Form 3520 - Annual Return To Report Transactions With Foreign Trusts And Receipt Of Certain Foreign Gifts - 2017 Page 4
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Form 3520 (2017)
Page
Part II
U.S. Owner of a Foreign Trust (see instructions)
(a)
(e)
20
(b)
(c)
(d)
Name of other foreign
Relevant Code
Address
Country of residence
Identification number, if any
trust owners, if any
section
(a)
(b)
(c)
21
Country code of country where foreign trust
Country code of country whose law governs the foreign trust
Date foreign trust was created
was created
22
Did the foreign trust file Form 3520-A for the current year? .
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Yes
No
If “Yes,” attach the Foreign Grantor Trust Owner Statement you received from the foreign trust.
If “No,” to the best of your ability, complete and attach a substitute Form 3520-A for the foreign trust.
See instructions for information on penalties.
23
Enter the gross value of the portion of the foreign trust that you are treated as owning at the end of the tax year
$
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Part III
Distributions to a U.S. Person From a Foreign Trust During the Current Tax Year (see instructions)
24
Cash amounts or FMV of property received, directly or indirectly, during the current tax year, from the foreign trust (exclude loans included on line 25).
(c)
(d)
(e)
(f)
(a)
(b)
FMV of property received
Description of property
FMV of property
Excess of column (c)
Date of distribution
Description of property received
(determined on date of distribution)
transferred, if any
transferred
over column (e)
Totals.
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25 During the current tax year, did you (or a person related to you) receive a loan from a related foreign trust (including an
extension of credit upon the purchase of property from the trust)? .
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Yes
No
If “Yes,” complete columns (a) through (g) below for each such loan.
Note: You are considered to have received a loan if you (or a U.S. person related to you) were permitted the
uncompensated use of trust property (as described in section 643(i)). See instructions for additional information, including
how to complete columns (a) through (g) for such transactions.
(e)
(c)
(g)
(b)
(d)
(f)
Is the obligation a
(a)
Maximum term of
Amount treated as distribution
Date of original
Interest rate
FMV of qualified
“qualified obligation?”
from the trust (subtract
FMV of loan proceeds
repayment of
loan transaction
of obligation
obligation
column (f) from column (a))
obligation
Yes
No
Total .
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26 With respect to each obligation you reported as a “qualified obligation” on line 25: Do you agree to extend the period of
assessment of any income or transfer tax attributable to the transaction, and any consequential income tax changes for
each year that the obligation is outstanding, to a date 3 years after the maturity date of the obligation?
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Yes
No
Note: You have the right to refuse to extend the period of limitations or limit this extension to a mutually agreed-upon
issue(s) or mutually agreed-upon period of time. Generally, if you refuse to extend the period of limitations with respect to
an obligation that you reported as a “qualified obligation” on line 25, then such obligation is not a qualified obligation and
you cannot check “Yes” in column (e) of line 25.
27 Total distributions received during the current tax year. Add line 24, column (f), and line 25, column (g)
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28 Did the trust, at any time during the tax year, hold an outstanding obligation of yours (or a person related to you) that you
reported as a “qualified obligation” in the current tax year?
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Yes
No
If “Yes,” complete columns (a) through (e) below for each obligation.
(e)
(a)
(b)
(c)
(d)
Does the loan still meet the criteria
Date of original loan
Tax year qualified
Amount of principal payments
Amount of interest payments
of a qualified obligation?
transaction
obligation first reported
made during the tax year
made during the tax year
Yes
No
3520
Form
(2017)
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