| PAYER'S name, street address, city, state, ZIP code, and telephone no. | 1 Rents | OMB No. 1545-0115 2004 Form 1099-MISC | Miscellaneous Income | |
|---|---|---|---|---|
| $1542.80 | ||||
| $ | ||||
| 2 Royalties | ||||
| 3 Other income | 4 Federal income tax withheld | Copy A For Internal Revenue Service Center File with Form 1096. | ||
| $ | $ | |||
| PAYER'S Federal identification number | RECIPIENT'S Identification number | 5 Fishing boat proceeds | 6 Medical and health care payments | |
| RECIPIENT's name | 7 Nonemployee compensation | 8 Substitute payments in lieu of dividends or interest | For Privacy Act and Paperwork Reduction Act Notice, see the 2004 General Instructions for Forms 1099, 1098, 5498, and W-2G. | |
| BLUE DIAMOND REALTY, LLC | $661.20 | |||
| Street address (including apt. no.) 103 FOULK ROAD, SUITE 200 | 9 Payer made direct sales of $5,000 or more of consumer products to a buyer (recipient) for resale ▷ | 10 Crop insurance proceeds | ||
| City, state, and ZIP code WILMINGTON, DE 19803 | 11 | 12 | ||
| Account number (optional) | 2nd TIN not. | 14 Gross proceeds paid to an attorney | ||
| 15 | 16 State tax withhold | 17 State/Payer's state no. | 18 State income | |
| PAYER'S name, street address, city, state, ZIP code, and telephone no. JEGE, INC. C/O GEORGE V. DELSON & ASSOCIATES 110 EAST 59TH STREET, 28TH FL. NEW YORK, NY 10022 | 1 Rents | OMB No. 1545-0115 2004 Form 1099-MISC | Miscellaneous Income | ||
|---|---|---|---|---|---|
| 2 Royalties | |||||
| 3 Other income | |||||
| PAYER'S Federal Identification number | RECIPIENT'S identification number | 5 Fishing boat proceeds | 6 Medical and health care payments | Copy A For Internal Revenue Service Center File with Form 1098. | |
| RECIPIENT'S name | 7 Nonemployee compensation $1000.00 | 8 Substitute payments in lieu of dividends or interest | |||
| Street address (including apt. no.) | 9 Payer made direct sales of $5,000 or more of consumer products to a buyer (recipient) for resale ▶ | 10 Crop insurance proceeds | |||
| City, state, and ZIP code SIMI VALLEY, CA 93056 | 11 | 12 | |||
| Account number (optional) | 2nd TIN not. | 13 Excess golden perachute payments | 14 Gross proceeds paid to an attorney | ||
| 15 | 16 State tax withheld | 17 State/Payer's state no. | 18 State income | ||