IRS

Form 109495C

Information Returns (1099/1098/1095 Series)

IRS Form 109495C

IRS Form 109495C. Official IRS tax form (288.86 KB). Get AI-powered field-by-field guidance in the BrieflyGo AI Editor.

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Plain English

This is an information return — a form used by businesses, banks, and other payers to report payments made to you or others during the year. You may receive a copy of this form showing income you earned, and the same information is sent to the IRS so they can verify your tax return.

Quick Facts

Who: Businesses, financial institutions, and payers who need to report payments made to individuals or entities during the tax year.
What: 109495C — an information return that reports specific types of income, payments, or transactions to the IRS and to the recipient.
When: By the applicable filing deadline — typically January 31 for most forms, with earlier dates for certain form types.
Where: Filed with the IRS (electronically if 250+ forms) and copies provided to the recipient.
Why: The IRS uses information returns to verify that recipients report all income and pay the correct tax.
How: Enter payer and recipient identifying information, report the applicable payment amounts, and file with the IRS.

Common Risks & Mistakes

  • •Entering incorrect taxpayer identification information — verify SSN or EIN matches IRS records
  • •Missing the applicable filing deadline — late filing can result in penalties and interest
  • •Incomplete or missing required information — fill in all applicable fields
  • •Not keeping a copy of the completed form for your records
  • •Failing to attach required supporting documents or schedules

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Field-by-Field Guide

Payer Info
Payer Name, Address, and TINREQUIREDtext

Identifying information of the business or person making the payment.

Recipient Info
Recipient Name, Address, and TINREQUIREDtext

Identifying information of the person or entity receiving the payment.

Amounts
Reportable AmountREQUIREDamount

The payment amount subject to reporting for the applicable box category.

Withholding
Federal Income Tax Withheldamount

Backup withholding amount if applicable.

Signatures
Contact Informationtext

Name and phone number of the person to contact about this return.

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Form Stats

288.86 KB
Size
2025-11-04 22:12:05
Date

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Disclaimer: We do not provide legal advice. We translate legal language into plain English and help you prepare for a conversation with a lawyer.