CORRECTED (if checked) PAYERS name. street address. city or town. state or province. country. ZIP or foreign postal code. and telephone no. 1 Original issue discount for 2017' OMB No. 1545-0117 PAYERS federal identification number RECIPIENTS identification number RECIPIENTS name Street address (including apt. no.) City or tovm. state or province. country. and ZIP or foreign postal code FATCA fifng requirement 0 Account number (see instructions) Form 1099-OID (keep for your records) $ • TTY9 May not the the Coned figure to report on your interne tax return.. See Inatruetiant on the teak. 2 Other periodic retest $ 3 Early withdrawal penalty $ 5 Market discount $ 7 Description 2017 Form 1099-OO 4 Federal income tax withheld 6 Acquisition premium $ 8 Original issue discount on U.S. Treasury obligations' 10 Bond premium 9 Investment expenses 11 Tax-exempt OID 13 State identification no. www.irs gov/form1099oid 14 State tax withheld $ Original Issue Discount Copy B For Recipient This is important tax information and is being furnished to the Internal Revenue Service. If you are required to file a return, a negligence penalty or other sanction may be imposed on you if this income is taxable and the IRS determines that it has not been reported. Department of the Treason - Internal Revenue Service EFTA01222603