Form 1099-SB Template

Use this form to report a seller’s investment in a life insurance contract and surrender amount.

By using this template, you agree to our Template Terms of Use.

Why use a Form 1099-SB?

A Form 1099-SB helps issuers document life insurance contract values
for the seller and recipient copy.

Record contract value

Capture the issuer’s estimate of the seller’s investment in the contract.
Show surrender amount

Document the surrender amount connected to the life insurance contract.
Provide issuer contact

Include issuer contact details so the seller can reach the reporting issuer.

This template includes issuer, seller, investment, surrender, contact, and recipient instruction details.

Issuer information
Fields for issuer name, address, telephone number, and taxpayer identification number.
Seller information
Fields for seller name, address, taxpayer identification number, and account number.
Investment in contract
A field for the issuer’s estimate of the seller’s investment in the contract.
Surrender amount
A field for reporting the surrender amount associated with the life insurance contract.
Seller instructions
Recipient instructions explain the investment amount, surrender amount, and TIN details.