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01 FIRST NATI~AL B Q <br />401 MAIN STREET <br />LONGMONT CO 8 0 502-115 9• ,pN u~ 2~~~ <br />3 0 3 7 7 6- 5 8 0 0 0,` `~\u~ ~~ a~~t1C~a~' b~eow9Y <br />Recipient Statement Form 1099-INT <br />For Tax Year 1999 Interest Income <br />ROCKY ROADS INVESTMENTS INC <br />ASSIGNED TO STATE OF COLO/MLRB <br />1313 SHERMAN ST ROOM 215 <br />DENVER CO 80203-0000 <br />Year-end Summary <br />Type <br />TIME DEPOSIT <br />TIME DEPOSIT <br />Account Interest Inc Early Wthd <br />Number Investmt Exp Penalty <br />25131 308.12 <br />.00 <br />41947 359.82 <br />.00" <br />OMB# 1545-0112 <br />Page 1 <br />12/31/99 <br />1 ID 840253875 <br />ID 841130369 <br />1 FED TAX <br />Withholding <br />0 .00 <br />0 .00 . <br />,,,,..:, <br />INTEREST Reported to the Internal Revenue Service for 999 <br />Interest Paid (Not in Box 3) (Box 1) 2 667.94 <br />Early Withdrawal Penalty (Box 2) <br />Interest on Savings Bonds (Box 3) <br />FEDERAL INCOME TAX WITHHELD (box 4) <br />Investment Expenses (in Box 1) (Box 5) <br />Foreign Tax Paid (Box 6) <br />THIS IS IMPORTANT TAX INFORMATION AND IS BEING FURNISH D TO THE <br />INTERNAL REVENUE SERVICE. IF YOU ARE REQUIRED TO FILE RETURN, A <br />NEGLIGENCE PENALTY OR OTHER SANCTION MAY BE IMPOSED ON YOU IF•THIS <br />INCOME IS TAXABLE AND THE IRS DETERMINES THAT IT HAS N T BEEN <br />REPORTED. <br />YK- tas5 - ago <br />~~,~k __ ; ~~. <br />~:: <br />00 <br />00 <br />00 <br />00 <br />00 <br />