2025 Form 1098 Mortgage Interest Statement

--- ## Page 1 The user wants me to transcribe all visible text on this page as clean markdown. The user wants: - No commentary - No analysis - No preamble - No "The document is..." sentences - Start directly with the content - Use ### for sections - Use **bold** for labels - Use markdown tables for tabular data - Use - bullets for lists - Preserve all numbers, dates, and values exactly as shown Let me carefully transcribe everything visible in the image. First, let me look at the top header area: - "Tax Statement for Forms 1098, 1099, 5498 for Year 2025" - There are OMB numbers listed in the top right corner: - 1098, Copy B, For Payer/Borrower, OMB #1545-1380 - 1098-E, Copy B, For Borrower, OMB #1545-1576 - 1098-INT, Copy B, For Borrower, OMB #1545-0112 - 1098-T, Copy B, For Borrower, OMB #1545-0123 - 1099-QID, Copy B, For Recipient, OMB #1545-0117 - 1099-SA, Copy B, For Recipient, OMB #1545-1517 - 5498, Copy B, For Participant, OMB #1545-0747 - 5498-ESA, Copy B, For Beneficiary, OMB #1545-1515 - 5498-SA, Copy B, For Participant, OMB #1545-1518 Left side (NAME, ADDRESS AND FEDERAL I.D. NO.): - VALLEY NATIONAL BANK - PO BOX 558 - WAYNE NJ 07474-0558 - Recipient's TIN 22-1186387 - Questions? (800) 522-4100 CUSTOMER CARE Right side (CUSTOMER NAME, ADDRESS): - JOHAN JONGSMA - TATYANA JONGSMA - 851 BRIGHTWATERS BLVD NE - ST PETERSBURG FL 33704-3719 Bottom right of that section: - 997L03000033550-1 000 - FORM 1 OF 1 Center title: - 2025 FORM 1098: MORTGAGE INTEREST STATEMENT Then the table: Account Number | IRS Description | IRS Box# | Amount 00800501300 00001 | Mortgage interest received from payer(s)/borrower(s) * | 1 | 101,977.65 | Outstanding mortgage principal | 2 | 1,250,000.00 | Mortgage origination date | 3 | 01/13/2016 | If address of property securing mortgage is the same as PAYER'S/BORROWER'S address, check the box, or enter the address or description in box 8 | 7 | | Address or description of property securing mortgage (see instructions) | 8 | 851 BRIGHTWATERS BLVD NE ST PETERSBURG | Number of properties securing the mortgage | 9 | | Mortgage acquisition date | 11 | Bottom left section: PAYER'S TIN ***-**-4568 Bottom middle/right - lots of fine print text. Let me transcribe this carefully. Left side fine print block (under PAYER'S TIN): (keep for your records) For Form 1096-QID, 1098-E, 1098-INT, 1098-T, 1098, OID, and Q: This is important tax information and is being furnished to the IRS. If you are required to file a return, a negligence penalty or other sanction may be imposed on you if this income is taxable and the IRS determines that it has not been reported. Form 1098-Caution: The amount shown may not be fully deductible by you. Limits based on the loan amount and the cost and value of the secured property may apply. Also, you may only deduct interest to the extent it was incurred by you, actually paid by you, and not reimbursed by another person. Form 1098-The information in boxes 1 through 9 and 11 is important tax information and is being furnished to the IRS. If you are required to file a return, a negligence penalty or other sanction may be imposed on you if the IRS determines that an underpayment of tax results because you overstated a deduction for this mortgage interest or for these points, reported in boxes 1 and 6 or because you didn't report the refund of interest (box 4) or because you claimed a non-deductible item. 1098-E - OMB #1545-1576 person (including a financial institution, a governmental unit, and an educational institution) that receives interest payments of $600 or more during the year on one or more qualified student loans must furnish this statement to you. If your loan was made before September 1, 2004, box 1 may show only the last four digits of your TIN (social security number (SSN), individual taxpayer identification number (ITIN), adoption taxpayer identification number (ATIN), or employer identification number (EIN)). However, the issuer has reported your complete TIN to the IRS. Box 1. Shows the student loan interest deduction you are allowed to claim for 2025. 5498-ESA-Copy B For Beneficiary Middle bottom section: www.irs.gov/form1098 1098 - OMB #1545 - 1380 A person (including a financial institution, a governmental unit, and a cooperative housing corporation) who is engaged in a trade or business and, in the course of such trade or business, receives interest of $600 or more on any mortgage during any calendar year on one or more qualified student loans must furnish this statement to you. If you received this statement as the payer of record on a mortgage on which there are other borrowers, furnish each of the other borrowers with information about the proper distribution of the interest paid or points paid to each borrower. Each borrower may have to include in income a share of any amount reported in box 4. Box 4. Shows a refund or credit of overpaid interest. See Pub. 936 and see the 2025 Instructions for Schedule A, C, or E (Form 1040). Box 5. Shows the mortgage insurance premiums paid by the borrower during the year. The amount includes interest paid on any obligation secured by real property, including a mortgage. See the instructions for Box 1. The mortgage interest that you paid on a home equity loan or line of credit secured