Exhibit J Form 1099-A
Publication 1179 — General Rules and Specifications For Substitute Forms 1096, 1098, 1099, 5498, and Certain Other Information Returns · 2026-10-03 edition · updated 2026-10-04 · United States
VOID CORRECTED
1.30 in
Copy A
For Internal Revenue
Service Center
For filing information,
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| LENDER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no. |
OMB No. 1545-0877 1099-A Form (Rev. April 2025) |
||
|---|---|---|---|
| LENDER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no. |
LENDER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no. |
For calendar year | |
| LENDER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no. |
LENDER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no. |
1 Date of lender’s acquisition or knowledge of abandonment |
2 Balance of principal outstanding $ |
| LENDER’S TIN | BORROWER’S TIN | BORROWER’S TIN | BORROWER’S TIN |
| BORROWER’S name | BORROWER’S name | 3 | 4 Fair market value of property $ |
| Street address (including apt. no.) | Street address (including apt. no.) | 5 Check if the borrower was personally liable for repayment of the debt . . . . . . . . . . . . . |
5 Check if the borrower was personally liable for repayment of the debt . . . . . . . . . . . . . |
| 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 | 6 Description of property | 6 Description of property |
| Account number (see instructions) | Account number (see instructions) | Account number (see instructions) | Account number (see instructions) |
Form 1099-A (Rev. 4-2025) Cat. No. 14412G www.irs.gov/Form1099A 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
Cat. No. 14412G
Department of the Treasury - Internal Revenue Service
VOID CORRECTED
Copy A
For Internal Revenue
Service Center
For filing information,
Privacy Act, and Paperwork Reduction
Act Notice, see the General Instructions
for Certain Information Returns .
| LENDER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no. |
OMB No. 1545-0877 1099-A Form (Rev. April 2025) |
||
|---|---|---|---|
| LENDER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no. |
LENDER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no. |
For calendar year | |
| LENDER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no. |
LENDER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no. |
1 Date of lender’s acquisition or knowledge of abandonment |
2 Balance of principal outstanding $ |
| LENDER’S TIN | BORROWER’S TIN | BORROWER’S TIN | BORROWER’S TIN |
| BORROWER’S name | BORROWER’S name | 3 | 4 Fair market value of property $ |
| Street address (including apt. no.) | Street address (including apt. no.) | 5 Check if the borrower was personally liable for repayment of the debt . . . . . . . . . . . . . |
5 Check if the borrower was personally liable for repayment of the debt . . . . . . . . . . . . . |
| 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 | 6 Description of property | 6 Description of property |
| Account number (see instructions) | Account number (see instructions) | Account number (see instructions) | Account number (see instructions) |
Form 1099-A (Rev. 4-2025) Cat. No. 14412G www.irs.gov/Form1099A 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
Cat. No. 14412G
Department of the Treasury - Internal Revenue Service
VOID CORRECTED
Copy A
For Internal Revenue
Service Center
For filing information,
Privacy Act, and Paperwork Reduction
Act Notice, see the General Instructions
for Certain Information Returns .
| LENDER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no. |
OMB No. 1545-0877 1099-A Form (Rev. April 2025) |
||
|---|---|---|---|
| LENDER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no. |
LENDER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no. |
For calendar year | |
| LENDER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no. |
LENDER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no. |
1 Date of lender’s acquisition or knowledge of abandonment |
2 Balance of principal outstanding $ |
| LENDER’S TIN | BORROWER’S TIN | BORROWER’S TIN | BORROWER’S TIN |
| BORROWER’S name | BORROWER’S name | 3 | 4 Fair market value of property $ |
| Street address (including apt. no.) | Street address (including apt. no.) | 5 Check if the borrower was personally liable for repayment of the debt . . . . . . . . . . . . . |
5 Check if the borrower was personally liable for repayment of the debt . . . . . . . . . . . . . |
| 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 | 6 Description of property | 6 Description of property |
| Account number (see instructions) | Account number (see instructions) | Account number (see instructions) | Account number (see instructions) |
Form 1099-A (Rev. 4-2025) Cat. No. 14412G www.irs.gov/Form1099A
45
Department of the Treasury - Internal Revenue Service
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