Acquisition or Abandonment of Secured Property

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Attention! This form is provided for informational purposes and should not be reproduced on personal computer printers by individual taxpayers for filing. The printed version of this form is a "machine readable" form. As such, it must be printed using special paper, special inks, and within precise specifications. Additional information about the printing of these specialized tax forms can be found in: Publication 1167, Substitute Printed, Computer-Prepared, and Computer-Generated Tax Forms and Schedules; and, Publication 1179, Specifications for Paper Document Reporting and Paper Substitutes for Forms 1096, 1098, 1099 Series, 5498, and W-2G. The publications listed above may be obtained by calling 1-800-TAX-FORM (1-800-829-3676). Be sure to order using the IRS publication number.

VOID LENDER S name, street address, city, state, ZIP code, and telephone no. LENDER S Federal identification number BORROWER S name Street address (including apt. no.) City, state, and ZIP code Account number (optional) 8080 CORRECTED BORROWER S identification number 1 Date of lender s acquisition or knowledge of abandonment (MMDDYY) OMB No. 1545-0877 2 Balance of principal outstanding 3 4 Fair market value of property 5 Was borrower personally liable for repayment of the debt? Yes No 6 Description of property Cat. No. 14412G Do NOT Cut or Separate Forms on This Page 97 Acquisition or Abandonment of Secured Property Copy A For Internal Revenue Service Center File with Form 1096. For Paperwork Reduction Act Notice and instructions for completing this form, see Instructions for Forms 1099, 1098, 5498, and W-2G. Department of the Treasury - Internal Revenue Service

LENDER S name, street address, city, state, ZIP code, and telephone no. LENDER S Federal identification number BORROWER S name Street address (including apt. no.) City, state, and ZIP code Account number (optional) BORROWER S identification number CORRECTED (if checked) 1 Date of lender s acquisition or knowledge of abandonment OMB No. 1545-0877 2 Balance of principal outstanding 3 4 Fair market value of property 5 Was borrower personally liable for repayment of the debt? Yes No 6 Description of property (Keep for your records.) 97 Acquisition or Abandonment of Secured Property Copy B For Borrower 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 taxable income results from this transaction and the IRS determines that it has not been reported. Department of the Treasury - Internal Revenue Service

Instructions for Borrower Certain lenders who acquire an interest in property that was security for a loan or who have reason to know that such property has been abandoned must provide you with this statement. You may have reportable income or loss because of such acquisition or abandonment. Gain or loss from an acquisition generally is measured by the difference between your adjusted basis in the property and the amount of your debt canceled in exchange for the property, or, if greater, the sale proceeds. If you abandoned the property, you may have income from the discharge of indebtedness in the amount of the unpaid balance of your canceled debt. You may also have a loss from abandonment up to the adjusted basis of the property at the time of abandonment. Losses on acquisitions or abandonments of property held for personal use are not deductible. See Pub. 544, Sales and Other Dispositions of Assets, for information about foreclosures and abandonments. Property means all real property, such as a personal residence; all intangible property; and tangible personal property that is held for investment or used in a trade or business. If you borrowed money on this property with someone else, each of you should receive this statement. Box 1. For a lender s acquisition of property that was security for a loan, the date shown is generally the earlier of the date title was transferred to the lender or the date possession and the burdens and benefits of ownership were transferred to the lender. This may be the date of a foreclosure or execution sale or the date your right of redemption or objection expired. For an abandonment, the date shown is the date on which the lender first knew or had reason to know that the property was abandoned or the date of a foreclosure, execution, or similar sale. Box 2. Shows the amount of the debt (principal only) owed to the lender on the loan at the time the interest in the property was acquired by the lender or on the date the lender first knew or had reason to know that the property was abandoned. Box 4. Shows the fair market value of the property. If the amount in box 4 is less than the amount in box 2, and your debt is canceled, you may have cancellation of debt income. Box 5. Shows whether you were personally liable for repayment of the loan at the time the debt was created or, if modified, at the time of the last modification. Box 6. Shows the description of the property acquired by the lender or abandoned by you. If CCC is shown, the form indicates the amount of any Commodity Credit Corporation loan outstanding when you forfeited your commodity.

VOID LENDER S name, street address, city, state, ZIP code, and telephone no. LENDER S Federal identification number BORROWER S name Street address (including apt. no.) City, state, and ZIP code Account number (optional) CORRECTED BORROWER S identification number 1 Date of lender s acquisition or knowledge of abandonment OMB No. 1545-0877 2 Balance of principal outstanding 3 4 Fair market value of property 5 Was borrower personally liable for repayment of the debt? Yes No 6 Description of property 97 Acquisition or Abandonment of Secured Property Copy C For Lender For Paperwork Reduction Act Notice and instructions for completing this form, see Instructions for Forms 1099, 1098, 5498, and W-2G. Department of the Treasury - Internal Revenue Service

Lenders, Please Note Specific information needed to complete this form and other forms in the 1099 series is given in the 1997 Instructions for Forms 1099, 1098, 5498, and W-2G. A chart in those instructions gives a quick guide to which form must be filed to report a particular payment. You can order those instructions and additional forms by calling 1-800-TAX-FORM (1-800-829-3676). Furnish Copy B of this form to the borrower by February 2, 1998. File Copy A of this form with the IRS by March 2, 1998.