Please help me check the p.2 is filled in correctly or fix the incorrect place.
Background information:
- Nestor and Emma inform you that they want to apply any refund they qualify for to their 2021 estimated tax (but they paid no estimated tax for 2020).
- Nestor and Emma do not want you or anyone else to discuss the return with the IRS.
o 0 Form 1040 (2020) Page 2 16 Tax (see instructions). Check if any from Form(s): 18814 2 4972 3 16 22292 17 Amount from Schedule 2, line 3 17 16 Add lines 16 and 17. 18 22292 19 Child tax credit or credit for other dependents 19 3000 20 Amount from Schedule 3, line 7 20 21 Add lines 19 and 20 21 3000 22 Subtract line 21 from line 18. If zero or less, enter-O- 19292 23 Other taxes, including self-employment tax, from Schedule 2, line 10 23 0 24 Add lines 22 and 23. This is your total tax 24 19292 25 Federal income tax withheld from a Form(s) W-2 25a 19400 b Form(s) 1099 25b Other forms (soe instructions) 25c d Add lines 25a through 25c 25d 19400 26 26 If you have a 2020 estimated tax payments and amount applied from 2019 return qualifying child, 27 Eamed income credit (EIC). 27 attach Sch. EIC 26 28 If you have Additional child tax credit. Attach Schedule 8812 nontaxable 29 29 combat pay, American opportunity credit from Form 8863, line 8. see instructions. 30 Recovery rebate credit. See instructions. 30 31 Amount from Schedule 3, line 13 31 32 Add lines 27 through 31. These are your total other payments and refundable credits 32 33 Add lines 25d, 26, and 32. These are your total payments 33 19400 34 Refund If line 33 is more than line 24, subtract line 24 from line 33. This is the amount you overpaid 34 108 35a Amount of line 34 you want refunded to you. If Form 8888 is attached, check here 35a 108 Direct deposit? b Routing number] Type: Checking Savings See Instructions. d Account number 36 Amount of line 34 you want applied to your 2021 estimated tax 36 108 Amount 37 Subtract line 33 from line 24. This is the amount you owe now 37 You Owe Note: Schedule H and Schedule SE filers, line 37 may not represent all of the taxes you owe for For detals on how to pay, see 2020. See Schedule 3, line 12e, and its instructions for details. Instructoris. 38 Estimated tax penalty (see instructions) 38 Third Party Do you want to allow another person to discuss this return with the RS? See Designee instructions Yes. Complete below. No Designee's Phone Personal Identification name . number (PIN) Sign Under penalties of perjury. I declare that I have examined this retum and accompanying schedules and statements, and to the best of my knowledge and bellef, they are true, correct, and complete. Declaration of preparer other than taxpayer is based on all Information of which preparer has any knowledge. Here Your signature Date Your occupation If the IRS sent you an identity Protection PIN, enter it here Joint return? (see Inst.) See Instructions. Spouse's signature. If a joint retum, both must sign. Date Spouse's occupation If the IRS sent your spouse an Keep a copy for Identity Protection PIN, enter it here your records. (See Inst.) Phone no Email address Preparer's name Preparer's signature Date PTIN Check it: Paid Osnit omninud Filing Status Single Married filing jointly Married filing separately (MFS) Head of household (HOH) Qualifying widowler) (QW) Check only If you checked the MFS box, enter the name of your spouse. If you checked the HOH or QW box, enter the child's name if the qualifying one box. person is a child but not your dependent Your first name and middle Initial Last name Your social securtty number Nestor Bakirtzis 5 1 619 55 115 If joint retum, spouse's first name and middle initial Last name Spouse's social security number Greta Bakirtzis 4 5 6 6 4 12 4 6 8 Home address (number