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Form 1098-T 2021 Tuition Statement Department of the Treasury - Internal Revenue Service Copy B For Student This is important tax information and is being furnished to the IRS. This form must be used to complete Form 8863 to claim education credits. Give it to the tax preparer or use it to prepare the tax return. OMB No. 1545-1574 CORRECTED FILER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone number FILER’S employer identification no. STUDENT’S TIN STUDENT’S name Street address (including apt. no.) City or town, state or province, country, and ZIP or foreign postal code Service Provider/Acct. No. (see instr.) 1 Payments received for qualified tuition and related expenses $ 2 3 4 Adjustments made for a prior year $ 5 Scholarships or grants $ 6 Adjustments to scholarships or grants for a prior year $ 7 Checked if the amount in box 1 includes amounts for an academic period beginning January– March 2022 8 Checked if at least half-time student 9 Checked if a graduate student 10 Ins. contract reimb./refund $ Form 1098-T (keep for your records) www.irs.gov/Form1098T California State College 1 Education Way Modesto, CA 23232 732-111-1111 12-1234545 000-00-0002 Carey Jones 12 South Street Napa Valley, CA 24556 X 10,000 2,000 Publication 970 (2021) Page 73