Instructions For Form 8938 - 2016 (Page 11 of 14) in pdf

account and check the box at the top of

2. The foreign currency exchange

Line 3. Enter the following

page 1 of the form.

rate used to convert the value of the

information about the account or asset,

account into U.S. dollars.

if required.

Lines 1 through 9. Enter the following

3. If the U.S. Treasury Bureau of the

1. If the account was opened or

information for each foreign deposit or

Fiscal Service did not provide an

closed, or the asset was acquired or

custodial account.

exchange rate, the source of the foreign

disposed of during the year, enter the

Line 1. Check the box to indicate if

currency exchange rate that you used.

date of opening and/or closure, or

this is a depository or a custodial

acquisition and/or disposition, as

You must use the foreign

account.

applicable. If the assets were acquired

currency exchange rate on the

or disposed of during different dates in

Line 2. Enter the account number of

last day of the tax year, even if

the year, enter “Various.”

CAUTION

the account or other specific identifying

you closed or disposed of the account

2. If you own the account or asset

information for the account if there is no

before the last day of the tax year.

jointly with your spouse, check the box

account number.

on line 3c.

Line 7a. Enter the name of the

Line 3. Check one or more boxes to

3. If you did not report any income,

financial institution in which the account

indicate if any of the following applies.

is maintained.

gain, loss, deduction, or credit for this

The account was opened during the

account or asset on your tax return or

tax year.

Line 7b. If you have been furnished

any schedule or form attached to your

The account was closed during the

the GIIN associated with the financial

income tax return filed for the tax year,

tax year.

account listed in line 7a, you have the

check the box on line 3d.

The account was jointly owned with

option of entering it here.

your spouse.

Line 4. Check the box for the value

Lines 8 and 9. Enter the mailing

You did not report any tax item in Part

range that represents the maximum

address of the financial institution in

III for this asset.

value of the account or asset during the

which the account is maintained.

tax year. If the maximum value is more

Line 4. Enter the maximum value of

Part VI. Detailed Information for

than $200,000, enter the maximum

the account during the tax year.

value on line 4e.

each "Other Foreign Asset"

See

Reporting Maximum

Value,

Included in Part II Summary

See

Reporting Maximum

Value,

earlier, for information on

TIP

earlier, for information on

determining the maximum value

Use Part VI to report information for

TIP

determining the maximum value

of the account.

financial accounts (other than foreign

of the account or asset.

deposit and custodial accounts) and

Joint interests. Use the following

other specified foreign financial assets

Joint interests. Use the following

rules to determine the maximum value

not held in a financial account. If you

rules to figure the maximum value to

to report.

have more than one asset, attach a

report.

continuation sheet with the required

Spouses filing a joint return. You

information for each additional asset

and your spouse report the maximum

and check the box at the top of page 1

value of an account held jointly by you

value of an account or asset held jointly

of the form.

and your spouse only once on the single

by you and your spouse only once on

Form 8938 filed with your joint income

Lines 1 through 8. Enter the following

the single Form 8938 filed with your joint

tax return.

information for each financial account

income tax return.

Spouses filing separate returns.

and specified foreign financial asset not

Spouses filing separate returns.

You and your spouse each report the

held in a financial account reported in

You and your spouse each report the

maximum value of an account held

Part II. For examples of specified foreign

maximum value of an account or asset

jointly by you and your spouse on your

financial assets not held in a financial

held jointly by you and your spouse on

separate Forms 8938 filed with your

account, see

Other specified foreign

your separate Forms 8938 filed with

separate income tax returns.

financial

assets, earlier.

your separate income tax returns.

Other joint owners. Report the

Line 1. Enter a description of the

Other joint owners. Report the

maximum value of the entire jointly held

account or asset. If the asset is stock or

maximum value of the entire jointly held

account on your Form 8938 filed with

securities, include the class or issue of

account or asset on your Form 8938

your income tax return, regardless of

the stock or securities.

filed with your income tax return,

the value of your separate interest in the

Example 1. You own 100 shares of

regardless of the value of your separate

account.

XYZ Company, an Italian S.A. A

interest in the account or asset.

Lines 5 and 6. If you used a foreign

sufficient description is “100 Class A

Lines 5 and 6. If you used a foreign

currency exchange rate to convert the

shares of XYZ Company, S.A.”

currency exchange rate to convert the

value of the account into U.S. dollars,

Example 2. You own a bond issued

value of the account or asset into U.S.

check the “Yes” box on line 5 and go to

by AB GmbH, a German GmbH. A

dollars, check the “Yes” box on line 5

line 6. Otherwise, check the “No” box

sufficient description is “Bond of AB

and go to line 6. Otherwise, check the

and go to line 7.

GmbH, maturing on December 31,

“No” box and go to line 7.

2016.”

Line 6. If you answered “Yes” on

Line 6. If you answered “Yes” to

line 5, enter the following information.

Line 2. Enter the identifying number

line 5, enter the following information.

1. The foreign currency in which the

or other information identifying the

1. The foreign currency in which the

account is maintained.

account or asset.

account or asset is denominated.

Instructions for Form 8938 (2016)

Instructions For Form 8938 - 2016 Page 11

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