1099-INT CORRECTION PREPARATION LOG Reporting Year: ________ Payer Name/TIN: ________________________________ Recipient Name/TIN: ____________________________ Account Number: ________________________________ 1. DEFECT IDENTIFICATION [ ] Original return identified in filing system [ ] Reason for correction documented: ________________________________________________ 2. FIELD VALIDATION (Enter values) Field | Original | Corrected Box 1: Interest | ________ | ________ Box 2: Early penalty | ________ | ________ Box 3: US Treasury int | ________ | ________ Box 4: Fed withholding | ________ | ________ Box 8: Tax-exempt int | ________ | ________ Box 9: Private activity | ________ | ________ Boxes 10-13: Premiums | ________ | ________ 3. DEPENDENCY CHECKS [ ] Unchanged fields carried over to corrected return [ ] Box 9 subset does not exceed Box 8 total [ ] Withholding changes verified against actual cash held 4. TRANSMISSION AND FURNISHING [ ] Transmitted via applicable channel (IRIS) [ ] Transmission status confirmed as Accepted [ ] Corrected statement furnished to recipient [ ] Explanation of change provided to recipient [ ] Master records updated with current version