U.S. Information Return Form 1041-A (Rev. September 2018) Trust Accumulation of Charitable Amounts OMB No. 1545-0094 ▶ Department of the Treasury Go to www.irs.gov/Form1041A for the latest information. Internal Revenue Service For calendar year 20 Name of trust Employer identification number Name of trustee Number, street, and room or suite no. (or P.O. box) City or town, state, and ZIP code Part I Income and Deductions (See the instructions for Form 1041 or Form 5227.) If total income is $25,000 or less, skip lines 1–8 and enter total income on line 9. 1 Interest income . . . . . . . . . . . . . . . . . . . . . . . . . 1 2 Dividends . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 3 Business income or (loss) (attach Schedule C or C-EZ (Form 1040)) . . . . . . . . 3 4 Capital gain or (loss) (attach Schedule D (Form 1041)) . . . . . . . . . . . . 4 5 Rents, royalties, partnerships, other estates and trusts, etc. (attach Schedule E (Form 1040)) 5 Income 6 Farm income or (loss) (attach Schedule F (Form 1040)) . . . . . . . . . . . . 6 7 Ordinary gain or (loss) (attach Form 4797) . . . . . . . . . . . . . . . . 7 8 Other income (state type of income) 8 9 Total income (combine lines 1 through 8) . . . . . . . . . . . . . . . . 9 10 Interest . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 11 Taxes . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 12 Charitable deduction (itemize by charitable purpose; include payee’s name and address) 12 13 Trustee fees . . . . . . . . . . . . . . . . . . . . . . . . . . 13 Deductions 14 Attorney, accountant, and return preparer fees . . . . . . . . . . . . . . . 14 15 Other deductions (attach schedule) . . . . . . . . . . . . . . . . . . 15 Part II Distributions of Income Set Aside for Charitable Purposes (see instructions) 16 Accumulated income set aside in prior tax years for which a deduction was claimed under section 642(c) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 17 Income set aside in prior tax years for which a deduction was claimed under section 642(c) and which was distributed during the current tax year (itemize by charitable purpose; include payee’s name and address): a 17a b 17b c 17c d 17d e 17e 18 Total (add lines 17a through 17e) . . . . . . . . . . . . . . . . . . . . . 18 19 Balance (subtract line 18 from line 16) . . . . . . . . . . . . . . . . . . . 19 20 Income set aside during the current tax year for which a deduction was claimed under section 642(c) (included in Part I, line 12) . . . . . . . . . . . . . . . . . . . . . 20 21 Carryover (add lines 19 and 20) . . . . . . . . . . . . . . . . . . . . . 21 Part III Distributions of Principal for Charitable Purposes (see instructions) 22 Principal distributed in prior tax years for charitable purposes . . . . . . . . . . . 22 23 Principal distributed during the current tax year for charitable purposes (itemize by charitable purpose; include payee’s name and address): a 23a b 23b c 23c d 23d e 23e 24 Total (add lines 23a through 23e) . . . . . . . . . . . . . . . . . . . . . 24 For Paperwork Reduction Act Notice, see the instructions. Cat. No. 10615B Form 1041-A (Rev. 9-2018) |
Form 1041-A (Rev. 9-2018) Page 2 Balance Sheets (see instructions). If line 9, page 1, is $25,000 or less, complete only lines 38, 42, Part IV and 45 (see instructions). (a) Beginning-of- (b) End-of-Year Assets Year Book Value Book Value 25 Cash—non-interest bearing . . . . . . . . . . . . . . . . . . 25 26 Savings and temporary cash investments . . . . . . . . . . . . . 26 27a Accounts receivable . . . . . . . . . . . . 27a b Less: allowance for doubtful accounts . . . . . . 27b 28a Notes and loans receivable . . . . . . . . . . 28a b Less: allowance for doubtful accounts . . . . . . 28b 29 Inventories for sale or use . . . . . . . . . . . . . . . . . . 29 30 Prepaid expenses and deferred charges . . . . . . . . . . . . . 30 31 Investments—U.S. and state government obligations (attach schedule) . . . 31 32 Investments—corporate stock (attach schedule) . . . . . . . . . . . 32 33 Investments—corporate bonds (attach schedule) . . . . . . . . . . . 33 34 a Investments—land, buildings, and equipment: basis . . 34a b Less: accumulated depreciation . . . . . . . . 34b 35 Investments—other (attach schedule) . . . . . . . . . . . . . . 35 36a Land, buildings, and equipment: basis . . . . . . 36a b Less: accumulated depreciation . . . . . . . . 36b 37 Other assets (describe ▶ ) 37 38 Total assets (add lines 25 through 37) . . . . . . . . . . . . . . 38 Liabilities 39 Accounts payable and accrued expenses . . . . . . . . . . . . . 39 40 Mortgages and other notes payable (attach schedule) . . . . . . . . . 40 41 Other liabilities (describe ▶ ) 41 42 Total liabilities (add lines 39 through 41) . . . . . . . . . . . . . 42 Net Assets 43 Trust principal or corpus . . . . . . . . . . . . . . . . . . . 43 44 Undistributed income and profits . . . . . . . . . . . . . . . . 44 45 Total net assets (add lines 43 and 44) . . . . . . . . . . . . . . 45 46 Total liabilities and net assets (add lines 42 and 45) . . . . . . . . . 46 Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than trustee) is based on all information of which preparer has any knowledge. Sign ▲ ▲ Here Signature of trustee or officer representing trustee Date Print/Type preparer’s name Preparer’s signature Date PTIN Paid Check if self-employed Preparer ▶ Firm’s name ▶ Firm’s EIN Firm’s address Use Only ▶ Phone no. Form 1041-A (Rev. 9-2018) |
