Organizer Blank Forms -...

Social security number . . .


CLIENT INFORMATION

DEPENDENTS

First name and initial. . . . .

Last name. . . . . . . . . . . . . . .

Title/suffix. . . . . . . . . . . . . . .


Occupation . . . . . . . . . . . . . .

Date of birth (m/d/y). . . . . .

Date of death (m/d/y). . . . .

1=blind. . . . . . . . . . . . . . . . . .

Home phone. . . . . . . . . . . . .

Work phone . . . . . . . . . . . . .

Work extension . . . . . . . . . .

Cell phone. . . . . . . . . . . . . . .

E-mail address. . . . . . . . . . .

In care of. . . . . . . . . . .

Street address. . . . . .

Apartment number. .

City. . . . . . . . . . . . . . . .

State. . . . . . . . . . . . . . .

ZIP code . . . . . . . . . . .

First name. . . . . . . . . . . . . . .

Last name. . . . . . . . . . . . . . .

Title/suffix. . . . . . . . . . . . . . .


Relationship . . . . . . . . . . . . .

Months lived at home . . . .

First name. . . . . . . . . . . . . . .

Last name. . . . . . . . . . . . . . .

Title/suffix . . . . . . . . . . . . . . .


Relationship . . . . . . . . . . . . .

Months lived at home . . . .

Taxpayer Spouse

Dependent No. Dependent No.

Dependent No. Dependent No.

Address

1040 US Tax Organizer

Tax Organizer

ORGANIZER

2018



Date of adoption (m/d/y). .

Date of adoption (m/d/y). .

Telephone number:Fax number:

This tax organizer will assist you in gathering information necessary for the preparationof your 2018 tax return. Please enter all pertinent 2018 information.

NOTE: If you claim the earned income credit, please provide proof that your child is a resident of the United States. This proof is typically in the formof: school records or statement, landlord or property management statement, health care provider statement, medical records, child care providerrecords, placement agency statement, social service records or statement, place of worship, Indian tribal office statement, or employer statement.

NOTE: If your child is disabled, please provide one of the following forms of proof of disability: doctor statement, other health care provider statement,or social services agency or program statement.

Stephen L Nelson CPA PLLC16310 NE 80th Street, Suite 201Redmond WA 98052

(425) 881-7350

(425) 786-9244

Attach Forms 1099

WAGES, SALARIES AND TIPSEmployer name:

INTEREST INCOMEPayer name:

DIVIDEND INCOMEPayer name:

PENSIONS, IRA AND GAMBLING INCOMEPayer name:

Winnings not reported on W-2G . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Total gambling losses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

OTHER GOVERNMENT FORMS - INCOMEForm 1099-B - Sales of stock (also include transaction history). . . . . .

Form 1099-MISC - Miscellaneous income . . . . . . . . . . . . . . . . . . . . . . . . . .Attach Forms 1099

Form 1099-S - Sales of real estate (also include closing statements)

Form 1099-G - State tax refunds . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Attach Forms 1099Taxpayer:

Form SSA-1099 - Social security benefits. . . . . . . . . . . . . . . . . . . . . . . . . .

Form 1099-G - Unemployment compensation. . . . . . . . . . . . . . . . . . . . . . .

Spouse:

Form SSA-1099 - Social security benefits. . . . . . . . . . . . . . . . . . . . . . . . . .

Form 1099-G - Unemployment compensation. . . . . . . . . . . . . . . . . . . . . . .

Please enter all pertinent 2018 information. If you have attacheda government form for an item, check the box and do not enter a 2018 amount.

Attach Forms W-2

Attach Forms 1099-INT

Attach Forms 1099-DIV

Attach Forms1099-R & W-2G

Attach Forms 1099


Tax Organizer

ORGANIZER

Form 1099-K - Merchant card and third party network payments. . . . .

2018

2018 Amount 2017 Amount

Form 1099-Q (529 Plan). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Form 1099-QA/5498-QA (ABLE Accounts). . . . . . . . . . . . . . . . . . . . . . . . . .

Form 1099-Q (529 Plan). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Form 1099-QA/5498-QA (ABLE Accounts). . . . . . . . . . . . . . . . . . . . . . . . . .

RETIREMENT PLAN CONTRIBUTIONSTaxpayer: Traditional IRA contributions (1=maximum). . . . . . . . . . . . . . . . . . . . .

