n 4004 Womb $ 13 Erman golden pinch& weenie $ 16 State tax withheld $ 10 Crap Insurance proceeds 14 Gross proceeds ask' on attorney $ 17 State/Peyere state no. For Privacy Act and Paperwork Reduction Act Notice, see the 2.005 General Instructions for Forms 1099, 1098, 6498, end W-20. 18 S