NOTE: Cash App does not report your Bitcoin cost-basis, gains, or

losses to the IRS or on this Form 1099-DA. Cash App reports the
total proceeds from Bitcoin sales made on the platform.
 Block, Inc.
f/k/a Square, Inc. If you have questions contact:
1955 Broadway [Link]
MSC 415
Oakland, CA 94612

HOWARD MICHAEL BRANDON CULPEPPER

4028 Magill Road
Jacksonville, FL 32220

Instructions for Recipient Box 2. If checked, the basis in box 1g has been reported to the IRS and
Brokers must report proceeds from (and in some cases, basis for) digital either the short-term or the long-term gain or loss box in box 6 will be
asset dispositions to you and the IRS on Form 1099-DA. You may be checked. If box 2 is checked on Form(s) 1099-DA and NO adjustment is
required to recognize gain from these dispositions of digital assets. required, see the instructions for your Schedule D (Form 1040), as you may
Reporting is also required when your broker knows or has reason to know be able to report your transaction directly on Schedule D (Form 1040). If
that a corporation in which you own a digital asset that is also stock has the "Ordinary" box in box 6 is checked, an adjustment may be required.
had a reportable change in control or capital structure. You may be Box 3a. If the exercise of a digital asset that is also a non-compensatory
required to recognize gain from the receipt of cash, services, digital assets, option resulted in a sale of a digital asset, a checked "Net proceeds" box
or other property that was exchanged for a digital asset that is also the indicates that the amount in box 1f was adjusted for option premium. A
corporation’s stock. checked "Gross proceeds" box indicates that the amount in box 1f was
If you received a Form 1099-DA, you generally sold, exchanged, or not adjusted for option premium.
otherwise disposed of a financial interest in a digital asset and should Box 3b. If checked, proceeds are from a transaction involving a Qualified
check the "Yes" box next to the question on page 1 of Form 1040. Opportunity Fund (QOF).
Recipient’s taxpayer identification number (TIN). For your protection, Box 4. Shows backup withholding. Generally, a filer must backup withhold
this form may show only the last four digits of your TIN (social security if you did not furnish your TIN to the filer. See Form W-9 for information on
number (SSN), individual taxpayer identification number (ITIN), adoption backup withholding. Include this amount on your income tax return as tax
taxpayer identification number (ATIN), or employer identification number withheld.
(EIN)). However, the issuer has reported your complete TIN to the IRS. Box 5. If checked, you cannot take a loss on your tax return based on
Account number. May show an account or other unique number the filer gross proceeds from a reportable change in control or capital structure
assigned to distinguish your account. reported in box 1f. See the Form 8949 and Schedule D (Form 1040)
CUSIP number. Shows the CUSIP (Committee on Uniform Security instructions. The broker should advise you of any losses on a separate
Identification Procedures) number or other applicable identifying number, if statement.
applicable to the digital assets disposed. Box 6. The short-term and long-term boxes pertain to short-term gain or
Applicable checkbox on Form 8949. Indicates where to report this loss and long-term gain or loss. If the "Ordinary" gain or loss box is
transaction on Form 8949 and Schedule D (Form 1040), and which checked, your digital asset may be subject to special rules. See the
checkbox is applicable. See the instructions for your Schedule D (Form Instructions for Form 8949, Pub. 550, or Pub. 1212 for more details on
1040) and/or Form 8949. whether there are any special rules or adjustments that might apply to your
digital asset. If box 9 is checked, box 6 may be blank.
Box 1a. Shows the Digital Token Identification Foundation (DTIF) code
associated with the name shown in box 1b for which the amounts are Box 7. If checked, you only received cash proceeds in the transaction.
being reported. Box 8. If checked, you provided acquisition information to your broker and
Box 1b. Shows the name of the digital asset. they relied on it when identifying which digital asset was sold, exchanged,
or disposed.
Box 1c. Shows the number of digital asset units sold, exchanged, or
otherwise disposed of in the transaction. Box 9. If checked, the digital asset sold was a noncovered security and
boxes 1d, 1g, 1h, 1i, 2, and 6 may be blank.
Box 1d. Shows the original date the assets were acquired. This box may
be blank if box 9 is checked or if the digital assets sold, exchanged, or Box 10. Reserved for future use.
otherwise disposed of were acquired on a variety of dates or if the date Box 11a. If checked, the digital assets sold were qualifying stablecoins or
was unknown to the filer. specified non-fungible tokens (NFTs) and the information reported in box 1f
Box 1e. Shows the sale or disposition date. represents the aggregate gross proceeds from those sales for the year.
Box 1f. Shows the total proceeds from the digital asset transaction. Total Box 11b. Shows the number of transactions if the information reported on
proceeds may include cash, the value of services, digital assets, or other this form represents more than one transaction.
property received in exchange for the disposed digital assets. This amount Box 11c. Shows the gross proceeds from the first sale of any specified
does not include the gross proceeds from the first sale of any specified NFTs you created or minted.
NFTs you created or minted, which are reported in box 11c. Box 12a. Shows the number of digital asset units transferred into an
Box 1g. Shows the aggregate cost or other basis of the digital assets sold, account at the broker.
exchanged, or otherwise disposed. If box 9 is checked, box 1g may be Box 12b. Shows the date of any transfer-in.
blank if the cost or other basis was unknown to the filer, or the digital
assets were acquired prior to 2026. If box 1g is blank, you will need to Box 13. Reserved for future use.
determine your basis based on your own books and records. If box 1g has Box 14-16. Show state(s)/local income tax information.
any entry, including zero, the information within that box has been reported Future developments. For the latest information about any developments
to the IRS as basis. related to Form 1099-DA and its instructions, such as legislation enacted
Box 1h. Shows the amount of accrued market discount for digital assets after they were published, go to [Link]/Form1099DA.
that are also debt instruments for tax purposes. For details on market Free File Program. Go to [Link]/FreeFile to see if you qualify for
discount, see the Schedule D (Form 1040) instructions, the Instructions for no-cost online federal tax preparation, e-filing, and direct deposit or
Form 8949, and Pub. 550. If box 9 is checked, box 1h may be blank. payment options.
Box 1i. Shows the amount of nondeductible loss in a wash sale
transaction involving digital assets that are also stock or securities for tax
purposes. For details on wash sales, see the Schedule D (Form 1040)
instructions, the Instructions for Form 8949, and Pub. 550. If box 9 is
checked, box 1i may be blank.
5H8946 1.000
5H8945 3.000
CORRECTED (if checked)
FILER’S name, street address, city or town, state or province, country, ZIP Applicable checkbox on Form 8949 OMB No. 1545-2330 Digital Asset
or foreign postal code, and telephone no.
Proceeds From
Block, Inc.
f/k/a Square, Inc.
À¾¶¹ Broker
Y Form 1099-DA Transactions
1955 Broadway 1a Code for digital asset
MSC 415 Copy B
Oakland, CA 94612 1b Name of digital asset For Recipient