Roth IRA contributions (1=maximum) . . . . . . . . . . . . . . . . . . . . . . . . . .

Self-employed, SEP, SIMPLE, & qualified plan contributions (1=maximum). . . . . .

Spouse: Traditional IRA contributions (1=maximum). . . . . . . . . . . . . . . . . . . . .

Roth IRA contributions (1=maximum) . . . . . . . . . . . . . . . . . . . . . . . . . .

Self-employed, SEP, SIMPLE, & qualified plan contributions (1=maximum). . . . . .

MEDICAL AND DENTAL EXPENSESPrescription medicines and drugs. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Doctors, dentists and nurses. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Hospitals and nursing homes. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Insurance premiums . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Long-term care premiums - taxpayer. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Long-term care premiums - spouse . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Insurance reimbursement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Out-of-pocket lodging and transportation expenses. . . . . . . . . . . . . . . . . . . . . . .

Number of medical miles. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Other:

OTHER GOVERNMENT FORMS - DEDUCTIONSForm 1098-E - Student loan interest. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Form 1098-T - Tuition and related expenses . . . . . . . . . . . . . . . . . . . . . . . . .Attach Forms 1098

ADJUSTMENTS TO INCOMETaxpayer:

Self-employed health insurance premiums. . . . . . . . . . . . . . . . . . . . . . . . . . .

Educator expenses. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Other adjustments to income:

Alimony paid - Recipient name & SSN. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Spouse:

Self-employed health insurance premiums. . . . . . . . . . . . . . . . . . . . . . . . . . .

Educator expenses. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Other adjustments to income:

Alimony paid - Recipient name & SSN. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

TAXES PAIDState income taxes - 1/18 payment on 2017 state estimate. . . . . . . . . . . . . . .


Tax Organizer

ORGANIZER

2018


Attach Forms 1095

AFFORDABLE CARE ACTForm 1095-A - Health Insurance Marketplace Statement. . . . . . . . . . . . . .

Form 1095-B - Health Coverage. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Form 1095-C - Employer-Provided Health Insurance Offer and Coverage. . . . . .

MISCELLANEOUS INCOMETaxpayer: Alimony received. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Spouse: Alimony received. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Other:

CASH CONTRIBUTIONS

Volunteer expenses (out-of-pocket). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Number of charitable miles. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

INTEREST PAIDHome mortgage interest and points paid:

Home mortgage interest not on Form 1098 (include name, SSN, & address of payee):

Points not reported on Form 1098:

Mortgage insurance premiums on post 12/31/06 contracts . . . . . . . . . . . . . . . .

Investment interest (interest on margin accounts):

Passive interest . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

NONCASH CONTRIBUTIONS

MISCELLANEOUS DEDUCTIONSUnion and professional dues. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Tax return preparation fee. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Safe deposit box rental . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Investment expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Estate tax, section 691(c) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Unreimbursed employee expenses:

Other:

TAXES PAID (continued)

Personal property taxes (including automobile fees in some states) . . . Attach Tax Notice

City/local income taxes - paid with 2017 city/local extension . . . . . . . . . . . . . .

City/local income taxes - paid with 2017 city/local return. . . . . . . . . . . . . . . . . .

State and local sales taxes (except autos and special items) . . . . . . . . . . . . .

Use taxes paid on 2018 purchases. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Use taxes paid on 2017 state return. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Sales tax on autos not included above . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Sales taxes paid on boats, aircraft, and other special items. . . . . . . . . . . . . . .

Real estate taxes - principal residence. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Real estate taxes - property held for investment . . . . . . . . . . . . . . . . . . . . . . . . .

Foreign income taxes. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

NOTE: No deduction is allowed for cash or check contributions unless the donor maintains a bank record, or a written communicationfrom the donee, showing the name of the organization, contribution date(s), and contribution amount(s).

NOTE: No deduction is allowed for contributions of clothing and household items that are not in good used condition or better, in addition,a deduction for any item with minimal monetary value may be denied.

Attach Forms 1098


Tax Organizer

ORGANIZER

2018


City/local income taxes - 1/18 payment on 2017 city/local estimate. . . . . . . .

State income taxes - paid with 2017 state extension . . . . . . . . . . . . . . . . . . . . .

