Create 1099-G Online: PDF Builder

1 Payer details

Tax year

The government unit or other reporting payer that made the payments.

Payer name *

Tax ID typeTaxpayer ID number *

Street address *

City / town *State *ZIP / postal code *

Apartment, country & phone Optional

Apartment / suiteCountryTelephone number

The person or business that received the payments. Use the name and TIN from their Form W-9.

Recipient name *

Tax ID typeTaxpayer ID number *

Street address *

City / town *State *ZIP / postal code *

Apartment, country Optional

Apartment / suiteCountry

Enter actual amounts paid during 2025. This is a payment statement; taxes are not estimated or deducted automatically.

Fill only the payment types that apply to your records. Amounts are reported before withholding; taxes are not calculated automatically.

Unemployment compensation · Box 1

State / local tax refunds Only if applicable

State / local income tax refunds, credits or offsets · Box 2Tax year the refund relates to · Box 3

Leave Box 3 blank when the refund relates to the selected current tax year. Use a separate form for each earlier refund tax year.

Box 2 is trade or business income · Box 8

Grants, RTAA, agriculture & market gain Only if applicable

RTAA payments · Box 5Taxable grants · Box 6Agriculture payments · Box 7Market gain · Box 9

Federal withholding & reporting options Only if applicable

Federal income tax withheld · Box 4Account numberMark as CORRECTED

State withholding Optional · up to 2 states

Add state information only when applicable, using actual state withholding records. A state ID is different from the payer’s federal EIN.

Copies 1, B and 2 will contain your details. All six original pages are included, with red Copy A left blank. Tax-agency filing is not included.

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