IRS Form 1099-LS "Reportable Life Insurance Sale"

What Is IRS Form 1099-LS?

This is a tax form that was released by the Internal Revenue Service (IRS) - a subdivision of the U.S. Department of the Treasury. As of today, no separate filing guidelines for the form are provided by the IRS.

Form Details:

  • A 8-page form available for download in PDF;
  • Actual and valid for filing 2020 taxes;
  • Editable, printable, and free;

Download a fillable version of IRS Form 1099-LS through the link below or browse more documents in our library of IRS Forms.

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Download IRS Form 1099-LS "Reportable Life Insurance Sale"

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Attention:
Copy A of this form is provided for informational purposes only. Copy A appears in red,
similar to the official IRS form. The official printed version of Copy A of this IRS form is
scannable, but the online version of it, printed from this website, is not. Do not print and file
copy A downloaded from this website; a penalty may be imposed for filing with the IRS
information return forms that can’t be scanned. See part O in the current General
Instructions for Certain Information Returns, available at www.irs.gov/form1099, for more
information about penalties.
Please note that Copy B and other copies of this form, which appear in black, may be
downloaded and printed and used to satisfy the requirement to provide the information to
the recipient.
To order official IRS information returns, which include a scannable Copy A for filing with
the IRS and all other applicable copies of the form, visit www.IRS.gov/orderforms. Click on
Employer and Information
Returns, and we’ll mail you the forms you request and their
instructions, as well as any publications you may order.
Information returns may also be filed electronically using the IRS Filing Information Returns
Electronically (FIRE) system (visit www.IRS.gov/FIRE) or the IRS Affordable Care Act
Information Returns (AIR) program (visit www.IRS.gov/AIR).
See IRS Publications 1141, 1167, and 1179 for more information about printing these tax
forms.
Attention:
Copy A of this form is provided for informational purposes only. Copy A appears in red,
similar to the official IRS form. The official printed version of Copy A of this IRS form is
scannable, but the online version of it, printed from this website, is not. Do not print and file
copy A downloaded from this website; a penalty may be imposed for filing with the IRS
information return forms that can’t be scanned. See part O in the current General
Instructions for Certain Information Returns, available at www.irs.gov/form1099, for more
information about penalties.
Please note that Copy B and other copies of this form, which appear in black, may be
downloaded and printed and used to satisfy the requirement to provide the information to
the recipient.
To order official IRS information returns, which include a scannable Copy A for filing with
the IRS and all other applicable copies of the form, visit www.IRS.gov/orderforms. Click on
Employer and Information
Returns, and we’ll mail you the forms you request and their
instructions, as well as any publications you may order.
Information returns may also be filed electronically using the IRS Filing Information Returns
Electronically (FIRE) system (visit www.IRS.gov/FIRE) or the IRS Affordable Care Act
Information Returns (AIR) program (visit www.IRS.gov/AIR).
See IRS Publications 1141, 1167, and 1179 for more information about printing these tax
forms.
VOID
CORRECTED
1616
ACQUIRER'S name, street address, city or town, state or province, country,
1 Amount paid to payment
OMB No. 1545-2281
recipient
ZIP or foreign postal code, and telephone no.
Reportable Life
$
2019
Insurance Sale
2 Date of sale
1099-LS
Form
Copy A
ACQUIRER'S TIN
PAYMENT RECIPIENT'S TIN
Issuer's name
For
Internal Revenue
PAYMENT RECIPIENT'S name
Acquirer's information contact name, street address, city or
Service Center
town, state or province, country, ZIP or foreign postal code,
File with Form 1096.
and telephone no. (if different from ACQUIRER)
For Privacy Act
and Paperwork
Street address (including apt. no.)
Reduction Act
Notice, see the
2019 General
City or town, state or province, country, and ZIP or foreign postal code
Instructions for
Certain
Policy number
Information
Returns.
1099-LS
Form
Cat. No. 71383M
www.irs.gov/Form1099LS
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
CORRECTED (if checked)
ACQUIRER'S name, street address, city or town, state or province, country,
1 Amount paid to payment
OMB No. 1545-2281
recipient
ZIP or foreign postal code, and telephone no.
Reportable Life
$
2019
Insurance Sale
2 Date of sale
1099-LS
Form
Copy B
ACQUIRER'S TIN
PAYMENT RECIPIENT'S TIN
Issuer's name
For Payment
Recipient
PAYMENT RECIPIENT'S name
Acquirer's information contact name, street address, city or
town, state or province, country, ZIP or foreign postal code,
This is important tax
and telephone no. (if different from ACQUIRER)
information and is being
furnished to the IRS. If
you are required to file a
Street address (including apt. no.)
return, a negligence
penalty or other
sanction may be
City or town, state or province, country, and ZIP or foreign postal code
imposed on you if this
item is required to be
reported and the IRS
Policy number
determines that it has
not been reported.
1099-LS
(keep for your records)
Form
www.irs.gov/Form1099LS
Department of the Treasury - Internal Revenue Service
Instructions for Payment Recipient
Box 2. Shows the date of sale.
An acquirer of a life insurance contract or any interest in a life
insurance contract in a reportable policy sale under section
Issuer's name. Shows the insurance company that bears the
6050Y must give this form to you for payments made to you in
risk with respect to the life insurance contract on the date a
the reportable policy sale.
Form 1099-LS is required to be furnished to that issuer.
Payment Recipient's taxpayer identification number (TIN).
Generally, this will be the life insurance company responsible
for administering the contract, including paying death benefits
For your protection, this form may show only the last four
under the life insurance contract.
digits of your TIN (social security number (SSN), individual
taxpayer identification number (ITIN), adoption taxpayer
Acquirer's information contact name, address, and phone
identification number (ATIN), or employer identification number
number. Shows the contact information of the acquirer. The
(EIN)). However, the acquirer has reported your complete TIN
contact information provided will give you direct access to a
to the IRS.
person who can answer questions about this form. If blank,
the contact information is the same as the ACQUIRER.
Policy number. Shows the policy number the life insurance
company assigned to the life insurance contract.
Future developments. For the latest developments related to
Form 1099-LS and its instructions, such as legislation enacted
Box 1. Shows the amount paid to you in the reportable policy
after they were published, go to www.irs.gov/Form1099LS.
sale under section 6050Y.
CORRECTED (if checked)
ACQUIRER'S name, street address, city or town, state or province, country,
1 Amount paid to payment
OMB No. 1545-2281
recipient (optional)
ZIP or foreign postal code, and telephone no.
Reportable Life
$
2019
Insurance Sale
2 Date of sale
1099-LS
Form
Copy C
ACQUIRER'S TIN
PAYMENT RECIPIENT'S TIN
Issuer's name
For Issuer
PAYMENT RECIPIENT'S name
Acquirer's information contact name, street address, city or
town, state or province, country, ZIP or foreign postal code,
Copy C is
and telephone no. (if different from ACQUIRER)
provided to you
for information
Street address (including apt. no.)
only. Only the
payment recipient is
required to
City or town, state or province, country, and ZIP or foreign postal code
report this
information on
Policy number
a tax return.
1099-LS
(keep for your records)
Form
www.irs.gov/Form1099LS
Department of the Treasury - Internal Revenue Service