State income taxes - paid with 2017 state return. . . . . . . . . . . . . . . . . . . . . . . . .

State income taxes - paid for prior years and/or to other states. . . . . . . . . . .

If any of the following items pertain to you or your spouse for 2018,please check the appropriate box and provide additional information if necessary.

Yes No

PERSONAL INFORMATION

Did your marital status change during the year?

Did your address change during the year?

Could you be claimed as a dependent on another person’s tax return for 2018?

DEPENDENTS

Were there any changes in dependents?

Were any of your unmarried children who might be claimed as dependents 19years of age or older at the end of 2018?

Did you have any children under age 19 or full-time students under age 24 at theend of 2018, with interest and dividend income in excess of $950, or totalinvestment income in excess of $1,900?

PURCHASES, SALES, AND DEBT

Did you start a business or farm, purchase rental or royalty property, or acquirean interest in a partnership, S corporation, trust, or REMIC?

Did you purchase or dispose of any business assets (furniture, equipment,vehicles, real estate, etc.), or convert any personal assets to business use?

Did you buy or sell any stocks, bonds or other investment property in 2018?

Did you sell or do you plan to sell any dividend generating stocks or mutualfunds during the first 60 days of 2019?

Did you purchase, sell, or refinance your principal home or second home, or didyou take a home equity loan?

Did you purchase a home in 2018 and you were overseas on official extendedduty?

Did you make any residential energy-efficient improvements or purchasesinvolving solar, wind, geothermal or fuel cell energy sources?

Did you have any debts cancelled or forgiven?

ORGANIZER

2018 1040 US Miscellaneous Questions

Miscellaneous Questions

Does anyone owe you money which has become uncollectible?

INTERNATIONAL INVESTMENTS

Did you have any foreign-source income?

Did you pay any foreign income taxes?

Did you have a financial account in a foreign country, such as a bank account,securities account, or other financial account?

Did you have an interest in a foreign financial account, even if you didn’tdirectly own it? (E.g., an attorney held it for you, the account was held through atrust, etc.)

Did you have signature authority on a foreign financial account, even if youdidn’t directly own it? (Most common example would be to have signingauthority on a foreign bank account of an employer)

Did you receive a distribution from, or were you the grantor of, or transferor to, aforeign trust? (Most common example of a foreign trust would be a foreigncountry’s equivalent of a 401(k) or IRA, e.g. a Canadian RRSP)

Did you have any other foreign investments held outside of a U.S. brokerageaccount? (E.g., direct investment in foreign stock, a foreign partnership, aforeign bond, a foreign insurance contract, etc.)

Did you make a payment to a foreign financial institution from which you didnot receive a global intermediary identification number (GIIN)?

OTHER INCOME

Did you receive unreported tip income of $20 or more in any month?

Did you cash any Series EE U.S. savings bonds issued after 1989 and payqualified higher education expenses for yourself, your spouse, or yourdependents?

Did you receive any disability income?

RETIREMENT PLANS

Did you receive a distribution from a retirement plan (401(k), IRA, SEP,SIMPLE, Qualified Plan, etc.)?

Did you make a contribution to a retirement plan (401(k), IRA, SEP, SIMPLE,Qualified Plan, etc.)?

ORGANIZER


Miscellaneous Questions (Continued)

Did you transfer or rollover any amount from one retirement plan to anotherretirement plan?

Did you convert part or all of your traditional, SEP, or SIMPLE IRA to a RothIRA in 2018?

Did you convert a traditional, SEP, or SIMPLE IRA (or other qualifiedretirement plan) to a Roth IRA in 2010, and defer the taxable amount of theconversion to tax year 2018 and 2019?

EDUCATION

Did you receive a distribution from an Education Savings Account or a QualifiedTuition Program?

Did you, your spouse, or a dependent incur any tuition expenses that are requiredto attend a college, university, or vocational school?

HEALTH CARE

Did you make a contribution to an HSA for 2018?

Did you receive a distribution from an HSA during 2018?

Did you receive a Form 1095-A for 2018?

Did you have a medical savings account (MSA), a Medicare + Choice MSA, oracquire an interest in an MSA or a Medicare + Choice MSA because of the deathof the account holder? Or, were you a policyholder who received paymentsunder a long-term care (LTC) insurance contract or received any accelerateddeath benefits from a life insurance policy?