and street). If you have a P.O.box, see Instructions. Apt.no. Presidential Election Campaign 655 Sweet Plum Lane Check here if you, or your City, town, or post office. If you have a foreign address, also complete spaces below. State ZIP code spouse if filing jointly, want $3 to go to this fund. Checking a Pleasant Hill California 94523 box below will not change Foreign country name Foreign province/state/county Foreign postal code your tax or refund. You Spouse At any time during 2020, did you receive, sell, send, exchange, or otherwise acquire any financial interest in any virtual currency? Yes No Standard Someone can claim: You as a dependent Your spouse as a dependent Deduction Spouse itemizes on a separate return or you were a dual-status alien Age/Blindness You: Were bom before January 2, 1956 Are blind Spouse: Was born before January 2, 1956 Is blind Dependents (see instructions): (2) Social security (3) Relationship 14 of qualities for see Instructions: If more (1) First name Last name number to you Child tax credit Credit for other dependents than four Julianna Bakirtzis 6 18 2 2 8 6 4 2 daughter dependents, Antonio see instructions Verdi 3 5 5 4 5 2 8 6 4 son and check Jaspar Adamos 3 8 0 2 7 7 6 31 cousin here 1 Wages, salaries, tips, etc. Attach Form(s) W-2 1 150000 Attach 2a Tax-exempt interest. 2a 8600 b Taxable interest 2b 5100 Sch. Bit 3a Qualified dividends 3a required. 3b b Ordinary dividends 9300 4a IRA distributions. 4a b Taxable amount 4b 5a Pensions and annuities 5a b Taxable amount 5b Standard 6a Social security benefits 6a b Taxable amount 6b Deduction for 7 Capital gain or loss). Attach Schedule Dif required. If not required, check here 7 Single or Married filing 8 Other income from Schedule 1, line 9. 8 separately $12,400 9 Add lines 1, 2, 3, 4, 5b, 6, 7, and 8. This is your total income 9 164400 Married filing 10 Adjustments to income: jointly or Qualifying From Schedule 1, line 22 10a widower) $24,800 10b b Charitable contributions if you take the standard deduction. See instructions Head of Add lines 10a and 10b. These are your total adjustments to income 10c household, $18,650 11 Subtract line 10c from line 9. This is your adjusted gross income 11 164400 If you checked 12 Standard deduction or itemized deductions (from Schedule A) 12 24800 any box under Standard 13 Qualified business income deduction. Attach Form 8995 or Form 8995-A 13 0 Deduction 14 Add lines 12 and 13 14 24800 see instructions 15 Taxable income. Subtract line 14 from line 11. If zero or less, enter-O- 15 139600 For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see separate Instructions. Cat. No. 113208 Form 1040 2020) a se file a Employee's social security number 576-95-5115 b Employer identification number (EIN) 62-8007993 c Employer's name, address, and ZIP code Fanfare Fisheries 3462 Westhaven Blvd. Emeryville, CA 94662 Safe, accurate, OMB No. 1545-0008 FAST! Use 1 Wages, tips, other compensation 86,000 3 Social security wages 86,000 5 Medicare wagos and tips 86,000 Visit the IRS website at www.irs.govlefile 2 Federal income tax withheld 11,300 4 Social security tax withheld 5,332 6 Medicare tax withheld 1,247 8 Allocated tips 7 Social security tips d Control number 10 Dependent care benefits e Employee's first name and initial Last name Sutt.11 Nonqualified plans 12a See Instructions for box 12 13 Story Retirement Theodowy sky 12b Nestor Bakirtzis 655 Sweet Plum Lane Pleasant Hill, CA 94523 14 Other 120 12d | Employee's address and ZIP code 15 Sale Employer's state ID number CA 86-3687000 18 Local wages, tips, etc. 19 Local income tax 20 Locality name 16 State wages, tips, etc | 17 State income tax 86,000 4,500 2020 Department of the Treasury-intamal Revenue Service Form W-2 wage and Tax Statement Copy