by a qualified residence. See the instructions for your income tax return. However, you may not be able to deduct the full amount of interest shown in box 1. See Limitations on Deduction below. Limitations on Deduction. You may not be able to deduct all of the interest paid or points reported in box 1. Interest on home equity loans and lines of credit is deductible only if, among other things, the loan proceeds were used to buy, build, or substantially improve the home that secures the loan. See Pub. 936 for more information. Right side fine print: Department of the Treasury - Internal Revenue Service NOTICE If you received this statement as the payer of record on a mortgage on which there are other borrowers, furnish each of the other borrowers with information about the proper distribution of amounts reported in this form. Each borrower may have to include in income a share of any amount reported in box 4. CAUTION! If you prepay interest in 2025 that is for 2026 or later, include that prepaid interest in your 2026 tax return, not your 2025 tax return. The mortgage interest statement may show more interest than you are allowed to deduct. See Pub. 936 to determine your deductible amount. You may only deduct mortgage interest you actually paid to the lender during the year. Points paid on a home purchase, home construction, or home equity loan or line of credit secured by a qualified residence, you can only deduct the interest paid on acquisition indebtedness, and you may be subject to limitations. Box 2. Shows the outstanding principal on the mortgage as of January 1, 2025. If the mortgage originated in 2025, box 2 shows the mortgage principal as of the origination date. Box 3. Shows the mortgage origination date. Box 7. Checkbox for address of property. Box 8. Shows the address or description of the property securing the mortgage. Box 9. Shows the number of properties securing the mortgage. Box 11. Shows the date the mortgage was acquired by the lender if after July 12, 1989. Let me look more carefully at the image to make sure I capture everything. Actually, looking at the layout, there are multiple fine print sections. Let me try to organize this. The document has: 1. Top header with form numbers and OMB numbers 2. Left payer info 3. Right recipient info 4. Main table 5. Bottom section with PAYER'S TIN 6. Three columns of fine print at the bottom Let me be very precise: Top right OMB numbers: 1098, Copy B, For Payer/Borrower, OMB #1545-1380 1098-E, Copy B, For Borrower, OMB #1545-1576 1098-T, Copy B, For Borrower, OMB #1545-0123 1098-INT, Copy B, For Borrower, OMB #1545-0112 1099-QID, Copy B, For Recipient, OMB #1545-0117 1099-SA, Copy B, For Recipient, OMB #1545-1517 5498, Copy B, For Participant, OMB #1545-0747 5498-ESA, Copy B, For Beneficiary, OMB #1545-1515 5498-SA, Copy B, For Participant, OMB #1545-1518 Left column: **NAME, ADDRESS AND FEDERAL I.D. NO.** VALLEY NATIONAL BANK PO BOX 558 WAYNE NJ 07474-0558 Recipient's TIN 22-1186387 Questions? (800) 522-4100 CUSTOMER CARE Right column: **CUSTOMER NAME, ADDRESS** JOHAN JONGSMA TATYANA JONGSMA 851 BRIGHTWATERS BLVD NE ST PETERSBURG FL 33704-3719 Below that right: 997L03000033550-1 000 Below that right: FORM 1 OF 1 Title: **2025 FORM 1098: MORTGAGE INTEREST STATEMENT** Table: | Account Number | IRS Description | IRS Box# | Amount | | 00800501300 00001 | Mortgage interest received from payer(s)/borrower(s) * | 1 | 101,977.65 | | | Outstanding mortgage principal | 2 | 1,250,000.00 | | | Mortgage origination date | 3 | 01/13/2016 | | | If address of property securing mortgage is the same as PAYER'S/BORROWER'S address, check the box, or enter the address or description in box 8 | 7 | | | | Address or description of property securing mortgage (see instructions) | 8 | 851 BRIGHTWATERS BLVD NE ST PETERSBURG | | | Number of properties securing the mortgage | 9 | | | | Mortgage acquisition date | 11 | | Bottom left: **PAYER'S TIN** ***-**-4568 (keep for your records) Left fine print column: For Form 1096-QID, 1098-E, 1098-INT, 1098-T, 1098, OID, and Q: This is important tax information and is being furnished to the IRS. If you are required to file a return, a negligence penalty or other sanction may be imposed on you if this income is taxable and the IRS determines that it has not been reported. Form 1098-Caution: The amount shown may not be fully deductible by you. Limits based on the loan amount and the cost and value of the secured property may apply. Also, you may only deduct interest to the extent it was incurred by you, actually paid by you, and not reimbursed by another person. Form 1098-The information in boxes 1 through 9 and 11 is important tax information and is being furnished to the IRS. If you are required to file a return, a negligence penalty or other sanction may be imposed on you if the IRS determines that an underpayment of tax results because you overstated a deduction for this mortgage interest or for these points, reported in boxes 1 and 6 or because you didn't report the refund of interest (box 4) or because you claimed a non-deductible item. 1098-E - OMB #1545-1576 person (including a financial institution, a governmental unit, and an educational institution) that receives interest payments of $600 or more during the year on one or more qualified student loans must furnish this statement to you. If your loan was made before September 1, 2004, box 1 may show only the last four digits of your TIN (social security number (SSN), individual taxpayer identification number (ITIN), adoption taxpayer identification number (ATIN), or employer identification number (EIN)). However, the issuer has reported your complete TIN to the IRS. Box 1. Shows the student loan interest deduction you are allowed to claim for 2025. 