Were you (or your spouse) the beneficiary of COBRA premium assistance forany month during 2018?

OTHER DEDUCTIONS

Did you incur a loss because of damaged or stolen property?

Did you work out of town for part of the year?

Did you use your car on the job (other than to and from work)?

Did you incur moving expenses due to a change of employment?

Was your home rented out or used for business?

ORGANIZER



ESTIMATED TAXES

Did you apply an overpayment of 2017 taxes to your 2018 estimated tax (insteadof being refunded)?

If you have an overpayment of 2018 taxes, do you want the excess applied toyour 2019 estimated tax (instead of being refunded)?

Do you expect your 2019 taxable income and withholdings to be different from2018?

MISCELLANEOUS

Do you want to electronically file your tax return?

Do you want to allocate $3 to the Presidential Election Campaign Fund?

Does your spouse want to allocate $3 to the Presidential Election CampaignFund?

May the IRS discuss your tax return with your preparer?

Were you notified or audited by either the Internal Revenue Service or the Statetaxing agency?

Did you engage the services of any household employees?

Did you or your spouse make any gifts to an individual that total more than$13,000, or any gifts to a trust?

ORGANIZER



Please enter all pertinent 2018 information.

DIRECT DEPOSIT / ELECTRONIC PAYMENT (3)

1=direct deposit of federal tax refund into bank account. . . . . . . . . . . . . . . . . .

1=electronic payment of balance due . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

1=electronic payment of estimated tax. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

1040 US Direct Deposit & Estimates (Form 1040 ES)

Direct Deposit & Estimates (Form 1040 ES)

ORGANIZER

Series: 5100, 5400 (t=taxpayer, s=spouse, blank=joint)

2018

Name of Bank Routing Number Account Number

Percent toDeposit(xx.xx)

BANK INFORMATIONType ofAccount(Table 1)

Type ofInvest.

(Table 2)

1 Type of Account

1 = Savings2 = Checking

Federal Amount Paid Date Paid TS

State

Additional EstimatedTax Payments

Additional EstimatedTax Payments

Amount Paid Date Paid TS

2018 ESTIMATED TAX / 1040-ES (6)

Overpayment applied from 2017. . . . . . . . . . .

1st quarter payment . . . . . . . . . . . . . . . . . . . . . .

2nd quarter payment. . . . . . . . . . . . . . . . . . . . . .

3rd quarter payment. . . . . . . . . . . . . . . . . . . . . .

4th quarter payment . . . . . . . . . . . . . . . . . . . . . .

Overpayment applied from 2017. . . . . . . . . . .

1st quarter payment . . . . . . . . . . . . . . . . . . . . . .

2nd quarter payment. . . . . . . . . . . . . . . . . . . . . .

3rd quarter payment. . . . . . . . . . . . . . . . . . . . . .

4th quarter payment . . . . . . . . . . . . . . . . . . . . . .

Paid with extension. . . . . . . . . . . . . . . . . . . . . . .

Paid with extension. . . . . . . . . . . . . . . . . . . . . . .

2018Voucher Amount

2018Voucher Amount

2 Type of Investment

1 = Checking or savings (default)2 = Taxpayer's IRA (next year limits)3 = Spouse's IRA (next year limits)4 = Health savings account (HSA)5 = Archer MSA

6 = Coverdell savings account (ESA)7 = Other8 = Taxpayer's IRA (current year limits)9 = Spouse's IRA (current year limits)

Former spouse SSN if joint estimates. . . . . .

Please enter all pertinent 2018 information.

APPLICATION OF 2018 OVERPAYMENT (7.1)

If you have an overpayment of 2018 taxes, do you want the excess refunded?. . or applied to 2019 estimate?. . . .

Other (please explain):

2019 ESTIMATED TAX INFORMATION

Do you expect your 2019 taxable income to be different from 2018? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

If "yes" explain any differences in income, deductions, dependents, etc.:

Do you expect your 2019 withholding to be different from 2018? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

If "yes" explain any differences:

Yes No

1040 US Direct Deposit & Estimates (Form 1040 ES) (cont.)

Direct Deposit & Estimates (Form 1040 ES) (cont.)

ORGANIZER

Series: 5400 (t=taxpayer, s=spouse, blank=joint)

2018

Please enter all pertinent 2018 amounts. Last year's amounts are provided for your reference.