FILER’S TIN RECIPIENT’S TIN

1c Number of units
80-0429876 XXX-XX-8143
RECIPIENT’S name, street address (including apt. no.), city or town, state or
0.000896150000000000
province, country, and ZIP or foreign postal code 1d Date acquired 1e Date sold or disposed

HOWARD MICHAEL BRANDON CULPEPPER 1f Proceeds 1g Cost or other basis This is important tax
4028 Magill Road information and is
$ 81.91 $ being furnished to
Jacksonville, FL 32220 1h Accrued market discount 1i Wash sales loss disallowed
the IRS. If you are
$ $ required to file a
2 Check if basis reported 3a Reported to IRS: return, a negligence
to IRS
penalty or other
Account number
X Gross proceeds
1F3D04E6 Net proceeds sanction may be
imposed on you if
3b Check if proceeds from: 4 Federal income tax withheld
CUSIP number this income is
Reserved for future use taxable and the IRS
QOF $ determines that it
5 Check if loss is not 6 Gain or loss: 7 Check if 1f is only cash 8 Check if broker relied has not been
allowed based on on customer-provided reported.
amount in 1f acquisition information
Short-term Ordinary
Long-term X
9 Check if digital 10 11a Check if gross proceeds
asset is a reported in 1f is an
noncovered aggregate amount for:
security Qualifying stablecoins
Specified NFTs
11b If 11a checked, 11c For aggregate reporting of specified 12a Number of units transferred in 12b If transferred in, provide 13
number of NFTs, aggregate gross proceeds transfer-in date
transactions reported in 1f that are attributable
to first sales by creator or minter

$ 0.000000000000000000
14 State name 15 State identification no. 16 State tax withheld

$
Form 1099-DA (Keep for your records) [Link]/Form1099DA Department of the Treasury - Internal Revenue Service
HOWARD MICHAEL BRANDON CULPEPPER Account 1F3D04E6

