Get IRS 1099-LTC 2016
Death benefits paid PAYER S federal identification number POLICYHOLDER'S identification number $ POLICYHOLDER'S name 3 Check one: Per Reimbursed diem amount INSURED'S name OMB No. 1545-1519 2016 Long-Term Care and Accelerated Death Benefits Form 1099-LTC INSURED'S taxpayer identification no. For Internal Revenue Service Center File with Form 1096. Street address (including apt. no.) Street address (including apt. no.) City or town, state or province, country, and ZIP or foreign pos.
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