Form 1041-A (Rev. 9-2018) Page 3 Section references are to the Internal To receive the automatic extension, the Do not merely enter the category (that Revenue Code unless otherwise noted. trustee must file Form 8868 on or before is, religious, charitable, scientific, literary, the original due date of Form 1041-A. or educational), but also enter the Future Developments purpose of the deduction. For example, Amended Return For the latest information about “payments of $4,000 to indigent persons developments related to Form 1041-A If you are filing an amended Form for medical purposes,” or a “grant of and its instructions, such as legislation 1041-A, you must complete the entire $25,000 to equip the chemistry lab at a enacted after they were published, go to return, not just the new or corrected university.” www.irs.gov/Form1041A. information. Enter “Amended Return” across the top of the amended Form Part III. Distributions of Principal What’s New 1041-A. for Charitable Purposes The Tax Cuts and Jobs Act of 2017 (P.L. The trustee may file an amended Lines 23a–23e. Provide a listing in 115-97) amended section 641(c)(2). As a return at any time to change or add to sufficient detail, similar to the examples result, electing small business trusts the information reported on a previously provided above, for each class of (ESBTs) are no longer subject to the filed return for the same period. activity for amounts paid out of principal for charitable purposes. charitable information reporting requirements under section 6034 and do Where To File See the Instructions for Form 1041, not file Form 1041-A. File Form 1041-A at the following U.S. Income Tax Return for Estates and address. Trusts, for more information regarding Reminder the allowance of deductions for amounts Department of the Treasury permanently set aside for a charitable Split-interest trusts as described in Internal Revenue Service Center purpose. section 4947(a)(2) don’t file Form Ogden, UT 84201-0027 1041-A. These types of trusts file Form Part IV. Balance Sheets 5227, Split-Interest Trust Information Penalties Complete the balance sheets using the Return, which meets the section 6034 Section 6652(c)(2) provides for separate accounting method the trust uses in filing requirements. penalties of $10 a day, up to a maximum keeping its books and records. All filers of $5,000, against both the trust and the must complete columns (a) and (b). General Instructions trustee for not filing Form 1041-A on time, unless there is reasonable cause. Assets Purpose of Form The law also provides penalties for filing When space is provided to the left of a false or fraudulent return. Use Form 1041-A to report the column (a) for reporting receivables and charitable information required by Rounding Off to Whole Dollars the related allowance for doubtful section 6034 and the related regulations. accounts or depreciable assets and You may show the money items on the accumulated depreciation, enter the Who Must File return and accompanying schedules as end-of-year figures. whole-dollar amounts. To do so, drop The trustee must file Form 1041-A for a amounts less than 50 cents and Line 25. Cash—non-interest bearing. trust that claims a charitable or other increase any amounts from 50 to 99 Enter the amount of cash on deposit in deduction under section 642(c) unless cents to the next dollar. checking accounts, deposits in transit, an exception applies. change funds, petty cash funds, or any Attachments Exceptions. The trustee doesn’t file other non-interest bearing accounts. Do Form 1041-A for: If you need more space, attach separate not include advances to employees or sheets showing the same information in officers or refundable deposits paid to • A trust that is required to distribute the same order as on the printed forms. suppliers or others. currently to the beneficiaries all the Show the totals on the printed forms. Line 26. Savings and temporary cash income for the tax year determined under section 643(b) and related Enter the trust’s employer investments. Enter the total of cash in regulations; identification number (EIN) on each savings or other interest-bearing sheet. Also, use sheets that are the accounts and temporary cash • A charitable trust described in section same size as the forms and indicate investments, such as money market 4947(a)(1); clearly the line of the printed form to funds, commercial paper, certificates of • For tax years beginning after 2006, a which the information relates. deposit, and U.S. Treasury bills or other split-interest trust described in section governmental obligations that mature in 4947(a)(2); or Public Inspection less than 1 year. • Electing small business trusts (ESBTs) See Regulations section 301.6104(b)- Line 27. Accounts receivable. Enter the described in section 641(c). 1(d) for the procedures to request public total accounts receivable (reduced by inspection of this form. the corresponding allowance for doubtful When To File accounts) that arose from the sale of File Form 1041-A by April 15 following Specific Instructions goods and/or the performance of services. Claims against vendors or the close of the calendar year. If the due Part II. Distributions of Income Set refundable deposits with suppliers or date falls on a Saturday, Sunday, or Aside for Charitable Purposes others may be reported here if not legal holiday, file on the next business significant in amount. If significant in day. Lines 17a–17e. Provide a listing in sufficient detail for each class of activity amount, report them (with any advances Extension of Time To File for which a disbursement was made, to employees or officers) on line 37, The trustee may obtain an automatic and a charitable deduction under section Other assets. extension of time to file Form 1041-A by 642(c) was taken. filing Form 8868, Application for Such amounts permanently set aside Automatic Extension of Time To File an must be earned from amounts transferred Exempt Organization Return. to the trust before October 9, 1969. |