Date Description Non Covered Security Account Only Cash Proceeds

FORM 1099-DA, Taxable Location - /State Account = FL/Unknown, Box 1a (Code for digital asset)=4H95J0R2X, Box 1b (Name of digital asset)=Bitcoin, Box 1e (Date sold or disposed)=2/22/2025, Form Identifier=1F3D04E6-58863118, Box 9 (Noncovered Security Ind)=Y
02-22-2025 0.000074840000000000 BTC Yes HOWARD MICHAEL BRANDON CU Yes $6.97

FORM 1099-DA, Taxable Location - /State Account = FL/Unknown, Box 1a (Code for digital asset)=4H95J0R2X, Box 1b (Name of digital asset)=Bitcoin, Box 1e (Date sold or disposed)=3/24/2025, Form Identifier=1F3D04E6-58863129, Box 9 (Noncovered Security Ind)=Y
03-24-2025 0.000017650000000000 BTC Yes HOWARD MICHAEL BRANDON CU Yes $1.48

FORM 1099-DA, Taxable Location - /State Account = FL/Unknown, Box 1a (Code for digital asset)=4H95J0R2X, Box 1b (Name of digital asset)=Bitcoin, Box 1e (Date sold or disposed)=4/9/2025, Form Identifier=1F3D04E6-58863138, Box 9 (Noncovered Security Ind)=Ye
04-09-2025 0.000124290000000000 BTC Yes HOWARD MICHAEL BRANDON CU Yes $9.20

FORM 1099-DA, Taxable Location - /State Account = FL/Unknown, Box 1a (Code for digital asset)=4H95J0R2X, Box 1b (Name of digital asset)=Bitcoin, Box 1e (Date sold or disposed)=4/9/2025, Form Identifier=1F3D04E6-58863146, Box 9 (Noncovered Security Ind)=Ye
04-09-2025 0.000122330000000000 BTC Yes HOWARD MICHAEL BRANDON CU Yes $9.78

FORM 1099-DA, Taxable Location - /State Account = FL/Unknown, Box 1a (Code for digital asset)=4H95J0R2X, Box 1b (Name of digital asset)=Bitcoin, Box 1e (Date sold or disposed)=4/10/2025, Form Identifier=1F3D04E6-58863156, Box 9 (Noncovered Security Ind)=Y
04-10-2025 0.000021650000000000 BTC Yes HOWARD MICHAEL BRANDON CU Yes $1.69

FORM 1099-DA, Taxable Location - /State Account = FL/Unknown, Box 1a (Code for digital asset)=4H95J0R2X, Box 1b (Name of digital asset)=Bitcoin, Box 1e (Date sold or disposed)=4/14/2025, Form Identifier=1F3D04E6-58863163, Box 9 (Noncovered Security Ind)=Y
04-14-2025 0.000003290000000000 BTC Yes HOWARD MICHAEL BRANDON CU Yes $0.26

FORM 1099-DA, Taxable Location - /State Account = FL/Unknown, Box 1a (Code for digital asset)=4H95J0R2X, Box 1b (Name of digital asset)=Bitcoin, Box 1e (Date sold or disposed)=4/21/2025, Form Identifier=1F3D04E6-58863175, Box 9 (Noncovered Security Ind)=Y
04-21-2025 0.000022150000000000 BTC Yes HOWARD MICHAEL BRANDON CU Yes $1.85

FORM 1099-DA, Taxable Location - /State Account = FL/Unknown, Box 1a (Code for digital asset)=4H95J0R2X, Box 1b (Name of digital asset)=Bitcoin, Box 1e (Date sold or disposed)=5/4/2025, Form Identifier=1F3D04E6-58863182, Box 9 (Noncovered Security Ind)=Ye
05-04-2025 0.000014450000000000 BTC Yes HOWARD MICHAEL BRANDON CU Yes $1.33

FORM 1099-DA, Taxable Location - /State Account = FL/Unknown, Box 1a (Code for digital asset)=4H95J0R2X, Box 1b (Name of digital asset)=Bitcoin, Box 1e (Date sold or disposed)=5/8/2025, Form Identifier=1F3D04E6-58863195, Box 9 (Noncovered Security Ind)=Ye
05-08-2025 0.000016800000000000 BTC Yes HOWARD MICHAEL BRANDON CU Yes $1.60

FORM 1099-DA, Taxable Location - /State Account = FL/Unknown, Box 1a (Code for digital asset)=4H95J0R2X, Box 1b (Name of digital asset)=Bitcoin, Box 1e (Date sold or disposed)=5/11/2025, Form Identifier=1F3D04E6-58863202, Box 9 (Noncovered Security Ind)=Y
05-11-2025 0.000285750000000000 BTC Yes HOWARD MICHAEL BRANDON CU Yes $28.72

