SCHEDULE B
(Form 1040A or 1040)
Department of the Treasury Internal Revenue Service (99) |
Interest and Ordinary
Dividends
► Attach to Form 1040A or 1040.
► Go to www.irs.gov/ScheduleB for instructions and
the latest information. |
OMB No. 1545-0074 |
2017
Attachment
Sequence No. 08
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Name(s) shown on return
Charles and Sally Heck |
Your social security number |
Part I
Interest
(See instructions and the instructions for Form 1040A, or Form
1040, line 8a.)
Note. If you received a Form 1099-INT, Form
1099-OID, or substitute statement from a brokerage firm, list the
firm's name as the payer and enter the total interest shown on that
form. |
1 |
List name of payer. If
any interest is from a seller-financed mortgage and the buyer used
the property as a personal residence, see the instructions and list
this interest first. Also, show that buyer's social security number
and address ►
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Amount |
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1 |
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2 |
Add the amounts on line 1 . . . . .
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2 |
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3 |
Excludable interest on series EE
and I U.S. savings bonds issued after 1989. Attach Form 8815 . . .
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3 |
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4 |
Subtract line 3 from line 2. Enter
the result here and on Form 1040A, or Form 1040, line 8a . . . . .
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4 |
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Note. If line 4 is over $1,500,
you must complete Part III. |
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Amount |
Part II
Ordinary Dividends
(See instructions and the instructions for Form 1040A, or Form
1040, line 9a.)
Note. If you received a Form 1099-DIV or
substitute statement from a brokerage firm, list the firm's name as
the payer and enter the ordinary dividends shown on that form. |
5 |
List name of payer ► |
5 |
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6 |
Add the amounts on line 5. Enter
the total here and on Form 1040A, or Form 1040, line 9a . . . . . .
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6 |
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Note. If line 6 is over $1,500,
you must complete Part III. |
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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
Foreign
Accounts
and Trusts
(See
instructions.) |
7a |
At any time during 2017, 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 country? |
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See instructions . . . . . . . . . . . . . . . . . . . . . . .
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✓ |
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If "Yes," are you required to file FinCEN Form 114, Report of
Foreign Bank and Financial Accounts (FBAR), to report that
financial interest or signature authority? See FinCEN Form 114 and
its instructions for filing requirements and exceptions to those
requirements . . . . . . . . . . . . . . . |
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b |
If you are required to file FinCEN Form 114, enter the name of
the foreign country where the financial account is located ► . . .
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8 |
During 2017, did you receive a distribution from, or were you
the grantor of, or transferor to, a foreign trust? |
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If "Yes," you may have to file Form 3520. See instructions . .
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✓ |
For Paperwork Reduction Act Notice, see your tax return
instructions. |
Cat. No. 17146N |
Schedule B (Form 1040A or 1040) 2017 |
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