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2. The Office of the Commissioner of the Revenue requests a detailed list of all contractors, subcontractors, and persons issued a Federal Form 1099 used by your company for work performed in Dinwiddie County during the prior calendar year (if applicable).
4. Company Information
6. Name
7. Business License Account Number
9. Trading as (if applicable)
11. Address1
13. Address2
15. City
16. State
17. Zip
19. Email Address
20. Phone Number
22. Prior Calendar Year Activity

    1. No, the above-referenced company did not contract nor subcontract any work to others nor did it issue any Federal Form 1099s for work performed in Dinwiddie County in the prior calendar year.
    2. Yes, the above-referenced company contracted or subcontracted or issued Federal Form 1099s to others for work performed in Dinwiddie County in the prior calendar year as follows:
24. Name
26. Trading-As Name (if applicable)
28. Address1
30. Address2
32. City
33. State
34. Zip
36. Type of Service
37. Job Location
39. Year (Enter last calendar year)
40. Amount paid to contractor / subcontractor / 1099 employee
42. Name
44. Trading-As Name (if applicable)
46. Address1
48. Address2
50. City
51. State
52. Zip
54. Type of Service
55. Job Location
57. Year (enter last calendar year)
58. Amount Paid to contractor / subcontractor / 1099 employee
60. Name
62. Trading-As Name (if applicable)
64. Address1
66. Address2
68. City
69. State
70. Zip
72. Type of Service
73. Job Location
75. Year (enter last calendar year)
76. Amount Paid to contractor / subcontractor / 1099 employee
Leave This Blank:


78. 1. Receive an email copy of this form.
79. Email address

    This field is not part of the form submission.

80. Submit

* indicates a required field