5498-ESA-Copy B For Beneficiary Middle fine print column: www.irs.gov/form1098 1098 - OMB #1545 - 1380 A person (including a financial institution, a governmental unit, and a cooperative housing corporation) who is engaged in a trade or business and, in the course of such trade or business, receives interest of $600 or more on any mortgage during any calendar year on one or more qualified student loans must furnish this statement to you. If you received this statement as the payer of record on a mortgage on which there are other borrowers, furnish each of the other borrowers with information about the proper distribution of the interest paid or points paid to each borrower. Each borrower may have to include in income a share of any amount reported in box 4. Box 4. Shows a refund or credit of overpaid interest. See Pub. 936 and see the 2025 Instructions for Schedule A, C, or E (Form 1040). Box 5. Shows the mortgage insurance premiums paid by the borrower during the year. The amount includes interest paid on any obligation secured by real property, including a mortgage. See the instructions for Box 1. The mortgage interest that you paid on a home equity loan or line of credit secured by a qualified residence. See the instructions for your income tax return. However, you may not be able to deduct the full amount of interest shown in box 1. See Limitations on Deduction below. Limitations on Deduction. You may not be able to deduct all of the interest paid or points reported in box 1. Interest on home equity loans and lines of credit is deductible only if, among other things, the loan proceeds were used to buy, build, or substantially improve the home that secures the loan. See Pub. 936 for more information. Right fine print column: Department of the Treasury - Internal Revenue Service NOTICE If you received this statement as the payer of record on a mortgage on which there are other borrowers, furnish each of the other borrowers with information about the proper distribution of amounts reported in this form. Each borrower may have to include in income a share of any amount reported in box 4. CAUTION! If you prepay interest in 2025 that is for 2026 or later, include that prepaid interest in your 2026 tax return, not your 2025 tax return. The mortgage interest statement may show more interest than you are allowed to deduct. See Pub. 936 to determine your deductible amount. You may only deduct mortgage interest you actually paid to the lender during the year. Points paid on a home purchase, home construction, or home equity loan or line of credit secured by a qualified residence, you can only deduct the interest paid on acquisition indebtedness, and you may be subject to limitations. Box 2. Shows the outstanding principal on the mortgage as of January 1, 2025. If the mortgage originated in 2025, box 2 shows the mortgage principal as of the origination date. Box 3. Shows the mortgage origination date. Box 7. Checkbox for address of property. Box 8. Shows the address or description of the property securing the mortgage. Box 9. Shows the number of properties securing the mortgage. Box 11. Shows the date the mortgage was acquired by the lender if after July 12, 1989. Wait, I need to look more carefully at the fine print. It's very small. Let me see if I can read it better. Actually, looking at the image again, I see the fine print is in three distinct columns at the bottom. Column 1 (left): - Starts with "1098-E - OMB #1545-1576" - Then text about student loans - Then "Box 1. Shows the student loan interest..." - Then "5498-ESA-Copy B For Beneficiary" Column 2 (middle): - "www.irs.gov/form1098" - "1098 - OMB #1545 - 1380" - Text about person receiving interest - Box 4 description - Box 5 description - Limitations on Deduction text Column 3 (right): - "Department of the Treasury - Internal Revenue Service" - "NOTICE" - Text about distributing to other borrowers - "CAUTION!" text - Box 2, 3, 7, 8, 9, 11 descriptions Also above these three columns, there's text that spans across or is positioned above the PAYER'S TIN area. Let me look at the text near PAYER'S TIN: Above the three columns, there's text starting with "(keep for your records)" And to the right of PAYER'S TIN, there's text about "For Form 1096-QID, 1098-E..." that appears to be in the left section. Let me organize this more carefully. The layout has: 1. PAYER'S TIN box on bottom left 2. Above the three columns of fine print, there's a section of text that is to the right of the PAYER'S TIN box. Actually, looking at the structure: - Bottom left: PAYER'S TIN ***-**-4568 - To the right of that, starting at the same level: "(keep for your records)" and then the warning text about Form 1098-Caution. - Then below that are three columns of fine print. Let me try to read --- ## Page 2 ### Form 1099-SA **OMB No. 1545-1517** ### Distributions From an HSA, Archer MSA, or Medicare Advantage MSA --- **Copy B For Recipient** --- ### Form Fields | Box 1 | Gross distribution | | Box 2 | Earnings on excess contributions | | Box 3 | Distribution code | | Box 4 | FMV on date of death | | Box 5 | Type of account (HSA, Archer MSA, Medicare Advantage MSA) | | Box 6 | Checkbox | --- ### Instructions for Recipient **Box 1.