CORRECTED (if checked)

PAYER’S name, address, ZIP/postal code, country & phone no. OMB No. 1545-0116
AYURBEAUTY WELNESS CENTER LLC
12 N. SUMMERLIN AVE Form 1099-NEC
Nonemployee
ORLANDO FL 32801
(Rev. January 2022) Compensation
For calendar year
(407) 617-9016 2022
PAYER’S TIN RECIPIENT’S TIN 1 Nonemployee compensation Copy B
46-1240832 XXX-XX-8976 $ 1410.00 For Recipient
RECIPIENT’S name, address, ZIP/postal code & country 2 Payer made direct sales totaling $5,000 or more of This is important tax
information and is being
MINERVA BETANCOURT consumer products to recipient for resale furnished to the IRS. If you
2734 EVELYN DR 3 are required to file a return, a
APOPKA FL 32703 negligence penalty or other
sanction may be imposed on
you if this income is taxable
4 Federal income tax withheld
and the IRS determines that it
$ has not been reported.

5 State tax withheld 6 State/Payer’s state no. 7 State income

Account number (see instructions) $ $
976641925656 $ $
Form 1099-NEC (Rev. 1-2022) (keep for your records) Department of the Treasury - Internal Revenue Service

CORRECTED (if checked)

PAYER’S name, address, ZIP/postal code, country & phone no. OMB No. 1545-0116
AYURBEAUTY WELNESS CENTER LLC
12 N. SUMMERLIN AVE Form 1099-NEC
Nonemployee
ORLANDO FL 32801 (Rev. January 2022) Compensation
For calendar year
(407) 617-9016 2022
PAYER’S TIN RECIPIENT’S TIN 1 Nonemployee compensation Copy B
46-1240832 XXX-XX-8976 $ 1410.00 Duplicate
RECIPIENT’S name, address, ZIP/postal code & country 2 Payer made direct sales totaling $5,000 or more of
MINERVA BETANCOURT consumer products to recipient for resale
2734 EVELYN DR 3
APOPKA FL 32703
4 Federal income tax withheld
$
5 State tax withheld 6 State/Payer’s state no. 7 State income
Account number (see instructions) $ $
976641925656 $ $
Form 1099-NEC (Rev. 1-2022) (keep for your records) Department of the Treasury - Internal Revenue Service

Instructions for Recipient Note: If you are receiving payments on which no income, social
security, and Medicare taxes are withheld, you should make estimated
You received this form instead of Form W-2 because the payer did not tax payments. See Form 1040-ES (or Form 1040-ES (NR)). Individuals
consider you an employee and did not withhold income tax or social must report these amounts as explained in these box 1 instructions.
security and Medicare tax. Corporations, fiduciaries, and partnerships must report these amounts on
If you believe you are an employee and cannot get the payer to correct the appropriate line of their tax returns.
this form, report the amount shown in box 1 on the line for “Wages, Box 2. If checked, consumer products totaling $5,000 or more were sold
salaries, tips, etc.” of Form 1040, 1040-SR, or 1040-NR. You must also to you for resale, on a buy-sell, a deposit-commission, or other basis.
complete Form 8919 and attach it to your return. For more information, see Generally, report any income from your sale of these products on
Pub. 1779, Independent Contractor or Employee. Schedule C (Form 1040).
If you are not an employee but the amount in box 1 is not self- Box 3. Reserved for future use.
employment (SE) income (for example, it is income from a sporadic activity
or a hobby), report the amount shown in box 1 on the “Other income” line Box 4. Shows backup withholding. A payer must backup withhold on
(on Schedule 1 (Form 1040)). certain payments if you did not give your TIN to the payer. See Form
2 9NECBBI

