Form 3520-A - Annual Information Return Of Foreign Trust With A U.s. Owner - 2015
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43520-A
Annual Information Return of Foreign
OMB No. 1545-0160
Form
Trust With a U.S. Owner
2015
(Under section 6048(b))
Department of the Treasury
Information about Form 3520-A and its separate instructions is at
Internal Revenue Service
▶
Note: All information must be in English. Show all amounts in U.S. dollars.
For calendar year 2015, or tax year beginning
, 2015, ending
, 20
.
Check appropriate boxes.
Initial return
Final return
Amended return
Check if any excepted specified foreign financial assets are reported on this form (see instructions) .
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Part I
General Information (see instructions)
1a
b(1) Employer identification number
Name of foreign trust
c
Number, street, and room or suite no. (if a P.O. box, see instructions)
b(2) Reference ID number (see instructions)
d
City or town
e
State or province
f
ZIP or foreign postal code
g
Country
2
Did the foreign trust appoint a U.S. agent (defined in the instructions) who can provide the IRS with all the relevant
trust information? .
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Yes
No
If “Yes,” skip lines 2a through 2e and go to line 3.
If “No,” you are required to attach a copy of all trust documents as indicated below. If these documents have been attached to a Form 3520-A
filed within the previous 3 years, attach only relevant updates.
Attached
Year
Have you attached a copy of:
Yes
No
Previously
Attached
a
Summary of all written and oral agreements and understandings relating to the trust? .
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b
The trust instrument? .
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c
Memoranda or letters of wishes?
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d
Subsequent variances to original trust documents? .
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Other trust documents? .
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e
3a
b
Name of U.S. agent
Identification number
c
Number, street, and room or suite no. (if a P.O. box, see instructions)
d
City or town
e
State or province
f
ZIP or postal code
g
Country
4a
Name of trustee
b
Identification number, if any
c
Number, street, and room or suite no. (if a P.O. box, see instructions)
d
City or town
e
State or province
f
ZIP or postal code
g
Country
5
Did the trust transfer any property (including cash) to another person (see instructions for definition) during the tax
year? If “Yes,” attach statement (see instructions).
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Yes
No
6
Enter the number of Foreign Grantor Trust Owner Statements (page 3) included with this Form 3520-A .
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▶
Under penalties of perjury, I declare that I have examined this return, including any accompanying reports, schedules, or statements, and to the best of my
knowledge and belief, it is true, correct, and complete.
Sign
Here
Trustee’s Signature
Title
Date
Print/Type preparer’s name
Preparer’s signature
Date
PTIN
Check
if
Paid
self-employed
Preparer
Firm’s name
Firm’s EIN
▶
▶
Use Only
Firm’s address
Phone no.
▶
3520-A
For Paperwork Reduction Act Notice, see instructions.
Form
(2015)
Cat. No. 19595G
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