Form 1099-INT - Interest Income Information

Company: Taxpayer ID No: (Required)
Submitted by: Your Email Address: (Required)

	Recipient No. 1	Recipient No. 2	Recipient No. 3
Name
SSN or FEIN.
Address 1
Address 2
City
State
Zip
Interest Inc (Not Fed Gov)
Early WD Penalty
Interest on US Treas/Sav Bonds
Fed Inc Tax WH
Foreign Tax Paid
Foreign Country

Other Information, Comments, Questions:

NOTE: If you have additional entries:
Press "Send to Jack Burson, CPA" to submit these three, then press "Clear Form",
enter your additional entries and press "Send to Jack Burson, CPA" again
...repeat for additional recipients.