W-9, Request for Taxpayer Identification Number and Certification, for

Recipient’s taxpayer identification number (TIN). For your protection, information on backup withholding. Include this amount on your income
this form may show only the last four digits of your TIN (social security tax return as tax withheld.
number (SSN), individual taxpayer identification number (ITIN), adoption
taxpayer identification number (ATIN), or employer identification number Boxes 5-7. State income tax withheld reporting boxes.
(EIN)). However, the issuer has reported your complete TIN to the IRS. Future developments. For the latest information about developments
Account number. May show an account or other unique number the payer related to Form 1099-NEC and its instructions, such as legislation enacted
assigned to distinguish your account. after they were published, go to www.irs.gov/Form1099NEC.
NTF 2585139

Box 1. Shows nonemployee compensation. If the amount in this box is Free File Program. Go to www.irs.gov/FreeFile to see if you qualify for
SE income, report it on Schedule C or F (Form 1040) if a sole proprietor, no-cost online federal tax preparation, e-filing, and direct deposit or
or on Form 1065 and Schedule K-1 (Form 1065) if a partnership, and the payment options.
recipient/partner completes Schedule SE (Form 1040). 1099-NEC
 VOID CORRECTED
PAYER’S name, address, ZIP/postal code, country & phone no. OMB No. 1545-0116
AYURBEAUTY WELNESS CENTER LLC
Form 1099-NEC
12 N. SUMMERLIN AVE Nonemployee
ORLANDO FL 32801
(Rev. January 2022) Compensation
For calendar year
(407) 617-9016 2022
PAYER’S TIN RECIPIENT’S TIN 1 Nonemployee compensation Copy C
46-1240832 583-76-8976 $ 1410.00 For Payer
RECIPIENT’S name, address, ZIP/postal code & country 2 Payer made direct sales totaling $5,000 or more of
MINERVA BETANCOURT consumer products to recipient for resale For Privacy Act and
2734 EVELYN DR 3 Paperwork Reduction Act
APOPKA FL 32703 Notice, see the current
General Instructions for
Certain Information
4 Federal income tax withheld Returns.
$
5 State tax withheld 6 State/Payer’s state no. 7 State income
Account number (see instructions) 2nd TIN not. $ $
976641925656 $ $
Form 1099-NEC (Rev. 1-2022) Department of the Treasury - Internal Revenue Service

VOID CORRECTED
PAYER’S name, address, ZIP/postal code, country & phone no. OMB No. 1545-0116

DETACH BEFORE MAILING

Form 1099-NEC
Nonemployee
(Rev. January 2022) Compensation
For calendar year
2022
PAYER’S TIN RECIPIENT’S TIN 1 Nonemployee compensation Copy C
$ For Payer
RECIPIENT’S name, address, ZIP/postal code & country 2 Payer made direct sales totaling $5,000 or more of
consumer products to recipient for resale For Privacy Act and
3 Paperwork Reduction Act
Notice, see the current
General Instructions for
Certain Information
4 Federal income tax withheld Returns.
$
5 State tax withheld 6 State/Payer’s state no. 7 State income
Account number (see instructions) 2nd TIN not. $ $
$ $
Form 1099-NEC (Rev. 1-2022) Department of the Treasury - Internal Revenue Service

VOID CORRECTED
PAYER’S name, address, ZIP/postal code, country & phone no. OMB No. 1545-0116

Form 1099-NEC
Nonemployee
(Rev. January 2022) Compensation
2 B99NECC

For calendar year

2022
PAYER’S TIN RECIPIENT’S TIN 1 Nonemployee compensation Copy C
$ For Payer
RECIPIENT’S name, address, ZIP/postal code & country 2 Payer made direct sales totaling $5,000 or more of
NTF 2585136

consumer products to recipient for resale For Privacy Act and

3 Paperwork Reduction Act
Notice, see the current
General Instructions for
Certain Information
4 Federal income tax withheld Returns.
$
BNECPAY

5 State tax withheld 6 State/Payer’s state no. 7 State income

Account number (see instructions) 2nd TIN not. $ $
$ $
Form 1099-NEC (Rev. 1-2022) Department of the Treasury - Internal Revenue Service