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                                                                                              Department of the Treasury
Instructions for Form 8937                                                                    Internal Revenue Service

(Rev. September 2015)

(Use with the December 2011 revision of Form 8937)
Report of Organizational Actions Affecting Basis of Securities

Section references are to the Internal Revenue Code unless       Organizational actions occurring after 2011 affecting 
otherwise noted.                                                 regulated investment company stock.
                                                                 Organizational actions occurring after 2013 affecting 
Future Developments                                              options, warrants, or stock rights.
For the latest information about developments related to         Organizational actions occurring after 2013 affecting 
Form 8937 and its instructions, such as legislation enacted      securities futures contracts.
after they were published, go to www.irs.gov/form8937.           Organizational actions occurring after 2013 affecting fixed 
                                                                 yield, fixed term debt instruments described in Regulations 
General Instructions                                             section 1.6045-1(n)(2)(i) (other than debt instruments 
                                                                 described in Regulations section 1.6045-1(n)(2)(ii)).
Who Must File                                                     Organizational actions occurring after 2015 affecting debt 
File Form 8937 if you are an issuer of a specified security that instruments described in Regulations section 1.6045-1(n)(3) 
takes an organizational action that affects the basis of that    (for example, a variable rate debt instrument, a contingent 
security. A specified security is:                               payment debt instrument, a convertible debt instrument, a 
 Any share of stock in an entity organized as, or treated for    payment-in-kind debt instrument, or an inflation-indexed debt 
federal tax purposes as, a corporation;                          instrument).
 Any interest treated as stock, including, for example, an 
American Depositary Receipt;                                     Exceptions
 An option, warrant, or stock right described in Regulations 
section 1.6045-1(m)(2);                                          Public reporting.  You are not required to file Form 8937 
 A securities futures contract; or                               with the IRS if, by the due date, you post a completed and 
 A debt instrument (other than a debt instrument subject to      signed Form 8937 in a readily accessible format in an area of 
section 1272(a)(6) or a short-term obligation).                  your primary public website dedicated to this purpose and 
                                                                 you keep it accessible to the public on this website or the 
File Form 8937 when an organizational action affects the         primary website of any successor organization for 10 years. 
basis of holders of a security or holders of a class of the      You may electronically sign the Form 8937 that is posted to 
security. For example, you must file Form 8937 if you make a     your website as long as you identify the individual who is 
nontaxable cash distribution to shareholders or if you make a    signing the penalties of perjury declaration.
nontaxable stock distribution to shareholders, including a       Exempt recipients.  No reporting is required if you 
stock split. In addition, if a conversion rate adjustment on a   determine that all the holders of the security are exempt 
convertible debt instrument results in a distribution under      recipients, including C corporations, charitable organizations, 
section 305(c) (for example, because of a cash distribution to   foreign holders, IRAs, Archer MSAs, health savings accounts 
shareholders), you must file Form 8937 if the adjustment         (HSAs), the United States, a state, or political subdivisions, 
occurs after December 31, 2015. Do not file Form 8937 if you     as defined in Regulations section 1.6045B-1(b)(5).
distribute stock to someone exercising a previously granted 
right to purchase stock. While this action bears on the basis    Certain money market funds.        No reporting is required by 
of the stock being distributed, it does not affect the basis of  a regulated investment company (RIC) that can hold itself out 
stock held by others. You must instead report the basis of the   as a money market fund under Rule 2a-7 under the 
stock being distributed when you purchase back or transfer       Investment Company Act of 1940.
custody of the stock. You do not need to file Form 8937 for 
an initial public offering or an issuance of a debt instrument.  Special Rules
However, you may need to file Form 8937 for an issuance of 
a debt instrument in a recapitalization, including a             S corporations. If an S corporation reports the effect of any 
recapitalization resulting from a significant modification or a  organizational action affecting the basis of its stock on a 
bankruptcy reorganization.                                       Schedule K-1 (Form 1120S) timely filed for each shareholder 
                                                                 and timely gives a copy to all proper parties, no Form 8937 is 
Do not report a distribution on Form 8937 if the distribution    required to be filed with regard to that organizational action.
is reportable as a dividend on Form 1099-DIV.
                                                                 Certain RICs and REITs. A regulated investment company 
The requirement to file Form 8937 applies to both                (RIC) or a real estate investment trust (REIT) that reports 
domestic and foreign issuers of securities if the security is    undistributed capital gains to shareholders on Form 2439 can 
owned by U.S. taxpayers, either directly or as a depositary      satisfy the organizational action reporting requirements for 
receipt.                                                         those undistributed gains if the RIC or REIT timely files and 
                                                                 gives Form 2439 to all proper parties for the organizational 
This filing requirement applies to organizational actions        action. RICs, REITs, and brokers holding custody of RIC and 
occurring after 2010 for a specified security as follows.        REIT stock must then adjust basis in accordance with the 
Organizational actions occurring after 2010 affecting stock      information reported on Form 2439.
other than regulated investment company stock.