GENERAL INFORMATION

Principal business/profession. . . . . . . . . . . . . . . . . . .

Principal business code. . . . . . . . . . . . . . . . . . . . . . . .

Business name, if different from Form 1040 . . . . .

Business address, if different from Form 1040 . . .

City, if different from Form 1040. . . . . . . . . . . . . . . .

Employer identification number. . . . . . . . . . . . . . . . .

Other accounting method. . . . . . . . . . . . . . . . . . . . . . .

Accounting method: 1=cash, 2=accrual. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Inventory method: 1=cost, 2=lower cost/market, 3=other. . . . . . . . . . . . . . . . . . .

1=change of inventory method. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

1=spouse, 2=joint. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

1=first Schedule C filed for this business . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

If required to file Form(s) 1099, did you or will you file all required Form(s) 1099: 1=yes, 2=no. .

1=not subject to self-employment tax . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

1=did not "materially participate". . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

1=personal services is not a material income producing factor. . . . . . . . . . . . . .

1=investment. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

1=minister's Schedule C. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

1=single member limited liability company. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

INCOME

Gross receipts or sales (Form 1099-MISC, box 7) . . . . . . . . . . . . . . . . . . . . . . . . . .

Returns and allowances. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Other income:

Inventory at beginning of the year. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Purchases. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Cost of items for personal use. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Cost of labor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Materials and supplies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Other costs:

Inventory at end of the year . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

COST OF GOODS SOLD

1040 US Business Income (Schedule C)

ORGANIZER

Series: 51

State, if different from Form 1040. . . . . . . . . . . . . . .

ZIP code, if different from Form 1040 . . . . . . . . . . .

2018


1=trader in financial instruments or commodities. . . . . . . . . . . . . . . . . . . . . . . . . . .

Foreign region. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Foreign postal code. . . . . . . . . . . . . . . . . . . . . . . . . . . .

Foreign country. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .


EXPENSES

Postage. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Printing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Rent - vehicles, machinery, & equipment (not entered elsewhere). . . . . . . . . . .

Rent - other. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Repairs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Security. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Supplies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Taxes - real estate. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Taxes - payroll . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Taxes - sales tax included in gross receipts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Taxes - other (not entered elsewhere). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Telephone. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Tools . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Travel. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Total meals in full (50%) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Department of Transportation meals in full (80%). . . . . . . . . . . . . . . . . . . . . . . . . .

Uniforms. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Utilities. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Wages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Other expenses:

NOTE: If you purchased or disposed of any business assets, please complete Sheet 22.

Accounting. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Advertising. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Answering service . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Bad debts from sales or service . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Bank charges. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Car and truck expenses (not entered elsewhere). . . . . . . . . . . . . . . . . . . . . . . . . . .

Commissions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Contract labor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Delivery and freight. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Dues and subscriptions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Employee benefit programs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Insurance (other than health). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Mortgage interest (paid to banks, etc.) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Other interest (not entered elsewhere) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Janitorial. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Laundry and cleaning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Legal and professional. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Miscellaneous . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Office expense . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Outside services. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Parking and tolls. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Pension and profit sharing plans - contributions. . . . . . . . . . . . . . . . . . . . . . . . . . . .

Pension and profit sharing plans - admin. and education costs. . . . . . . . . . . . . .

1040 US Business Income (Schedule C) (cont.)

Business Income (Schedule C) (cont.)

ORGANIZER

Series: 51

2018



Description of property. . . . . . . . .

Street address. . . . . . . . . . . . . . . . .

Percentage of ownershipif not 100% (.xxxx). . . . . . . . . . . . . . . . . Percentage of tenant occupancyif not 100% (.xxxx). . . . . . . . . . . . . . . . .

1=nonpassive activity,2=passive royalty . . . . . . . . . . . . . . . . . .

1=single member limitedliability company . . . . . . . . . . . . . . . . . .

INCOME

Rents or royalties received . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

DIRECT EXPENSES

Advertising. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Association dues . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Auto and travel (not entered elsewhere). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Cleaning and maintenance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Commissions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Gardening. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Insurance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Legal and professional fees . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Licenses and permits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Management fees. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Miscellaneous . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .


NOTE: If you purchased or disposed of any business assets, please complete Sheet 22.

NOTE: Direct expenses are related only to the rental activity. These include rental agency fees, advertising, and office supplies.