B-To Be Filed With Employee's FEDERAL Tax Return. This information is being furnished to the Internal Revenue Service a Employee's social security number 456-64-2468 b Employer identification number (EIN) 45-4559335 c Employer's name, address, and ZIP code Blackberry Woodworks 3462 Cunningham Blvd. Concord, CA 94518 Safe, accurate, Visit the IRS website at OMB No. 1545-0008 FAST! Use urse file www.irs.govlefilc 1 Wages, tips, other compensation 2 Federal income tax withheld 64,000 8,100 3 Social security wages 4 Social security tex withheld 64,000 3,968 5 Medicare wagos and tips 6 Medicare tax withheld 64,000 928 7 Social security tips 8 Allocated tips d Control number 9 10 Dependent care benefits e Employee's first name and initial Last name Sutt. 11 Nonqualified plans 12a See instructions for box 12 13 ory Retrament Third F 12b employee Greta Bakirtzis 655 Sweet Plum Lane Pleasant Hill, CA 94523 14 Other 12c 12d 1 Employee's address and ZIP code 15 Sizle Employer's state ID number 72-3468002 18 Local wages, tips, ato. 19 Local income tax 20 Locality name CAL 16 State wages, tips, etc. 17 State income tax 64,000 3,700 2020 Department of the Treasury - Intemal Revenue Service Form W-2 wage and Tax Statement Copy B-To Be Filed With Employee's FEDERAL Tax Return. This information is being furnished to the Internal Revenue Service. OMB No. 1545-0112 CORRECTED (if checked) PAYER'S name, street address, city or town, state or province, country, ZIP Payer's RTN (optional) or foreign postal code, and telephone no. Verdant Pastures, Inc. 3068 Corydon Avenue Asheville, NC 28732 1 Interest Income 2020 Interest Income Form 1099-INT $ 5,100 2 Earty withdrawal penalty Copy B PAYER'S TIN RECIPIENT'S TIN For Recipient 3 Interest on U.S. Savings Bonds and Treas. obligations 46-6466782 576-95-5115 RECIPIENT'S name 4 Federal income tax withheld 5 Investment expenses This is important tax $ $ information and is Nestor Bakirtzis being furnished to the 6 Foreign tax pald 7 Foreign country or US possession IRS. If you are Street address (including apt. no.) $ required to file a 655 Sweet Plum Lane 8 Tax-exempt interest 9 Specified private activity bond return, a negligence Interest penalty or other sanction may be City or town, state or province, country, and ZIP or foreign postal code $ $ imposed on you if this income is 10 Market discount 11 Bond premium Pleasant Hill, CA 94523 taxable and the IRS determines that it has FATCA fling $ $ not been reported. requirement 12 Bond premium on Treasury obligations 13 Bond premium on tax-exempt bond $ $ Account number (see instructions) 14 Tax-exempt and tax credt 15 State 16 State identification no. 17 State tax withheld bond OUSIP no. COF487-87 $ Form 1099-INT (keep for your records) www.lrs.gowForm1099INT Department of the Treasury - Internal Revenue Service OMB No. 1545-0112 CORRECTED (if checked) PAYER'S name, street address, city or town, state or province, country, ZIP Payer's RTN (optional) or foreign postal code, and telephone no. State of California P.O.Box 942980 Sacramento, CA 94250 1 Interest Income 2020 Interest Income Form 1099-INT 2 Earty withdrawal penalty Copy B PAYER'S TIN RECIPIENT'S TIN For Recipient 3 Interest on U.S. Savings Bonds and Treas. obligations 94-60001347 576-95-5115 RECIPIENT'S name 4 Federal income tax withheld 5 Investment expenses This is important tax information and is Nestor Bakirtzis being furnished to the 6 Foreign tax paid 7 Foreign country or U.S. possession IRS. If you are Street address (including pt. no.) $ required to file a 655 Sweet Plum Lane 8 Tax-exempt interest 9 Specified private activity bond return, a negligence Interest penalty or other sanction may be City or town, state or province, country, and ZIP or foreign postal code |$ 8,6001S