| # | Id | Type | Description |
| 1 | foreignAccountTaxCompliance | boolean | FATCA filing requirement |
| 2 | accountNumber | string | Account number |
| 3 | payerRtn | string | Payer's RTN |
| 4 | interestIncome | number | Box 1, Interest income |
| 5 | earlyWithdrawalPenalty | number | Box 2, Early withdrawal penalty |
| 6 | usBondInterest | number | Box 3, Interest on U.S. Savings Bonds and Treasury obligations |
| 7 | federalTaxWithheld | number | Box 4, Federal income tax withheld |
| 8 | investmentExpenses | number | Box 5, Investment expenses |
| 9 | foreignTaxPaid | number | Box 6, Foreign tax paid |
| 10 | foreignCountry | string | Box 7, Foreign country or U.S. possession |
| 11 | taxExemptInterest | number | Box 8, Tax-exempt interest |
| 12 | specifiedPabInterest | number | Box 9, Specified private activity bond interest |
| 13 | marketDiscount | number | Box 10, Market discount |
| 14 | bondPremium | number | Box 11, Bond premium |
| 15 | usBondPremium | number | Box 12, Bond premium on Treasury obligations |
| 16 | taxExemptBondPremium | number | Box 13, Bond premium on tax-exempt bond |
| 17 | cusipNumber | string | Box 14, Tax-exempt bond CUSIP no. |
| 18 | stateAndLocal | Array of StateAndLocalTaxWithholding | Boxes 15-17, State and Local tax withholding |
| 19 | foreignIncomes | Array of DescriptionAmount | Supplemental foreign income amount information (description is country) |
| 20 | stateTaxExemptIncome | Array of DescriptionAmount | Supplemental tax-exempt income by state (description is state) |
| 21 | secondTinNotice | boolean | Second TIN Notice |