sageameridata 1099s 93-96 (gt-02)

8/14/2019 SageAmeriData 1099s 93-96 (GT-02)

http://slidepdf.com/reader/full/sageameridata-1099s-93-96-gt-02 1/4

\

.- - - ,- ,- ....--.- . . .. '- - ' - - ~ - ' - - - - - - -

" (Keep For Yopr Record)o.m 1099-Mls e

. . .cORRECT!=D (if checked) . .P;';''ER'S nsrne, sire..at.,dd"'>-... c i l y ~ n ; e 1 " Z J p@ !l=' ' P e n b ~

--- OMS No. 1545-01 16

$

Sag e. Tecb.no,l o g i e s . In c . t Royal ties- Mis-celf

C : a J s t reet . $

S tsrrnfu r d CT 06 90E Prizes, " " J a I t J e:::. :

: $

p . . I . ~ a r a ' : n t f f i ; 1 nu ITlb"r/ r : : l i idefrtm.....:ztbn numbar 4 Feder,,1income tu : wiih.!d :1 :?) :rshing bost l l ) _ ~ ., ..-..Q6- 1.3-02103 ' $, $ , _For R

RECrPJe. .fj 'S 1'l3m3 5 11:::lii:31 and h C careP¥1W!;; 7 e f f i p ' c o n ; : > 8 r . s ~ f This is ini:. info[ ina~ p Bzuno $ ' .s ' 4 4 "eeo , 0-0 being fumi3. ,_ p ~ " " ' " , d /9= m" ' , .rood sales "lrtt:m

, , dMd=n::l3 or Int::rest • S5,oOO-<:>r'fror:3 of consumer &lr.1c:02

, ' , p;tldu...-tl 10a b,lf' 0 q i r B u EQa.a

return,a89 $ . lracipi:mfJ br r a , penall

10 Croj) irisur"ace proceees /11S!EE ircome tax : J :Gnposed on

3:3:'OY If"i ' 1218 0 $ ' $ , lncomeis ta

Acro<.mt number t i l i " 1 2 l ) 12 Sl3te/P2yers slEl.3nurnbsr r I d th31 rt,has. .

I

J

IL .

GOVERNMENT

EXHIBIT

GT-2

..

8/14/2019 SageAmeriData 1099s 93-96 (GT-02)

http://slidepdf.com/reader/full/sageameridata-1099s-93-96-gt-02 2/4

DePartment of the Treasury- Inlp-mal Revenue & l r v ' ~ '

. ~ f j ~ t _, ~ r ~ l ~ ~ ~ ~ ~ t ~ ~ ; c . ~ ; ~ : ~ t t ~ ~ ? f ; j f " ¥ . g ~ ~ " " " = ' ; " ' - " " ' ; " " ; ' ' ' ' ' ~ ' ' ' ; ; ~ + ' ' ' ' : ; = = = " - : ' : ' : : . . i i ' ' ' " ' ' ~ ' ' ' ; ' ; ' .......... "'"1

. . . . r r-r-r--'---..- - - ~ . _ - ~ _ .

.

8/14/2019 SageAmeriData 1099s 93-96 (GT-02)

http://slidepdf.com/reader/full/sageameridata-1099s-93-96-gt-02 3/4

PAYER'S name, street aooress, city, state, andZIPcode

$

2

$

$

10C Insurnnc::e

$

w - " ' _ ~ . . . : .o CORRECTED(it ctlecxed)' .:.>.

inc.

-

Road

12180

-----

89 Bulson

Trov HY.Al:counl number (optional)

Form 1 O ~ 3 - M I S C D..pamnent o! If"'<> Treascry • Imema! R e I

- - - - - - - - - - - - - - - - - - - -- - - - - - - - -- - -- - - - - - ~ - - - - ~

8/14/2019 SageAmeriData 1099s 93-96 (GT-02)

http://slidepdf.com/reader/full/sageameridata-1099s-93-96-gt-02 4/4

O VOID o CORRECTED DJi.VI D PE

PAYER'Sname•• treetsddress, city, state, and ZIP code 1 Rents OMU No. 1545·0 115 12031 3 0 . 00 Miscella

AMERIDATA TPCHNOLOGI ES INC 2 Royanies

1996I

7 0 0 CANAL STREET 0 . 00STANFORD CT 0 6 9 0 2 3 Oth er income

0 .0 0 FOlIl1 lO99-l'vIlSC

?A'fER'S Federnl identificationnumber IRECIPIEl'rS identification number 4 Federal income tax withh<1 d 5 Fi>!ung bOllt proceeds

i0 6 - 1 3 0 2 1 0 3 0.

00 0 . 00 for RIREClP£Elo.,TfS name, street address. Clly . state, andZIPcode oMedical arid health care payments 7 Nonempleyeecompenssucn

0 . 00 24 , 0 00 . 00 11W is''BRUNO J OSEPH &Substitute !X!yments in lieuof I) Pay" made direct •• \ of mformaticn

89 BULSON ROJl..n div dends 0: mterest S5,OOO 0:more of consumer tiJmlshcd to

TROY, Wi 12 180 RcvtJlI1: Servic

0 . 00 0 requred to f

toCrop insuranceproceeds 11 Stale meome tax w thheld nezhgeneepen

sanenon ",-,y be

0 . 0 0 0 . 0 0 yoo if <:c<>blt:in

Accountnumber (opuonal) 12 S l d v a statenum ber fromun.=,tlle lRS deter

1 h. . not b

Form 1099-MlS C Depuruncnt oftheTreasury- lniemal Revenue Serv

0012 84