imposed on you if 10 Market discount Pleasant Hill, CA 94523 11 Bond premium this income is taxable and the IRS determines that it has FATCA fling $ not been reported. requirement 12 Bond premium on Treasury obligations 13 Bond premium on tax-exempt bond |$ $ Account number (see instructions) 14 Tax-exempt and tax credit 15 State 16 State identification no. 17 State tax withheld bond OUSP no. $ TA-3678884 $ Form 1099-INT (keep for your records) www.lrs.gow Form1099INT Department of the Treasury - Internal Revenue Service OMB No. 1545-0110 CORRECTED (if checked) PAYER'S name, street address, city or town, state or province, country. ZIP 1a Total ordinary dividends or foreign postal code, and telephone no. Fruta de Peru SA $ 477 Madison Avenue, Twenty-Eighth Floor New York, NY 10022 1b Qualified dividends 9,300 2020 Dividends and Distributions 0 $ 2a Total capital gain distr. $ 2c Section 1202 gain Form 1099-DIV 2b Unrecap. Sec. 1250 gain S 2d Collectibles (28%) gain Copy B For Recipient PAYER'S TIN RECIPIENT'S TIN 65-20004500 576-95-5115 $ RECIPIENT'S name 3 Nondividend distributions 4 Federal Income tax withheld $ $ This is important tax Nestor Bakirtzis Information and is 5 Section 199A dividends 6 Investment expenses being furnished to Street address (including apt. no.) $ $ the IRS. If you are required to me a 655 Sweet Plum Lane 7 Foreign tax pald 8 Foreign country or U.S. possession return, a negligence penalty or other sanction may be City or town, state or province, country, and ZIP or foreign postal code $ Imposed on your this income is taxable Pleasant Hill, CA 94523 9 Cash liquidation distributions 10 Noncash liquidation distributions and the IRS $ S determines that it has not been reported FATCA fing 11 Exempt Interest dividends 12 Specified private activity requirement bond Interest dividends $ $ Account number (see Instructions 13 State 14 State Identification na 15 State tax withheld $ 218A-200 $ Form 1099-DIV keep for your records) www.lrs.gov/Form1099DIV Department of the Treasury - Internal Revenue Service o 0 Form 1040 (2020) Page 2 16 Tax (see instructions). Check if any from Form(s): 18814 2 4972 3 16 22292 17 Amount from Schedule 2, line 3 17 16 Add lines 16 and 17. 18 22292 19 Child tax credit or credit for other dependents 19 3000 20 Amount from Schedule 3, line 7 20 21 Add lines 19 and 20 21 3000 22 Subtract line 21 from line 18. If zero or less, enter-O- 19292 23 Other taxes, including self-employment tax, from Schedule 2, line 10 23 0 24 Add lines 22 and 23. This is your total tax 24 19292 25 Federal income tax withheld from a Form(s) W-2 25a 19400 b Form(s) 1099 25b Other forms (soe instructions) 25c d Add lines 25a through 25c 25d 19400 26 26 If you have a 2020 estimated tax payments and amount applied from 2019 return qualifying child, 27 Eamed income credit (EIC). 27 attach Sch. EIC 26 28 If you have Additional child tax credit. Attach Schedule 8812 nontaxable 29 29 combat pay, American opportunity credit from Form 8863, line 8. see instructions. 30 Recovery rebate credit. See instructions. 30 31 Amount from Schedule 3, line 13 31 32 Add lines 27 through 31. These are your total other payments and refundable credits 32 33 Add lines 25d, 26, and 32. These are your total payments 33 19400 34 Refund If line 33 is more than line 24, subtract line 24 from line 33. This is the amount you overpaid 34 108 35a Amount of line 34 you want refunded to you. If Form 8888 is attached, check here 35a 108 Direct deposit? b Routing number] Type: Checking Savings See Instructions. d Account number 36 Amount of line 34 you want applied to your 2021 estimated tax 36 108 Amount 37 Subtract line 33 from line 24. This is the amount you owe now 37 You Owe Note: Schedule H and Schedule SE filers, line 37 may not represent all of the taxes you owe for For detals on how to pay, see 2020. See Schedule 3, line 12e, and its instructions for details. Instructoris. 