FORM 1099-DA, Taxable Location - /State Account = FL/Unknown, Box 1a (Code for digital asset)=4H95J0R2X, Box 1b (Name of digital asset)=Bitcoin, Box 1e (Date sold or disposed)=5/16/2025, Form Identifier=1F3D04E6-58863214, Box 9 (Noncovered Security Ind)=Y
05-16-2025 0.000009640000000000 BTC Yes HOWARD MICHAEL BRANDON CU Yes $0.96

FORM 1099-DA, Taxable Location - /State Account = FL/Unknown, Box 1a (Code for digital asset)=4H95J0R2X, Box 1b (Name of digital asset)=Bitcoin, Box 1e (Date sold or disposed)=5/19/2025, Form Identifier=1F3D04E6-58863224, Box 9 (Noncovered Security Ind)=Y
05-19-2025 0.000008280000000000 BTC Yes HOWARD MICHAEL BRANDON CU Yes $0.81

FORM 1099-DA, Taxable Location - /State Account = FL/Unknown, Box 1a (Code for digital asset)=4H95J0R2X, Box 1b (Name of digital asset)=Bitcoin, Box 1e (Date sold or disposed)=6/9/2025, Form Identifier=1F3D04E6-58863242, Box 9 (Noncovered Security Ind)=Ye
06-09-2025 0.000012790000000000 BTC Yes HOWARD MICHAEL BRANDON CU Yes $1.11

FORM 1099-DA, Taxable Location - /State Account = FL/Unknown, Box 1a (Code for digital asset)=4H95J0R2X, Box 1b (Name of digital asset)=Bitcoin, Box 1e (Date sold or disposed)=6/20/2025, Form Identifier=1F3D04E6-58863249, Box 9 (Noncovered Security Ind)=Y
06-20-2025 0.000015480000000000 BTC Yes HOWARD MICHAEL BRANDON CU Yes $1.35
HOWARD MICHAEL BRANDON CULPEPPER Account 1F3D04E6

Date Description Non Covered Security Account Only Cash Proceeds

FORM 1099-DA, Taxable Location - /State Account = FL/Unknown, Box 1a (Code for digital asset)=4H95J0R2X, Box 1b (Name of digital asset)=Bitcoin, Box 1e (Date sold or disposed)=7/11/2025, Form Identifier=1F3D04E6-58863263, Box 9 (Noncovered Security Ind)=Y
07-11-2025 0.000004980000000000 BTC Yes HOWARD MICHAEL BRANDON CU Yes $0.55

FORM 1099-DA, Taxable Location - /State Account = FL/Unknown, Box 1a (Code for digital asset)=4H95J0R2X, Box 1b (Name of digital asset)=Bitcoin, Box 1e (Date sold or disposed)=7/22/2025, Form Identifier=1F3D04E6-58863272, Box 9 (Noncovered Security Ind)=Y
07-22-2025 0.000006030000000000 BTC Yes HOWARD MICHAEL BRANDON CU Yes $0.69

FORM 1099-DA, Taxable Location - /State Account = FL/Unknown, Box 1a (Code for digital asset)=4H95J0R2X, Box 1b (Name of digital asset)=Bitcoin, Box 1e (Date sold or disposed)=8/11/2025, Form Identifier=1F3D04E6-58863286, Box 9 (Noncovered Security Ind)=Y
08-11-2025 0.000006060000000000 BTC Yes HOWARD MICHAEL BRANDON CU Yes $0.69

FORM 1099-DA, Taxable Location - /State Account = FL/Unknown, Box 1a (Code for digital asset)=4H95J0R2X, Box 1b (Name of digital asset)=Bitcoin, Box 1e (Date sold or disposed)=8/19/2025, Form Identifier=1F3D04E6-58863294, Box 9 (Noncovered Security Ind)=Y
08-19-2025 0.000007620000000000 BTC Yes HOWARD MICHAEL BRANDON CU Yes $0.82

FORM 1099-DA, Taxable Location - /State Account = FL/Unknown, Box 1a (Code for digital asset)=4H95J0R2X, Box 1b (Name of digital asset)=Bitcoin, Box 1e (Date sold or disposed)=9/11/2025, Form Identifier=1F3D04E6-58863307, Box 9 (Noncovered Security Ind)=Y
09-11-2025 0.000008060000000000 BTC Yes HOWARD MICHAEL BRANDON CU Yes $0.88