1040 US Rental & Royalty Income (Schedule E)

Rental & Royalty Income (Schedule E)

ORGANIZER

Series: 53

City. . . . . . . . . . . . . . . . . . . . . . . . . . .

State . . . . . . . . . . . . . . . . . . . . . . . . .

ZIP code. . . . . . . . . . . . . . . . . . . . . .

Type of property (see table). . . .

Other type of property. . . . . . . . . .

If required to file Form(s) 1099, did you or will you file all required Form(s) 1099: 1=yes, 2=no. . . . . . . . .

Qualified mortgage insurance premiums. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Excess mortgage interest . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .


Painting and decorating. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

2018


Number of days rented. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

2018 Amount 2017 AmountGENERAL INFORMATION

1=spouse, 2=joint. . . . . . . . . . . . . .

1=qualified joint venture. . . . . . . .

1=did not actively participate. . .1=RE prof., activity is trade or business,2=RE prof., not trade or business. . . . . . .

1=investment. . . . . . . . . . . . . . . . . .

Other:

Pest control . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Plumbing and electrical . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Repairs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Supplies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .



Telephone. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Utilities. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Wages and salaries. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Type of Property

1 = Single Family Residence2 = Multi-Family Residence3 = Vacation/Short-Term Rental4 = Commercial5 = Land6 = Royalties7 = Self-Rental

1=rental other than real estate .

OIL AND GAS

Production type (preparer use only). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Cost depletion. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Percentage depletion rate or amount. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

State cost depletion, if different (-1 if none) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

State % depletion rate or amount, if different (-1 if none). . . . . . . . . . . . . . . . . . .

VACATION HOME

Number of days personal use. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Number of days owned (if optional method elected). . . . . . . . . . . . . . . . . . . . . . . .

INDIRECT EXPENSES

Advertising. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Association dues . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Auto and travel (not entered elsewhere). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Cleaning and maintenance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Commissions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Gardening. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Insurance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Legal and professional fees . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Licenses and permits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Management fees. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Miscellaneous . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .


Please enter all pertinent 2018 amounts. Last year's amounts are provided for your reference. The indirectexpense column should only be used for vacation homes or less than 100% tenant occupied rentals.

NOTE:Indirect expenses are related to operating or maintaining the dwelling unit.These include repairs, insurance, and utilities.

1040 US Rental & Royalty Income (Sch. E) (cont.)

Rental & Royalty Income (Sch. E) (cont.)

ORGANIZER

Series: 53

Qualified mortgage insurance premiums. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Excess mortgage interest . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .


Painting and decorating. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

2018

Other:

Pest control . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Plumbing and electrical . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Repairs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Supplies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .



Telephone. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Utilities. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Wages and salaries. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

GENERAL INFORMATION


Foreign region. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Foreign postal code. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Foreign country. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Please add, change or delete 2018 information as appropriate. Be sure to attach all Schedule K-1s.

PARTNERSHIP INFORMATION (20.1)

S CORPORATION INFORMATION (20.2)

No. Name of PartnershipEmployer

IdentificationNumber

Tax ShelterRegistration

Number

Additional AmountsInvested inPartnership

No. Name of S corporationEmployer

IdentificationNumber

Tax ShelterRegistration

Number

Additional AmountsInvested in

S corporation

1040 US Partnership and S corporation Information

Partnership and S corporation Information

ORGANIZER

Series: 55, 56

2018


GENERAL INFORMATION

Canadian province or Mexican state. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Other type of filer. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

1040 US Report of Foreign Bank and Financial Accounts

Report of Foreign Bank and Financial Accounts

ORGANIZER

Series: 74

2018


Foreign identification:

1=passport, 2=foreign TIN. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Taxpayer:

Spouse:

Other type of identification . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Number. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Country of issue. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

1=passport, 2=foreign TIN. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Other type of identification . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Number. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Country of issue. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Taxpayer:

Title. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Spouse:

Title. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .


1040 US Report of Foreign Bank & Fin. Accts.

Report of Foreign Bank & Fin. Accts.

