Instructions For Form 4720 - 2016 Page 6

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Schedule and item number of the act
1. Write “ATTACHMENT TO FORM
column (d), that the individual took part
or transaction that hasn't been
4720” at the top of page 1.
in as a foundation manager.
corrected,
2. Enter the trust's name under
Column (f). Enter for each person
A description of the act or
“Name of organization” and complete
listed in column (a) the tax on political
transaction, and
item D and E at the top of page 1.
expenditures from Schedule F, Part II,
A detailed explanation of why
column (d), that the individual took part
3. Complete Parts I and II. If a line
correction hasn't been made and what
in as an organization or foundation
doesn't apply, leave it blank.
steps are being taken to make the
manager.
4. Complete any of the Schedules
correction.
on Form 990-T or other forms or attach
Column (g). Enter for each person
If you are correcting deficient
a schedule as required by any line on
listed in column (a) the tax on
distributions under section 4942 where
which an entry is made for Parts I and II.
disqualifying lobbying expenditures from
an election under section 4942(h)(2)
Also, attach any schedule as may be
Schedule H, Part II, column (d), that the
was filed with the IRS, provide a copy of
required on any Schedule on Form
individual took part in as an organization
the election. See the instructions for
990-T or other form that you are
manager.
Form 990-PF, Part XIII, lines 4b and 4c
required to complete. However, if
for more information.
Column (h). For each person listed in
Schedule D (Form 1041) is required,
column (a), enter the sum of:
Part I
don't complete Part V of Schedule D
1. Taxes that person owes as a
(Form 1041).
Line 8
disqualified person, from Schedule I,
5. Enter the amount from line 34 of
Part II, column (d), and
If the organization has an entry
Form 990-T on Part I, line 11 of Form
on this line, it must also file
2. Tax on excess benefit
4720. Don't complete Parts III-V or the
TIP
Form 8870.
transactions in which the organization
signature area of Form 990-T.
manager participated knowing that the
Enter the total of all premiums paid by
If you don't complete a Form 990-T
transaction was an excess benefit
the organization on any personal benefit
as the attached statement, then attach a
transaction, from Schedule I, Part III,
contract if the payment of premiums is in
schedule with the same information as
column (d).
connection with a transfer for which a
Form 990-T and its Schedules (as
deduction isn't allowed under section
discussed above) including all the
Column (i). Enter for each person
170(f)(10)(A). Also, if there is an
information that must be attached to
listed in column (a) the tax on the entity
understanding or expectation that any
Form 990-T and its Schedules, such as
manager who approved or otherwise
person will directly or indirectly pay any
other forms and attachments. Be sure to
caused the entity to be a party to a
premium on a personal benefit contract
enter the amount shown as unrelated
prohibited tax shelter transaction from
for the transferor, include those
business taxable income on Part I,
Schedule J, Part II, column (d).
premium payments in the amount
line 11 of Form 4720.
Column (j). Enter for each person
entered on this line.
Part II­A
listed in column (a) the tax on taxable
distributions from sponsoring
A personal benefit contract is (to the
Columns (a) and (b). List the names,
organizations maintaining donor
transferor) any life insurance, annuity, or
addresses, and taxpayer identification
advised funds from Schedule K, Part II,
endowment contract that benefits
numbers of all persons who owe tax in
column (d), that the individual took part
directly or indirectly the transferor, a
connection with the foundation or
in as a manager.
member of the transferor's family, or any
organization, whether as managers,
other person designated by the
Column (k). For each person listed in
self-dealers, disqualified persons,
transferor (other than an organization
column (a), enter the:
donors, donor advisors, or related
described in section 170(c)).
persons, as shown in Schedules A, D,
1. Tax imposed on a donor, donor
E, F, H, I, J, K, and L.
advisor, or related person, from
For more information, see Notice
Schedule L, Part II, column (d), and
Column (c). For each person listed in
2000-24, 2000-17 I.R.B. 952, at
column (a), enter the sum of:
2. Tax on each fund manager who
agreed to the making of a distribution of
1. Taxes that person owes as a
a prohibited benefit from Schedule L,
self-dealer, from Schedule A, Part II,
Line 11
Part III, column (d), that the individual
column (d), and
Enter the charitable remainder trust's
took part in as a manager.
2. Tax for acts of self-dealing in
unrelated business taxable income on
which the individual participated as a
Liability for tax. A person's liability
line 11. Charitable remainder trusts
manager, from Schedule A, Part III,
for tax as a manager, self-dealer,
must attach a statement that shows how
column (d).
disqualified person, donor, donor
their unrelated business taxable income
advisor, or related person, under
was computed. The excise tax imposed
Column (d). Enter for each person
sections 4912, 4941, 4944, 4945, 4955,
on a charitable remainder trust is equal
listed in column (a) the tax on
4958, 4966, and 4967 is joint and
to the trust's unrelated business taxable
investments that jeopardize charitable
several. Therefore, if more than one
income.
purpose from Schedule D, Part II,
person owes tax on an act as a
Attached statement. Charitable
column (d), that the individual took part
manager, self-dealer, disqualified
remainder trusts may use Form 990-T
in as a foundation manager.
person, donor, donor advisor, or related
as the attached statement. If the trust
person, they may apportion the tax
Column (e). Enter for each person
uses Form 990-T as the attached
among themselves. However, when all
listed in column (a) the tax on taxable
statement, complete Form 990-T as
managers, self-dealers, donors, donor
expenditures from Schedule E, Part II,
follows:
­6­
Instructions for Form 4720 (2016)

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