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Form 1041-A (Rev. 1-2017) 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’t held 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 book value.
• 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 your comments to
reported as a lump-sum total. Do not sign the return. the Internal Revenue Service, Tax Forms
and Publications Division, 1111
combine U.S. government obligations Generally, anyone who is paid to Constitution Ave. NW, IR-6526,
with state and municipal obligations on prepare a tax return must sign the return Washington, DC 20224. Do not send the
the attached schedule. and fill in the other blanks in the Paid tax form to this address. Instead, see
Line 34. Investments—land, buildings, Preparer Use Only area of the return. Where To File, earlier.
and equipment. Attach a schedule of all
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.
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