38 Estimated tax penalty (see instructions) 38 Third Party Do you want to allow another person to discuss this return with the RS? See Designee instructions Yes. Complete below. No Designee's Phone Personal Identification name . number (PIN) Sign Under penalties of perjury. I declare that I have examined this retum and accompanying schedules and statements, and to the best of my knowledge and bellef, they are true, correct, and complete. Declaration of preparer other than taxpayer is based on all Information of which preparer has any knowledge. Here Your signature Date Your occupation If the IRS sent you an identity Protection PIN, enter it here Joint return? (see Inst.) See Instructions. Spouse's signature. If a joint retum, both must sign. Date Spouse's occupation If the IRS sent your spouse an Keep a copy for Identity Protection PIN, enter it here your records. (See Inst.) Phone no Email address Preparer's name Preparer's signature Date PTIN Check it: Paid Osnit omninud Filing Status Single Married filing jointly Married filing separately (MFS) Head of household (HOH) Qualifying widowler) (QW) Check only If you checked the MFS box, enter the name of your spouse. If you checked the HOH or QW box, enter the child's name if the qualifying one box. person is a child but not your dependent Your first name and middle Initial Last name Your social securtty number Nestor Bakirtzis 5 1 619 55 115 If joint retum, spouse's first name and middle initial Last name Spouse's social security number Greta Bakirtzis 4 5 6 6 4 12 4 6 8 Home address (number and street). If you have a P.O.box, see Instructions. Apt.no. Presidential Election Campaign 655 Sweet Plum Lane Check here if you, or your City, town, or post office. If you have a foreign address, also complete spaces below. State ZIP code spouse if filing jointly, want $3 to go to this fund. Checking a Pleasant Hill California 94523 box below will not change Foreign country name Foreign province/state/county Foreign postal code your tax or refund. You Spouse At any time during 2020, did you receive, sell, send, exchange, or otherwise acquire any financial interest in any virtual currency? Yes No Standard Someone can claim: You as a dependent Your spouse as a dependent Deduction Spouse itemizes on a separate return or you were a dual-status alien Age/Blindness You: Were bom before January 2, 1956 Are blind Spouse: Was born before January 2, 1956 Is blind Dependents (see instructions): (2) Social security (3) Relationship 14 of qualities for see Instructions: If more (1) First name Last name number to you Child tax credit Credit for other dependents than four Julianna Bakirtzis 6 18 2 2 8 6 4 2 daughter dependents, Antonio see instructions Verdi 3 5 5 4 5 2 8 6 4 son and check Jaspar Adamos 3 8 0 2 7 7 6 31 cousin here 1 Wages, salaries, tips, etc. Attach Form(s) W-2 1 150000 Attach 2a Tax-exempt interest. 2a 8600 b Taxable interest 2b 5100 Sch. Bit 3a Qualified dividends 3a required. 3b b Ordinary dividends 9300 4a IRA distributions. 4a b Taxable amount 4b 5a Pensions and annuities 5a b Taxable amount 5b Standard 6a Social security benefits 6a b Taxable amount 6b Deduction for 7 Capital gain or loss). Attach Schedule Dif required. If not required, check here 7 Single or Married filing 8 Other income from Schedule 1, line 9. 