** Shows the gross amount paid to you or on your behalf from the HSA, Archer MSA, or Medicare Advantage MSA during the calendar year. This amount includes all amounts paid to you or on your behalf even if the amount is not taxable. Generally, you must include in your income any amount you received during the year from the HSA, Archer MSA, or Medicare Advantage MSA that was not used to pay or reimburse you for qualified medical expenses. See the Instructions for Form 8853 or the Instructions for Form 8889 to figure the taxable amount. If you are the beneficiary of a deceased account holder and you received a distribution from the account, see the Instructions for Form 8853 or the Instructions for Form 8889. **Box 2.** Shows the earnings on any excess contributions and excess amounts in your Archer MSA or excess contributions in your HSA that are taxable. Include this amount in your income on your tax return. See the Instructions for Form 8853 or the Instructions for Form 8889. **Box 3.** Shows the distribution code. The code identifies the type of distribution you received. See the chart below for an explanation of the codes. If the code is not shown, the payer did not have the information necessary to determine the code. **Distribution Codes** | Code | Description | |------|-------------| | 1 | Normal distribution | | 2 | Excess contributions | | 3 | Disability | | 4 | Death | | 5 | Prohibited transaction | | 6 | Excess contributions and earnings taxable in same year | **Box 4.** If you are the designated beneficiary of a deceased account holder and you received a distribution from the account, this box shows the fair market value (FMV) of the assets in the account on the date of death. See the Instructions for Form 8853 or the Instructions for Form 8889. **Box 5.** Shows the type of account. The account is an HSA, Archer MSA, or Medicare Advantage MSA. **Box 6.** If this box is checked, the payer is reporting the distribution as an HSA, Archer MSA, or Medicare Advantage MSA distribution. Generally, the account trustee or custodian is required to file Form 1099-SA to report distributions from the account. --- ### Additional Information If you rolled over a distribution from an Archer MSA to an Archer MSA or a distribution from a Medicare Advantage MSA to a Medicare Advantage MSA, you must include the amount shown in Box 1 on your tax return unless you meet one of the exceptions. See the Instructions for Form 8853 to report the distribution. If you rolled over a distribution from an HSA to an HSA, you do not have to report the distribution on your tax return. However, you must reduce the amount you can contribute to your HSA for the year by the amount rolled over. If you received a distribution from an HSA, you must file Form 8889. If you received a distribution from an Archer MSA or Medicare Advantage MSA, you must file Form 8853. Report the amount from Box 1 on Form 8889, line 14a, or Form 8853, line 17a, unless one of the exceptions applies. If you meet an exception, you may have to report the distribution on Form 8889, line 16a, or Form 8853, line 19a. See the instructions for Form 8889 or Form 8853 for more information. If you received a distribution that you did not roll over and the distribution was not used to pay for qualified medical expenses, you must include the amount in your income and it may be subject to an additional 20% tax. See the instructions for Form 8889 or Form 8853. **Exception.** You do not have to report the distribution on Form 8889 or Form 8853 if all of the following apply. - You rolled over the distribution to the same type of account (HSA to HSA, Archer MSA to Archer MSA, or Medicare Advantage MSA to Medicare Advantage MSA). - You did not receive cash or other benefits in addition to the distribution. - The distribution was not from an inherited account. If you meet all three exceptions, do not report the distribution on Form 8889 or Form 8853. --- ### Copy C Information **Copy C For Payer or State Copy** Retain this copy for your records. --- **Note:** Keep this form with your tax records. Do not attach it to your tax return. The IRS does not require you to attach Form 1099-SA to your tax return. --- **Form 1099-SA** **OMB No. 1545-0112** --- ### Payer Information - **Payer's name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.** - **Payer's Federal identification number** - **Recipient's identification number** - **Recipient's name** - **Street address (including apt. no.)** - **City or town, state or province, country, and ZIP or foreign postal code** - **Account number** (optional) --- **Privacy Act Notice:** Section 6109 requires you to provide your correct TIN to the payer. You must provide this information so that the payer can report distributions from your account to the IRS. The IRS uses this information to determine whether you properly reported the distributions on your tax return. --- **1099-SA**