IRS Form 1099-PATR "Taxable Distributions Received From Cooperatives"

What Is IRS Form 1099-PATR?

This is a tax form that was released by the Internal Revenue Service (IRS) - a subdivision of the U.S. Department of the Treasury. Check the official IRS-issued instructions before completing and submitting the form.

Form Details:

  • A 6-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-PATR through the link below or browse more documents in our library of IRS Forms.

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Download IRS Form 1099-PATR "Taxable Distributions Received From Cooperatives"

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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
9797
1 Patronage dividends
OMB No. 1545-0118
PAYER'S name, street address, city or town, state or province, country, ZIP
Taxable
or foreign postal code, and telephone no.
$
2019
Distributions
2 Nonpatronage distributions
Received From
$
Cooperatives
3 Per-unit retain allocations
1099-PATR
$
Form
Copy A
PAYER’S TIN
RECIPIENT’S TIN
4 Federal income tax withheld
$
For
Internal Revenue
RECIPIENT’S name
5 Redemption of nonqualified
6 Domestic production
Service Center
notices and retain allocations
activities deduction
$
$
File with Form 1096.
For Privacy Act
Street address (including apt. no.)
7 Qualified payments
8 Investment credit
and Paperwork
$
$
Reduction Act
9 Work opportunity credit
10 Patron’s AMT adjustment
Notice, see the
City or town, state or province, country, and ZIP or foreign postal code
2019 General
$
$
Instructions for
Account number (see instructions)
2nd TIN not.
11 Other credits and deductions
Certain Information
$
Returns.
1099-PATR
Form
Cat. No. 14435F
www.irs.gov/Form1099PATR
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)
1 Patronage dividends
OMB No. 1545-0118
PAYER'S name, street address, city or town, state or province, country, ZIP
Taxable
or foreign postal code, and telephone no.
$
2019
Distributions
2 Nonpatronage distributions
Received From
$
Cooperatives
3 Per-unit retain allocations
1099-PATR
$
Form
Copy B
PAYER’S TIN
RECIPIENT’S TIN
4 Federal income tax withheld
$
For Recipient
RECIPIENT’S name
5 Redemption of nonqualified
6 Domestic production
This is important tax
notices and retain allocations
activities deduction
information and is
being furnished to the
$
$
IRS. If you are required
to file a return, a
Street address (including apt. no.)
7 Qualified payments
8 Investment credit
negligence penalty or
$
$
other sanction may be
imposed on you if this
9 Work opportunity credit
10 Patron’s AMT adjustment
City or town, state or province, country, and ZIP or foreign postal code
income is taxable and
$
$
the IRS determines that
it has not been
Account number (see instructions)
11 Other credits and deductions
reported.
$
1099-PATR
(keep for your records)
www.irs.gov/Form1099PATR
Form
Department of the Treasury - Internal Revenue Service
Instructions for Recipient
Box 5. Shows amounts you received when you redeemed nonqualified written
notices of allocation and nonqualified per-unit retain allocations. Because these
Distributions you received from a cooperative may be includible in your income.
were not taxable when issued to you, you must report the redemption as
Generally, if you are an individual, report any amounts shown in boxes 1, 2, 3,
ordinary income to the extent of the stated dollar value.
and 5 as income, unless nontaxable, on Schedule F (Form 1040), Schedule C
Box 6. Shows your share of the cooperative's domestic production activities
(Form 1040), or Form 4835. See the Instructions for Schedule F (Form 1040) and
deduction. The amount must have been identified on this or another written
Pub. 225 for more information.
notice sent to you from the cooperative during the payment period described in
Recipient's taxpayer identification number (TIN). For your protection, this
section 1382(d). To claim the deduction, you must not be a C corporation.
form may show only the last four digits of your TIN (social security number
Box 7. Shows the amount of the qualified payments on which the cooperative
(SSN), individual taxpayer identification number (ITIN), adoption taxpayer
computed its 199A(g) deduction.
identification number (ATIN), or employer identification number (EIN)). However,
Box 8. Shows unused investment credits passed through to you by the
the issuer has reported your complete TIN to the IRS.
cooperative. Use Form 3468, and its instructions, to figure the amount of credit
Account number. May show an account or other unique number the payer
to which you are entitled.
assigned to distinguish your account.
Box 9. Shows unused work opportunity credits passed through to you by the
Box 1. Shows patronage dividends paid to you during the year in cash, qualified
cooperative. Use Form 5884 to figure the amount of credit to which you are
written notices of allocation (at stated dollar value), or other property (not including
entitled. If your only source of the credit is the cooperative, use Form 3800
nonqualified allocations). Any dividends paid on (1) property bought for personal
instead.
use or (2) capital assets or depreciable property used in your business are not
Box 10. Shows the alternative minimum tax (AMT) adjustment passed through
taxable. However, if (2) applies, reduce the basis of the assets by this amount.
to you by the cooperative. Report this amount on Form 6251 on the appropriate
Box 2. Shows nonpatronage distributions paid to you during the year in cash,
line in Part I.
qualified written notices of allocation, or other property (not including
Box 11. Shows other unused credits and deductions (including depreciation)
nonqualified written notices of allocation).
passed through to you by the cooperative. For information on how to report
Box 3. Shows per-unit retain allocations paid to you during the year in cash,
credits, see the instructions for the specific credit form. For information on how
qualified per-unit retain certificates, or other property.
to report deductions, see the instructions for Schedules C and F (Form 1040)
Box 4. Shows backup withholding. Generally, a payer must backup withhold if
and Pub. 946.
you didn't furnish your taxpayer identification number to the payer. See Form
Future developments. For the latest information about developments related to
W-9 for information on backup withholding. Include this amount on your income
Form 1099-PATR and its instructions, such as legislation enacted after they were
tax return as tax withheld.
published, go to www.irs.gov/Form1099PATR.
VOID
CORRECTED
1 Patronage dividends
OMB No. 1545-0118
PAYER'S name, street address, city or town, state or province, country, ZIP
Taxable
or foreign postal code, and telephone no.
$
2019
Distributions
2 Nonpatronage distributions
Received From
$
Cooperatives
3 Per-unit retain allocations
1099-PATR
$
Form
PAYER’S TIN
RECIPIENT’S TIN
4 Federal income tax withheld
Copy C
$
For Payer
RECIPIENT’S name
5 Redemption of nonqualified
6 Domestic production
notices and retain allocations
activities deduction
For Privacy Act
$
$
and Paperwork
Street address (including apt. no.)
7 Qualified payments
8 Investment credit
Reduction Act
$
$
Notice, see the
2019 General
9 Work opportunity credit
10 Patron’s AMT adjustment
City or town, state or province, country, and ZIP or foreign postal code
Instructions for
$
$
Certain Information
Returns.
Account number (see instructions)
2nd TIN not.
11 Other credits and deductions
$
1099-PATR
Form
www.irs.gov/Form1099PATR
Department of the Treasury - Internal Revenue Service