Schedule B-1 (Form 1120s) - Information On Certain Shareholders Of An S Corporation

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SCHEDULE B-1
Information on Certain Shareholders of an S Corporation
(Form 1120S)
Attach to Form 1120S.
▶
OMB No. 1545-0130
(December 2013)
Information about Schedule B-1 (Form 1120S) and
▶
Department of the Treasury
its instructions is at
Internal Revenue Service
Name of corporation
Employer identification number
Information on Any Shareholder That Was a Disregarded Entity, a Trust, an Estate, or a Nominee or Similar
Person at Any Time During the Tax Year (Form 1120S, Schedule B, Question 3)
(b)
(d)
(a)
Social Security Number (SSN)
(c)
Name and SSN or EIN (if any) of Individual or
Name of Shareholder of Record—Disregarded Entity,
or Employer Identification
Type of Shareholder
Entity Responsible for Reporting Shareholder’s
Trust, Estate, Nominee or Similar Person
Number (EIN) (if any) of
of Record
Income, Deductions, Credits, etc., From
Shareholder of Record
Schedule K-1
For Paperwork Reduction Act Notice, see the Instructions for Form 1120S.
Cat. No. 60837X
Schedule B-1 (Form 1120S) (12-2013)

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