Form 1041-A (Rev. 9-2018) Page 4 Line 28. Notes and loans receivable. Line 35. Investments—other. Enter the If you have questions about whether a Enter the combined total of notes amount of all other investment holdings preparer is required to sign the return, receivable and net loans receivable not reported on lines 31 through 34. please contact an IRS office. (including receivables due from officers, Attach a schedule describing each of The person signing the return as the directors, trustees, and other disqualified these investments held at the end of the preparer should complete the requested persons). In an attached schedule, show year. List the cost, or other basis, and preparer information and do the the following information (preferably in the end-of-year book value. following. columnar format). Line 36. Land, buildings, and • Sign it in the space provided for the • Borrower’s name and title. equipment. Attach a schedule of all preparer’s signature. (A facsimile • Original amount. land, buildings, and equipment that signature is acceptable.) aren’theld for investment purposes, • Balance due. such as the trust’s offices. List the cost • Give the trustee a copy of the return in • Date of note. or other basis of these assets, addition to the copy to be filed with the accumulated depreciation, and end-of- IRS. • Maturity date. year bookvalue. • Repayment terms. Line 37. Other assets. Enter the book Paperwork Reduction Act Notice. We • Interest rate. value of any trust assets that haven’t ask for the information on this form to • Security provided by the borrower. been reported on lines 25 through 36. If carry out the Internal Revenue laws of more space is needed, attach a separate the United States. You are required to • Purpose of the loan. schedule with a description of the asset, give us the information. We need it to • Description and fair market value of date acquired, and end-of-year book ensure that you are complying with the consideration furnished by the value. these laws and to allow us to figure and collect the right amount of tax. lender. Liabilities You aren’t required to provide the Line 29. Inventories for sale or use. Line 39. Accounts payable and information requested on a form that is Enter the amount of materials, goods, accrued expenses. Enter the total subject to the Paperwork Reduction Act and supplies purchased or manufactured accounts payable to suppliers and unless the form displays a valid OMB by the trust and held for sale or use in others, and accrued expenses such as control number. Books or records some future period. salaries payable, accrued payroll taxes, relating to a form or its instructions must Line 30. Prepaid expenses and and interest payable. be retained as long as their contents deferred charges. Enter the amount of Line 40. Mortgages and other notes may become material in the short-term and long-term prepayments payable. Attach a schedule showing, as administration of any Internal Revenue of future expenses attributable to one or of the end of the year, the total amount law. Generally, tax returns and return more future accounting periods. of all mortgages payable, and for each information are confidential, as required Examples include prepayments of rent, nonmortgage note payable, the lender’s by Code section 6103. insurance, and pension costs. name and the other information specified The time needed to complete and file Lines 31, 32, and 33. Investments— in the line 28 instructions. this form will vary depending on government obligations, corporate Line 41. Other liabilities. Enter the book individual circumstances. The estimated stocks, and corporate bonds. Enter the value of any trust liabilities that haven’t average time is: book value (which may be market value) been reported on line 39 or 40. If more Recordkeeping . . . 24 hr., 52 min. of these investments. Attach a schedule space is needed, attach a separate that lists each security held at the end of schedule with a description of the Learning about the the year and shows whether the security liability and amount. law or the form . . . . 2 hr., 37 min. is listed at cost (including the value recorded at the time of receipt in the Signature Preparing the form . . 7 hr., 48 min. case of donated securities) or Form 1041-A must be signed by the Copying, assembling, end-of-year market value. Do not include trustee or by an authorized and sending the amounts on line 26. Government representative. form to the IRS . . . . 1 hr., 20 min. obligations reported on line 31 are those that mature in 1 year or more. Debt If you, as trustee (or an employee or If you have comments concerning the securities of the U.S. government may officer of the trust), fill in Form 1041-A, accuracy of these time estimates or be reported as a single total rather than the Paid Preparer space should be left suggestions for making this form itemized. Obligations of state and blank. If someone prepares this return simpler, we would be happy to hear from municipal governments may also be without charge, that person shouldn’t you. You can send us comments reported as a lump-sum total. Do not sign the return. through www.irs.gov/FormComments. Or you can write to: Internal Revenue combine U.S. government obligations Generally, anyone who is paid to Service, Tax Forms and Publications, with state and municipal obligations on prepare a tax return must sign the return 1111 Constitution Ave. NW, IR-6526, the attached schedule. and fill in the other blanks in the Paid Washington, DC 20224. Do not send the Line 34. Investments—land, buildings, Preparer Use Only area of the return. tax form to this address. Instead, see and equipment. Attach a schedule of all Where To File, earlier. land, buildings, and equipment that are held for investment purposes, such as rental properties. List the cost or other basis of these assets, accumulated depreciation, and end-of-year book value. |