8 separately $12,400 9 Add lines 1, 2, 3, 4, 5b, 6, 7, and 8. This is your total income 9 164400 Married filing 10 Adjustments to income: jointly or Qualifying From Schedule 1, line 22 10a widower) $24,800 10b b Charitable contributions if you take the standard deduction. See instructions Head of Add lines 10a and 10b. These are your total adjustments to income 10c household, $18,650 11 Subtract line 10c from line 9. This is your adjusted gross income 11 164400 If you checked 12 Standard deduction or itemized deductions (from Schedule A) 12 24800 any box under Standard 13 Qualified business income deduction. Attach Form 8995 or Form 8995-A 13 0 Deduction 14 Add lines 12 and 13 14 24800 see instructions 15 Taxable income. Subtract line 14 from line 11. If zero or less, enter-O- 15 139600 For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see separate Instructions. Cat. No. 113208 Form 1040 2020) a se file a Employee's social security number 576-95-5115 b Employer identification number (EIN) 62-8007993 c Employer's name, address, and ZIP code Fanfare Fisheries 3462 Westhaven Blvd. Emeryville, CA 94662 Safe, accurate, OMB No. 1545-0008 FAST! Use 1 Wages, tips, other compensation 86,000 3 Social security wages 86,000 5 Medicare wagos and tips 86,000 Visit the IRS website at www.irs.govlefile 2 Federal income tax withheld 11,300 4 Social security tax withheld 5,332 6 Medicare tax withheld 1,247 8 Allocated tips 7 Social security tips d Control number 10 Dependent care benefits e Employee's first name and initial Last name Sutt.11 Nonqualified plans 12a See Instructions for box 12 13 Story Retirement Theodowy sky 12b Nestor Bakirtzis 655 Sweet Plum Lane Pleasant Hill, CA 94523 14 Other 120 12d | Employee's address and ZIP code 15 Sale Employer's state ID number CA 86-3687000 18 Local wages, tips, etc. 19 Local income tax 20 Locality name 16 State wages, tips, etc | 17 State income tax 86,000 4,500 2020 Department of the Treasury-intamal Revenue Service Form W-2 wage and Tax Statement Copy B-To Be Filed With Employee's FEDERAL Tax Return. This information is being furnished to the Internal Revenue Service a Employee's social security number 456-64-2468 b Employer identification number (EIN) 45-4559335 c Employer's name, address, and ZIP code Blackberry Woodworks 3462 Cunningham Blvd. Concord, CA 94518 Safe, accurate, Visit the IRS website at OMB No. 1545-0008 FAST! Use urse file www.irs.govlefilc 1 Wages, tips, other compensation 2 Federal income tax withheld 64,000 8,100 3 Social security wages 4 Social security tex withheld 64,000 3,968 5 Medicare wagos and tips 6 Medicare tax withheld 64,000 928 7 Social security tips 8 Allocated tips d Control number 9 10 Dependent care benefits e Employee's first name and initial Last name Sutt. 11 Nonqualified plans 12a See instructions for box 12 13 ory Retrament Third F 12b employee Greta Bakirtzis 655 Sweet Plum Lane Pleasant Hill, CA 94523 14 Other 12c 12d 1 Employee's address and ZIP code 15 Sizle Employer's state ID number 72-3468002 18 Local wages, tips, ato. 19 Local income tax 20 Locality name CAL 16 State wages, tips, etc. 17 State income tax 64,000 3,700 2020 Department of the Treasury - Intemal Revenue Service Form W-2 wage and Tax Statement Copy B-To Be Filed With Employee's FEDERAL Tax Return. This information is being furnished to the Internal Revenue Service. OMB No. 1545-0112 CORRECTED (if checked) PAYER'S name, street address, city or town, state or province, country, ZIP Payer's RTN (optional) or foreign postal code, and telephone no. Verdant Pastures, Inc. 3068 Corydon Avenue Asheville, NC 28732 1 Interest Income 2020 Interest Income Form 1099-INT $ 5,100 2 Earty withdrawal penalty Copy B PAYER'S TIN RECIPIENT'S TIN For Recipient 3 Interest on U.S. Savings Bonds and Treas. obligations 46-6466782 576-95-5115 RECIPIENT'S name 4 Federal income tax withheld 5 Investment expenses This is important tax $ $ information and is Nestor Bakirtzis being furnished to the 6 Foreign tax pald 7 Foreign country or US possession IRS. If you are Street address (including