 Recharacterized contributions $
TRUSTEE’S orISSUER’S TIN	PARTICIPANT’S TIN	PARTICIPANT’S TIN	PARTICIPANT’S TIN	PARTICIPANT’S TIN	PARTICIPANT’S TIN	PARTICIPANT’S TIN	PARTICIPANT’S TIN	PARTICIPANT’S TIN	PARTICIPANT’S TIN	PARTICIPANT’S TIN
		5 FMV of account	5 FMV of account	5 FMV of account	5 FMV of account	5 FMV of account	6 Life insurance cost included in box1 $	6 Life insurance cost included in box1 $	6 Life insurance cost included in box1 $	6 Life insurance cost included in box1 $

		$	$	$	$	$	$	$	$	$
PARTICIPANT’S name	PARTICIPANT’S name	7 IRA		SEP		SIMPLE	SIMPLE		Roth IRA
PARTICIPANT’S name	PARTICIPANT’S name	8 SEP contributions $	8 SEP contributions $	8 SEP contributions $	8 SEP contributions $	8 SEP contributions $	9 SIMPLE contributions $	9 SIMPLE contributions $	9 SIMPLE contributions $	9 SIMPLE contributions $
Street address (including apt. no.)	Street address (including apt. no.)	10 $ Roth IRA contributions	10 $ Roth IRA contributions	10 $ Roth IRA contributions	10 $ Roth IRA contributions	10 $ Roth IRA contributions	11Check if RMD for 2024	11Check if RMD for 2024	11Check if RMD for 2024	11Check if RMD for 2024
Street address (including apt. no.)	Street address (including apt. no.)	10 $ Roth IRA contributions	10 $ Roth IRA contributions	10 $ Roth IRA contributions	10 $ Roth IRA contributions	10 $ Roth IRA contributions	11Check if RMD for 2024	11Check if RMD for 2024	11Check if RMD for 2024
Street address (including apt. no.)	Street address (including apt. no.)	12aRMD date	12aRMD date	12aRMD date	12aRMD date	12aRMD date	12bRMD amount $	12bRMD amount $	12bRMD amount $	12bRMD amount $
City or town, state or province, country, and ZIP or foreign postal code
City or town, state or province, country, and ZIP or foreign postal code	City or town, state or province, country, and ZIP or foreign postal code	13aPostponed/late contrib. $	13aPostponed/late contrib. $	13aPostponed/late contrib. $	13aPostponed/late contrib. $	13aPostponed/late contrib. $	13bYear	13cCode	13cCode	13cCode
		14aRepayments $	14aRepayments $	14aRepayments $	14aRepayments $	14aRepayments $	14bCode	14bCode	14bCode	14bCode
Account number (see instructions)	Account number (see instructions)	15aFMV of certain specified assets $	15aFMV of certain specified assets $	15aFMV of certain specified assets $	15aFMV of certain specified assets $	15aFMV of certain specified assets $	15bCode(s)	15bCode(s)	15bCode(s)	15bCode(s)

October 2, 2023 1054 Bulletin No. 2023–40

PAYER’S name, street address, city or town, province or state, country, and ZIP or foreign postal code		1 Reportable winnings 0.50 in $	2 Date won
PAYER’S name, street address, city or town, province or state, country, and ZIP or foreign postal code	PAYER’S name, street address, city or town, province or state, country, and ZIP or foreign postal code	3 Type of wager	4 Federal income tax withheld $
PAYER’S name, street address, city or town, province or state, country, and ZIP or foreign postal code	PAYER’S name, street address, city or town, province or state, country, and ZIP or foreign postal code	5 Transaction	6 Race 0.33 in
PAYER’S name, street address, city or town, province or state, country, and ZIP or foreign postal code	PAYER’S name, street address, city or town, province or state, country, and ZIP or foreign postal code	7 Winnings from identical wagers $	8 Cashier
PAYER’S federal identifcation number	PAYER’S telephone number 0.67 in	PAYER’S telephone number 0.67 in	PAYER’S telephone number 0.67 in
PAYER’S federal identifcation number	PAYER’S telephone number 0.67 in	9 Winner’s taxpayer identifcation no.	10Window
WINNER’S name	WINNER’S name	11First identifcation 0.50 in	12Second identifcation
Street address (including apt. no.)	Street address (including apt. no.)	13 State/Payer’s state identifcation no.	14State winnings $
City or town, province or state, country, and ZIP or foreign postal code	City or town, province or state, country, and ZIP or foreign postal code	15State income tax withheld $	16Local winnings $
		17Local income tax withheld $	18Name of locality

PAYER’S name, street address, city or town, province or state, country, and ZIP or foreign postal code		1 Reportable winnings $	2 Date won
PAYER’S name, street address, city or town, province or state, country, and ZIP or foreign postal code	PAYER’S name, street address, city or town, province or state, country, and ZIP or foreign postal code	3 Type of wager	4 Federal income tax withheld $
PAYER’S name, street address, city or town, province or state, country, and ZIP or foreign postal code	PAYER’S name, street address, city or town, province or state, country, and ZIP or foreign postal code	5 Transaction	6 Race
PAYER’S name, street address, city or town, province or state, country, and ZIP or foreign postal code	PAYER’S name, street address, city or town, province or state, country, and ZIP or foreign postal code	7 Winnings from identical wagers $	8 Cashier
PAYER’S federal identifcation number	PAYER’S telephone number	PAYER’S telephone number	PAYER’S telephone number
PAYER’S federal identifcation number	PAYER’S telephone number	9 Winner’s taxpayer identifcation no.	10Window
WINNER’S name	WINNER’S name	11First identifcation	12Second identifcation
Street address (including apt. no.)	Street address (including apt. no.)	13 State/Payer’s state identifcation no.	14State winnings $
City or town, province or state, country, and ZIP or foreign postal code	City or town, province or state, country, and ZIP or foreign postal code	15State income tax withheld $	16Local winnings $
		17Local income tax withheld $	18Name of locality

Bulletin No. 2023–40 1055 October 2, 2023