FORM 1099-DA, Taxable Location - /State Account = FL/Unknown, Box 1a (Code for digital asset)=4H95J0R2X, Box 1b (Name of digital asset)=Bitcoin, Box 1e (Date sold or disposed)=10/2/2025, Form Identifier=1F3D04E6-58863318, Box 9 (Noncovered Security Ind)=Y
10-02-2025 0.000039260000000000 BTC Yes HOWARD MICHAEL BRANDON CU Yes $4.44

FORM 1099-DA, Taxable Location - /State Account = FL/Unknown, Box 1a (Code for digital asset)=4H95J0R2X, Box 1b (Name of digital asset)=Bitcoin, Box 1e (Date sold or disposed)=10/8/2025, Form Identifier=1F3D04E6-58863331, Box 9 (Noncovered Security Ind)=Y
10-08-2025 0.000002600000000000 BTC Yes HOWARD MICHAEL BRANDON CU Yes $0.30

FORM 1099-DA, Taxable Location - /State Account = FL/Unknown, Box 1a (Code for digital asset)=4H95J0R2X, Box 1b (Name of digital asset)=Bitcoin, Box 1e (Date sold or disposed)=10/27/2025, Form Identifier=1F3D04E6-58863347, Box 9 (Noncovered Security Ind)=
10-27-2025 0.000008390000000000 BTC Yes HOWARD MICHAEL BRANDON CU Yes $0.93

FORM 1099-DA, Taxable Location - /State Account = FL/Unknown, Box 1a (Code for digital asset)=4H95J0R2X, Box 1b (Name of digital asset)=Bitcoin, Box 1e (Date sold or disposed)=11/5/2025, Form Identifier=1F3D04E6-58863355, Box 9 (Noncovered Security Ind)=Y
11-05-2025 0.000018290000000000 BTC Yes HOWARD MICHAEL BRANDON CU Yes $1.59

FORM 1099-DA, Taxable Location - /State Account = FL/Unknown, Box 1a (Code for digital asset)=4H95J0R2X, Box 1b (Name of digital asset)=Bitcoin, Box 1e (Date sold or disposed)=11/10/2025, Form Identifier=1F3D04E6-58863369, Box 9 (Noncovered Security Ind)=
11-10-2025 0.000007760000000000 BTC Yes HOWARD MICHAEL BRANDON CU Yes $0.80

FORM 1099-DA, Taxable Location - /State Account = FL/Unknown, Box 1a (Code for digital asset)=4H95J0R2X, Box 1b (Name of digital asset)=Bitcoin, Box 1e (Date sold or disposed)=11/15/2025, Form Identifier=1F3D04E6-58863377, Box 9 (Noncovered Security Ind)=
11-15-2025 0.000007820000000000 BTC Yes HOWARD MICHAEL BRANDON CU Yes $0.72

FORM 1099-DA, Taxable Location - /State Account = FL/Unknown, Box 1a (Code for digital asset)=4H95J0R2X, Box 1b (Name of digital asset)=Bitcoin, Box 1e (Date sold or disposed)=12/4/2025, Form Identifier=1F3D04E6-75393108, Box 9 (Noncovered Security Ind)=Y
12-04-2025 0.000016720000000000 BTC Yes HOWARD MICHAEL BRANDON CU Yes $1.29

FORM 1099-DA, Taxable Location - /State Account = FL/Unknown, Box 1a (Code for digital asset)=4H95J0R2X, Box 1b (Name of digital asset)=Bitcoin, Box 1e (Date sold or disposed)=12/27/2025, Form Identifier=1F3D04E6-75393113, Box 9 (Noncovered Security Ind)=
12-27-2025 0.000008730000000000 BTC Yes HOWARD MICHAEL BRANDON CU Yes $0.73
HOWARD MICHAEL BRANDON CULPEPPER Account 1F3D04E6

Date Description Non Covered Security Account Only Cash Proceeds

FORM 1099-DA, Taxable Location - /State Account = FL/Unknown, Box 1a (Code for digital asset)=4H95J0R2X, Box 1b (Name of digital asset)=Bitcoin, Box 1e (Date sold or disposed)=12/31/2025, Form Identifier=1F3D04E6-75393118, Box 9 (Noncovered Security Ind)=
12-31-2025 0.000004440000000000 BTC Yes HOWARD MICHAEL BRANDON CU Yes $0.37