CCOunt number (optional) lake s 2nd TIN not 9 Payer made direct sales el 10 Crop ircuance proceeds $5.00) ce ream of consulter podtcs lea bum (recIplera) for remit h O s r 11 12 / / A 13 Excess geden perachuta 14 Gloss proceeds pats to paymertt; an attorney $ 16 State tax whNield 17 SusehiPa