apt. no.) $ required to file a 655 Sweet Plum Lane 8 Tax-exempt interest 9 Specified private activity bond return, a negligence Interest penalty or other sanction may be City or town, state or province, country, and ZIP or foreign postal code $ $ imposed on you if this income is 10 Market discount 11 Bond premium Pleasant Hill, CA 94523 taxable and the IRS determines that it has FATCA fling $ $ not been reported. requirement 12 Bond premium on Treasury obligations 13 Bond premium on tax-exempt bond $ $ Account number (see instructions) 14 Tax-exempt and tax credt 15 State 16 State identification no. 17 State tax withheld bond OUSIP no. COF487-87 $ Form 1099-INT (keep for your records) www.lrs.gowForm1099INT Department of the Treasury - Internal Revenue Service OMB No. 1545-0112 CORRECTED (if checked) PAYER'S name, street address, city or town, state or province, country, ZIP Payer's RTN (optional) or foreign postal code, and telephone no. State of California P.O.Box 942980 Sacramento, CA 94250 1 Interest Income 2020 Interest Income Form 1099-INT 2 Earty withdrawal penalty Copy B PAYER'S TIN RECIPIENT'S TIN For Recipient 3 Interest on U.S. Savings Bonds and Treas. obligations 94-60001347 576-95-5115 RECIPIENT'S name 4 Federal income tax withheld 5 Investment expenses This is important tax information and is Nestor Bakirtzis being furnished to the 6 Foreign tax paid 7 Foreign country or U.S. possession IRS. If you are Street address (including pt. no.) $ required to file a 655 Sweet Plum Lane 8 Tax-exempt interest 9 Specified private activity bond return, a negligence Interest penalty or other sanction may be City or town, state or province, country, and ZIP or foreign postal code |$ 8,6001S imposed on you if 10 Market discount Pleasant Hill, CA 94523 11 Bond premium this income is taxable and the IRS determines that it has FATCA fling $ not been reported. requirement 12 Bond premium on Treasury obligations 13 Bond premium on tax-exempt bond |$ $ Account number (see instructions) 14 Tax-exempt and tax credit 15 State 16 State identification no. 17 State tax withheld bond OUSP no. $ TA-3678884 $ Form 1099-INT (keep for your records) www.lrs.gow Form1099INT Department of the Treasury - Internal Revenue Service OMB No. 1545-0110 CORRECTED (if checked) PAYER'S name, street address, city or town, state or province, country. ZIP 1a Total ordinary dividends or foreign postal code, and telephone no. Fruta de Peru SA $ 477 Madison Avenue, Twenty-Eighth Floor New York, NY 10022 1b Qualified dividends 9,300 2020 Dividends and Distributions 0 $ 2a Total capital gain distr. $ 2c Section 1202 gain Form 1099-DIV 2b Unrecap. Sec. 1250 gain S 2d Collectibles (28%) gain Copy B For Recipient PAYER'S TIN RECIPIENT'S TIN 65-20004500 576-95-5115 $ RECIPIENT'S name 3 Nondividend distributions 4 Federal Income tax withheld $ $ This is important tax Nestor Bakirtzis Information and is 5 Section 199A dividends 6 Investment expenses being furnished to Street address (including apt. no.) $ $ the IRS. If you are required to me a 655 Sweet Plum Lane 7 Foreign tax pald 8 Foreign country or U.S. possession return, a negligence penalty or other sanction may be City or town, state or province, country, and ZIP or foreign postal code $ Imposed on your this income is taxable Pleasant Hill, CA 94523 9 Cash liquidation distributions 10 Noncash liquidation distributions and the IRS $ S determines that it has not been reported FATCA fing 11 Exempt Interest dividends 12 Specified private activity requirement bond Interest dividends $ $ Account number (see Instructions 13 State 14 State Identification na 15 State tax withheld $ 218A-200 $ Form 1099-DIV keep for your records) www.lrs.gov/Form1099DIV Department of the Treasury - Internal Revenue Service
