Case File
efta-efta00788401DOJ Data Set 9OtherK CORRECTED (if checked)
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Unknown
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DOJ Data Set 9
Reference
efta-efta00788401
Pages
2
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0
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K CORRECTED (if checked)
NUR'S norm suet redeem dry cc town stew a webby, cowry, tendon:IV
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Clark, Hunt Ahern & Embry
150 Cambridgepark Drive
Cambri e MA 02140
a DM of doing
12/18/2017
1 Owe twonsts
1,715,000.00
can Ms. 2545007
2017
Form 1099-5
Proceeds From Real
Estate Transactions
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Avram Noam Chomsky
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9777 N. Korth Lane
City. Sum, are be code
Oro Valley AZ 85704
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Copy 8
For Transferor
Thin IF Important tax
kiformation and is being
hewed to the intorno
Revenue Street. if you
are rewired to tie a
return, a negligence
oenbay of odor
sanction may be
imposed on you RINI
ken IS redirect to be
retorted and the IRS
deterrnIna that a l'as
not been reported.
Form 1099-5
(keep for your records)
www.bs.gw/formlo99s
Instructions for Transferor
For saes or exchanges of certain real estate, the person responsible for closing
a real estate transaction must report the real estate proceeds to thy IRS and
must furnish this statement to you. To determine If you have to report the sale
or eidunge of your main home on your tax return, see the instructions for
Schedule 0 (Form 1040). If the real estate was not you• malt home, report the
transaction on Form 4797, Form 6252, and/or the Schedule 0 for the
appropriate income tax form. if box 41s checked and you received or AI
receive like-kind property, you must fee Form 8824.
Federal mortgage subsidy. You may have to recapture (pay back) ail or part of
a federal mortgage subsidy If all the Slowing apply.
•
You received a loan provided from the proceeds of a qualified
mortgage bond or you received a mortgage aedk certificate.
a
Your onsfinal mortgage loan was provided after 1990.
You sold or disposed of your home at a gain during the first 9 years
alter you received the federal mortgage subsidy.
•
Your Income for the year you sold or disposed of your home was
over a specified amount.
This will Increase your tax. See Form 8828 and Pub.523.
Transferor's taxpayer identification number. For your protection, this
form may stow only the last four digits of your social security number
(SSR), individual taxpayer identification number (MN). adoption
taxpayer Identification number (ATIN), or employer identification
number (BIN). However, the Issuer has reported your complete
identification number to the IRS.
Department of the Treasury — Internal Revenue Service
Account number. May show an account or other unique number the filer
assigned to distinguish your account.
Box 1. Shows the date of closing,
Box 2. Shows the gross proceeds from a roil estate transaction. generally
the sales price. Gross proceeds Include cash and notes payable to you,
notes assumed by the transferee (buyer), and any notes paid off at
settlement. Box 2 does not include the value of other property or services
you received or will receive. See Box I.
Box 3. Shows the address or legal description of the property transferred.
Box 4.0 marked, shows that you received or will receive services or
property (other than cash or notes) as part of the consideration for the
property transferred. The value of any services or property (other than
cash or notes) Is not Included in box 2.
Box S. If checked. shows that you are a foreign person (nonresident alien.
foreign partnership, foreign estate, or foreign oust).
box 6. Shows certain real estate tax on a residence charged to the buyer at
settlement. If you have already paid the real estate tax for the period that
Includes the sale date, subtract the amount in box 6 from the amount Shady
paid to determine your deductible real estate tax. But a you have already
deducted the real estate tax Ina prior year, generally report this amount as
income on the 'Other income One of the appropriate inccene tax form. For
TOM Information, see ►ub, 523, Pub. 525, and Pub. 530.
EFTA00788401
K VOID
K CORRECTED
FitErS name. wawa .dins. <Ova town sine or prodnce,country.r) or bean
PPM toot, and telephone number.
Clark, Hunt, Ahern & Embry
150 Cambridgepark Drive
Cambridge MA 02140
10.4 of *IM
12/18/2017
I. oaw precnos
$ 1,715,000.00
OMB..
7
2017
Form 1099-S
Proceeds From Real
Estate Transactions
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TAANSICSIOWS Ithacan", nomter
IRAIIPSIMS Name
Avram Noam Chomsky
Sued Matest IlehAhlina opt. !haat)
9777 N. Korte Lane
City. Sum and Zn. code
Oro Valley AZ 85704
3. Mons a lava descrIston
984 Memorial Drive, Apartment 404
Cambridge MA 02138
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Copy C
For Filer
For privacy Act
and Paperwork
Reduction Act
Notice, see the
2027 General
Instructions for
Certain
Information
Return>.
Farm 1099-S
www.in.govitomace9s
Avram Noam Chomsky
Departmere of the Treasury — Internal Revenue SerOce
EFTA00788402
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