ORGANIZER

Series: 74

2018

Accounts where filer has no financial interest:

Last name or org. name (mandatory). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

First name. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Middle initial. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Taxpayer identification number. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Address . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

City . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

State. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

ZIP/postal code. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

TIN type: 1=EIN, 2=SSN/ITIN, 3=foreign. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Country (if not US). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Filer's title. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

INFORMATION ON FINANCIAL ACCOUNTS

1=spouse . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Type of account: 1=bank account, 2=securities account, or specify. . . . . . . . . .

Maximum value of account (-1 if unknown). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Number of joint owners (Mandatory for Part III accounts) (-1 if joint owner is joint filer). . . .

Financial institution:

Name of institution (Line 1) (mandatory). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Name of institution (Line 2). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Mailing address. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Account number . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

City . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

State. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

ZIP/postal code. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Country (if not US). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Accounts owned jointly:

Principal joint owner:

Taxpayer identification number, if not joint filer. . . . . . . . . . . . . . . . . . .

TIN type: 1=EIN, 2=SSN/ITIN, 3=foreign. . . . . . . . . . . . . . . . . . . . . . . . . .

Last name . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

First name . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Address. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

City. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

State . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

ZIP/postal code. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Country (if not US). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Middle initial. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .



1040 US Foreign Reporting (8938)

Foreign Reporting (8938)

ORGANIZER

Series: 3500

2018

Foreign entity information (complete if stock or interest):

Name of entity. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Type of entity. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Mailing address of entity. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

City of entity. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Postal code of entity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Country of entity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

State/province of entity. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

FOREIGN DEPOSIT AND CUSTODIAL ACCOUNTS (Part I)

Type of account: 1=deposit, 2=custodial. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Use financial institution information from Form 114 . . . . . . . . . . . . . . . . . . . .

Financial institution information (if not filing Form 114):

Maximum value of account during year . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Name of institution. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Account number (mandatory for part I) . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Mailing address of institution. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

City of institution. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

State/province of institution. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Postal code of institution . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Country of institution . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .


Description of asset. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

1=account opened during year. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

1=account closed during year. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

1=account jointly owned with spouse. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

1=no tax item in Part III with respect to this account . . . . . . . . . . . . . . . . . . .

1=used foreign currency exchange rate to convert value to US dollars . . . . . . . . . . . . . . . . .

Foreign currency in which account is maintained. . . . . . . . . . . . . . . . . . . . . . .

Foreign currency exchange rate (xxxx.xxxx) . . . . . . . . . . . . . . . . . . . . . . . . . . .

Source of exchange rate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

OTHER FOREIGN ASSETS (Part II)

Date asset acquired during year (m/d/y). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Date asset disposed of during year (m/d/y). . . . . . . . . . . . . . . . . . . . . . . . . . . .

Identifying number or other designation (mandatory for part II). . . . . . . . . .

1=jointly owned with spouse. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

1=no tax item in Part III with respect to this asset. . . . . . . . . . . . . . . . . . . . . .

Maximum value of asset during year . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

1=used foreign currency exchange rate to convert value to US dollars . . . . . . . . . . . . . . . . .

Foreign currency in which asset is denominated . . . . . . . . . . . . . . . . . . . . . . .

Foreign currency exchange rate (xxxx.xxxx) . . . . . . . . . . . . . . . . . . . . . . . . . . .

Source of exchange rate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Type of Entity

1 = Partnership2 = Corporation3 = Trust4 = Estate

1


1040 US Foreign Reporting (8938) (continued)

Foreign Reporting (8938) (continued)

ORGANIZER

Series: 3500

2018

OTHER FOREIGN ASSETS (Part II) (continued)

Issuer or counterparty (#1):

Name . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

1=issuer, 2=counterparty . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Type of issuer or counterparty (see table 2). . . . . . . . . . . . . . . . . . . . . . . .

Issuer or counterparty: 1=US person, 2=foreign person. . . . . . . . . . . . .

City . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

State/province . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Mailing address. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Postal code. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Country. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Name . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .




City . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

State/province . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Mailing address. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Postal code. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Country. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Name . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .




City . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

State/province . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Mailing address. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Postal code. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Country. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Name . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .




City . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

State/province . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Mailing address. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Postal code. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Country. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .




Type of Issuer orCounterparty

1 = Individual2 = Partnership3 = Corporation4 = Trust5 = Estate

2

Date post:	21-Dec-2018
Category:	Documents
Upload:	vuhanh
View:	216 times
Download:	0 times

Organizer Blank Forms -...

Documents