Irs form 8815 for 2019

SCHEDULE B (Form 1040 or 1040-SR)

Department of the Treasury Internal Revenue Service (99)

Interest and Ordinary Dividends ▶ Go to www.irs.gov/ScheduleB for instructions and the latest information.

▶ Attach to Form 1040 or 1040-SR.

OMB No. 1545-0074

2019 Attachment Sequence No. 08

Name(s) shown on return Your social security number

Part I

Interest (See instructions and the instructions for Forms 1040 and 1040-SR, line 2b.) 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 ▶

1

Amount

2 Add the amounts on line 1 . . . . . . . . . . . . . . . . . . . 2 3

Excludable interest on series EE and I U.S. savings bonds issued after 1989. Attach Form 8815 . . . . . . . . . . . . . . . . . . . . . . 3

4

Subtract line 3 from line 2. Enter the result here and on Form 1040 or 1040-SR, line 2b . . . . . . . . . . . . . . . . . . . . . . . . ▶ 4

Note: If line 4 is over $1,500, you must complete Part III. Amount

Part II

Ordinary Dividends (See instructions and the instructions for Forms 1040 and 1040-SR, line 3b.) 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

6

Add the amounts on line 5. Enter the total here and on Form 1040 or 1040-SR, line 3b . . . . . . . . . . . . . . . . . . . . . . . . ▶ 6

Note: If line 6 is over $1,500, you must complete Part III.

Part III

Foreign Accounts and Trusts Caution: If required, failure to file FinCEN Form 114 may result in substantial penalties. See instructions.

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

7

a

At any time during 2019, 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? See instructions . . . . . . . . . . . . . . . . . . . . . . . .

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 . . . . . .

b

If you are required to file FinCEN Form 114, enter the name of the foreign country where the financial account is located ▶

8

During 2019, 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 . . . . . . . . .

For Paperwork Reduction Act Notice, see your tax return instructions. Cat. No. 17146N Schedule B (Form 1040 or 1040-SR) 2019

Version A, Cycle 7

INTERNAL USE ONLY DRAFT AS OF July 22, 2019

SCHEDULE B

(Form 1040 or 1040-SR)

Department of the Treasury Internal Revenue Service (99)

Interest and Ordinary Dividends

▶ Go to www.irs.gov/ScheduleB for instructions and the latest information.

▶ Attach to Form 1040 or 1040-SR.

OMB No. 1545-0074

2019

2019. Cat. No. 17146N.

Attachment

Sequence No. 08

Attachment Sequence No. 08. For Paperwork Reduction Act Notice, see your tax return instructions.

Part I

Interest

(See instructions and the instructions for Forms 1040 and 1040-SR, line 2b.)

Note: If you received a Form 1099-INT, Form 1099-OID, or substitute statement froma brokerage firm, list the firm’s name as thepayer 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 ▶

1

Amount

2

Add the amounts on line 1

2

3

Excludable interest on series EE and I U.S. savings bonds issued after 1989. Attach Form 8815

3

4

Subtract line 3 from line 2. Enter the result here and on Form 1040 or 1040-SR, line 2b ▶

4

Note: If line 4 is over $1,500, you must complete Part III.

Amount

Part II

Ordinary Dividends

(See instructions and theinstructions for Forms 1040 and 1040-SR, line 3b.)

Note: If youreceived a Form1099-DIV orsubstitutestatement froma brokerage firm,list the firm’sname as thepayer and enterthe ordinarydividends shownon that form.

5

5

6

Add the amounts on line 5. Enter the total here and on Form 1040 or 1040-SR, line 3b ▶

6

Note: If line 6 is over $1,500, you must complete Part III.

Part III

Foreign Accounts and Trusts

Caution: If required, failure

to file FinCEN Form 114 may result in substantial penalties. See instructions.

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

7

a

At any time during 2019, 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? See instructions

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

b

If you are required to file FinCEN Form 114, enter the name of the foreign country where the financial account is located ▶

8

During 2019, 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

For Paperwork Reduction Act Notice, see your tax return instructions.

Cat. No. 17146N

Schedule B (Form 1040 or 1040-SR) 2019

8.2.1.3144.1.471865.466429

Interest and Ordinary Dividends

SE:W:CAR:MP

2019 Schedule B (Form 1040 or 1040-SR)

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