Professional Documents
Culture Documents
SB CN Form
SB CN Form
1545-0074
Interest and Ordinary Dividends
2016
(Form 1040A or 1040)
(Rev. January 2017) Attach to Form 1040A or 1040.
Department of the Treasury Information Attachment
Internal Revenue Service (99) about Schedule B and its instructions is at www.irs.gov/scheduleb. Sequence No. 08
Name(s) shown on return Your social security number
Note: If you
received a Form
1099-INT, Form
1099-OID, or
substitute
statement from
a brokerage firm,
list the firms
name as the 2 Add the amounts on line 1 . . . . . . . . . . . . . . . . . . 2 2000 00
payer and enter
the total interest 3 Excludable interest on series EE and I U.S. savings bonds issued after 1989.
shown on that Attach Form 8815 . . . . . . . . . . . . . . . . . . . . . 3 2452 00
form. 4 Subtract line 3 from line 2. Enter the result here and on Form 1040A, or Form
1040, line 8a . . . . . . . . . . . . . . . . . . . . . . 4 452 00
Note: If line 4 is over $1,500, you must complete Part III. Amount
Part II 5 List name of payer Sun Lin 72 00
Ordinary
Dividends
(See instructions
on back and the
instructions for
Form 1040A, or
Form 1040, 5
line 9a.)
Note: If you
received a Form
1099-DIV or
substitute
statement from
a brokerage firm,
list the firms
name as the
payer and enter
the ordinary 6 Add the amounts on line 5. Enter the total here and on Form 1040A, or Form
dividends shown
on that form. 1040, line 9a . . . . . . . . . . . . . . . . . . . . . . 6 72 00
Note: If line 6 is over $1,500, you must complete Part III.
You must complete this part if you (a) had over $1,500 of taxable interest or ordinary dividends; (b) had a
foreign account; or (c) received a distribution from, or were a grantor of, or a transferor to, a foreign trust. Yes No
Part III 7a At any time during 2016, did you have a financial interest in or signature authority over a financial
account (such as a bank account, securities account, or brokerage account) located in a foreign
Foreign country? See instructions . . . . . . . . . . . . . . . . . . . . . . . .
Accounts
If Yes, are you required to file FinCEN Form 114, Report of Foreign Bank and Financial
and Trusts Accounts (FBAR), to report that financial interest or signature authority? See FinCEN Form 114
(See and its instructions for filing requirements and exceptions to those requirements . . . . . .
instructions on b If you are required to file FinCEN Form 114, enter the name of the foreign country where the
back.)
financial account is located
8 During 2016, did you receive a distribution from, or were you the grantor of, or transferor to, a
foreign trust? If Yes, you may have to file Form 3520. See instructions on back . . . . . .
For Paperwork Reduction Act Notice, see your tax return instructions. Cat. No. 17146N Schedule B (Form 1040A or 1040) 2016
Schedule B (Form 1040A or 1040) 2016 Page 2
Line 1. Report on line 1 all of your taxable interest. the total on line 5. Do this even if you later If you are required to file FinCEN Form
Taxable interest generally should be shown on your
Forms 1099-INT, Forms 1099-OID, or substitute
statements. Include interest from series EE, H, HH,
distributed some or all of this income to others.
Under your last entry on line 5, put a subtotal of all
ordinary dividends listed on line 5. Below this
!CAUTION
114 but don't properly do so, you may
have to pay a civil penalty up to
$10,000. A person who willfully fails to
and I U.S. savings bonds. Also include any accrued subtotal, enter Nominee Distribution and show the report an account or provide account
market discount that is includible in income. List each total ordinary dividends you received as a nominee. identifying information may be subject to a civil
payers name and show the amount. Don't report on Subtract this amount from the subtotal and enter the penalty equal to the greater of $100,000 or 50% of
this line any tax-exempt interest from box 8 or box 9 result on line 6. the balance in the account at the time of the
of Form 1099-INT. Instead, report the amount from violation. Willful violations may also be subject to
If you received dividends as a nominee,
box 8 on line 8b of Form 1040A or 1040. If an amount criminal penalties.
you must give the actual owner a Form
is shown in box 9 of Form 1099-INT, you generally
must report it on line 12 of Form 6251. See the
TIP 1099-DIV (unless the owner is your spouse) Line 7b. If you are required to file FinCEN Form 114,
enter the name of the foreign country or countries in
and file Forms 1096 and 1099-DIV with the
Instructions for Form 6251 for more details. For more IRS. For more details, see the General the space provided on line 7b. Attach a separate
information on market discount and other investment Instructions for Certain Information Returns and the statement if you need more space.
income, see Pub. 550. Instructions for Form 1099-DIV. Line 8. If you received a distribution from a foreign
Seller-financed mortgages. If you sold your trust, you must provide additional information. For
home or other property and the buyer used the Part III. Foreign Accounts and this purpose, a loan of cash or marketable securities
property as a personal residence, list first any Trusts generally is considered to be a distribution. See
interest the buyer paid you on a mortgage or other Form 3520 for details.
form of seller financing. Be sure to show the buyers Regardless of whether you are required
to file FinCEN Form 114 (FBAR), you If you were the grantor of, or transferor to, a
name, address, and SSN. You must also let the
buyer know your SSN. If you don't show the buyers TIP may be required to file Form 8938, foreign trust that existed during 2016, you may have
Statement of Specified Foreign to file Form 3520.
name, address, and SSN, or let the buyer know your
SSN, you may have to pay a $50 penalty. Financial Assets, with your income tax Don't attach Form 3520 to Form 1040. Instead, file
return. Failure to file Form 8938 may result in it at the address shown in its instructions.
Nominees. If you received a Form 1099-INT that penalties and extension of the statute of limitations.
includes interest you received as a nominee (that is, in If you were treated as the owner of a foreign trust
See www.irs.gov/form8938 for more information.
your name, but the interest actually belongs to under the grantor trust rules, you are also
someone else), report the total on line 1. Do this even Line 7aQuestion 1. Check the Yes box if at any responsible for ensuring that the foreign trust files
if you later distributed some or all of this income to time during 2016 you had a financial interest in or Form 3520-A. Form 3520-A is due on March 15,
others. Under your last entry on line 1, put a subtotal signature authority over a financial account located 2017, for a calendar year trust. See the instructions
of all interest listed on line 1. Below this subtotal, enter in a foreign country. See the definitions that follow. for Form 3520-A for more details.
Nominee Distribution and show the total interest you Check the Yes box even if you aren't required to
received as a nominee. Subtract this amount from the file FinCEN Form 114.
subtotal and enter the result on line 2.