automat or !mrnt 10 Cop lr strenCe proceeds 14 Gross proceeds paid to an attorney 1E. ss stele taeynenota S 17 StaterOcitar's State no. ill Stale Inootne $ Forrrt 1O99'MISC O VOID D CORRECTED I I Department of the Treasury • Internal Raysnos Wald, PAYER'S name, street address, dly, stele. ZIP c