Aug 21, 2015                                              Cat. No. 57457H



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When To File                                                          remains liable for any penalty for any failure to comply unless 
Form 8937 must be filed with the IRS on or before the 45th            it is shown that the failure is due to reasonable cause and not 
day following the organizational action or, if earlier, January       willful neglect. See sections 6721 through 6724.
15 of the year following the calendar year of the                     Acquiring and successor entities.               An acquiring or 
organizational action. You may file the return before the             successor entity of an issuer must satisfy these reporting 
organizational action if the quantitative effect on basis is          obligations if the issuer has not done so. If neither the issuer 
determinable. For purposes of determining this deadline, a            nor the acquiring or successor entity satisfies the reporting 
redemption occurs on the last day a holder may redeem a               obligations, both are jointly and severally liable for any 
security.                                                             applicable penalties.
     To report the quantitative effect on basis by the due 
TIP  date, you may make reasonable assumptions about                  Specific Instructions
     facts that cannot be determined before the due date. 
You must file a corrected return within 45 days of determining        Part I
facts that result in a different quantitative effect on basis from 
what was previously reported. For additional information, see         Boxes 1 and 2.  Enter the issuer's name and employer 
Regulations sections 1.6045B-1(a)(2)(ii) and 1.6045B-1(g),            identification number (EIN).
Example 2.                                                            Boxes 3, 4, 5, 6, and 7.      Enter the name, telephone number, 
                                                                      email address, and mailing address of a contact person.
Where To File                                                         Boxes 8, 9, 10, 11, 12, and 13.         For each security involved 
Send Form 8937 to Department of the Treasury, Internal                in the organizational action, enter the requested information. 
Revenue Service, Ogden, UT 84201-0054.                                Complete all boxes that apply.
Issuer Statements                                                     Note. If a box does not apply, leave it blank.
If you are required to file Form 8937, you must give a copy of        In box 9, enter the classification of the security (such as 
Form 8937 to each security holder of record as of the date of         stock) and include any description about the class of security 
the organizational action and all subsequent holders of               affected.
record up to the date you give the copy of Form 8937. If you 
record the security on your books in the name of a nominee,           Part II
you must give the copy of Form 8937 to the nominee in lieu of         For each security involved in the organizational action, enter 
the holder. However, if you, your agent, or a plan you operate        the requested information.
is listed as the nominee, you must give the copy of Form 
8937 to the holder.                                                   Paperwork Reduction Act Notice.               We ask for the 
You are considered to have given a copy of Form 8937 to               information on this form to carry out the Internal Revenue 
all holders and nominees if you post a completed Form 8937            laws of the United States. You are required to give us the 
to your primary public website under the rules listed under           information. We need it to ensure that you are complying with 
Public reporting, earlier.                                            these laws and to allow us to figure and collect the right 
                                                                      amount of tax.
You are not required to, but may, give a copy of Form 
8937 to a holder or nominee if the holder is an exempt                You are not required to provide the information requested 
recipient. See Exempt recipients, earlier.                            on a form that is subject to the Paperwork Reduction Act 
You may give holders and nominees a written statement                 unless the form displays a valid OMB control number. Books 
instead of a copy of Form 8937. The written statement must            or records relating to a form or its instructions must be 
include the same information as provided on Form 8937 and             retained as long as their contents may become material in 
must indicate that the information is being reported to the           the administration of any Internal Revenue law. Generally, 
IRS.                                                                  tax returns and return information are confidential, as 
                                                                      required by section 6103.
Time for furnishing statements.   You must give holders or 
nominees an issuer statement on or before January 15 of the           The time needed to complete and file this form will vary 
year following the calendar year of the organizational action.        depending on individual circumstances. The estimated 
For purposes of determining this deadline, a redemption               average time is:
occurs on the last day a holder may redeem a security. You 
                                                                      Learning about the law or the form. . . . . . .                 35 min.
can give an issuer statement before the organizational action 
if you have determined the quantitative effect on basis. If you       Preparing the form. . . . . . . . . . . . . . . . .             40 min.
file a corrected Form 8937 with the IRS, you must give a              Recordkeeping . . . . . . . . . . . . . . . . . . . 2 hr., 52 min.
corrected issuer statement by the later of the January 15 due 
date above or 45 days after you determine the facts that 
result in a different quantitative effect on basis from what was 
previously reported.

Penalties
Agents.   An issuer may use an agent, including a depositary, 
to satisfy these reporting requirements. However, the issuer 

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