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* PAYER’S name, street address, city, state, ZIP code, and telephone no.
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1 Unemployment compensation
|
2001
Form 1099-G |
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2 State or local income tax
refunds, credits, or offsets
|
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* PAYER’S Federal ID number
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* RECIPIENT'S ID number
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3 Box 2 amount is for tax year
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4 Federal income tax withheld
|
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* RECIPIENT'S name, street address, city, state, and ZIP code
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5 Qualified state tuition
program earnings
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6 Taxable grants
|
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7 Agriculture payments
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8 The amount in box 2
applies to income from a trade
or business
|
| |
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Account number (optional)
|
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Form 1099-G |