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Appendix-Schedule B.pdf - SCHEDULE B OMB No 154543074(Fm mm...

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Unformatted text preview: SCHEDULE B OMB No. 154543074 (Fm mm mm, interest and Ordinary fiwidends 2© 1 6 (“5“ figmféawea bAttach to Form 111ch or 1046. A“ h t ,mem magma ) > Information about Schedule and its instructions is at mimgovischedulem MaWNO. Namefs) shown on rstum Your sods! secufify number Part 1 1 List name of payer. if any interest is from a seiler~financed mortgage and the WWW“ buyer used the property as a personal residence, see instructions on back and list interest this interest first. Aiso, show that buyer’s sooiai security number and address > interest income (See insiruciions on basic and the """""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""" instructions for Form 1040A. or Form 1040, line So.) Note: if you received a Form _______________________________________________________________________________________________________________ 1099-iNT, Form ____________________________ ‘iBQQ-OID, or """""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""" substitute statement from a brokerage firm, fist the firm’s - name as the 2 Add the amounts on fine 1 . . . . . . . . . . . . . . . . . u 20 payer and enter . . . . rho ma interest 3 Exoiudabie interest on some EE and i 0.8. sayings bonds issued after 1989. Shown on that Attach Fm 8815 . . . . . . . - . . . . . . . . . . . . . ffifm- 4 Subtract line 3 from fine 2. Enter the result here and on Form 1040A, 0r Form 1040, iine Ba . . , . . . . . . . . . . , . . . . . . . P Note: if iine 4 is over $1,504). ou must consists Part iii. - Amount Part a s Ustnameofpayerr _ Wands Ordinary - gividends — (See instruciions — Macmdme - instructions for — Form 1049A, or Form 1049, - line as.) — Note: if you _ received a Form — resonator _ substitute statement from — abrokaagemm. — “New — name as the nomad enter — ffiggfi’gom 6 Add the amounts on fine 5. Enter the total here and on Form 1040A, or Form on that fun“, 1040. line 93 . i . . . . . . . a ‘ . . , . x . . . . . . b 6000 Note: if line 6 is over $1,596, ou must com date Part iii. _ You must compieie this part if you {a} had over $1,560 of taxabio interest or ordinary dividends; in} had a foreign account; or to) received a distribution from, or were a grantor of, or a transferor to, a foreign trust. Part I H 73 At any time during 2016, did you have a financier! interest in or signature authority over a financial F . acouun't (such as a bank account, securities account, or brokerage account) iooated in a foreign 97939" country? See instructions . Accounts If “Yes,” are you required to fife F inCEN Form 114, Report of Foreign Bank and Finanoiai and Twas Accounts (FEAR), to report that financier: interest or signature authority? See FinCEN Form 114 (See and its instructions for filing requirements and exceptions to those requirements . . Sigft'ons 0" i3 if you are required to file FinCEN Form 114, enter the name of the foreign country where the financial account is located > 3 During 2016, did you receive a distribution from. or were you the grantor of, or transform to, a foreign trust? If “Yes," you may have to iiia Form 3520. See instructions on back ._ . . . . . For Paperwork Reduction Act Notice, see yourtax return Mons. Cat ”9‘ "145“ Wk 3 {Form 1040AW1040) 2015 ...
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