Reportable Transaction Disclosure Statement                                                OMB No. 1545-1800 
Form   8886                                                   ▶ Attach to your tax return.  
(Rev. December 2019)                                        ▶ See separate instructions.                                     Attachment 
                                                                                                                             Sequence No. 137 
Department of the Treasury        ▶ Go to www.irs.gov/Form8886 for instructions and the latest information. 
Internal Revenue Service 
Name(s) shown on return (individuals enter last name, first name, middle initial)                                      Identifying number

Number, street, and room or suite no.                             City or town                                                      State  ZIP code

A      If you are filing more than one Form 8886 with your tax return, sequentially number  
       each Form 8886 and enter the statement number for this Form 8886 .         . . .  .  .     ▶ Statement number               of 
B      Enter the form number of the tax return to which this form is attached or related .  .     . . .  .   .       . . ▶
       Enter the year of the tax return identified above  . .  . . . . .          . . .  .  .     . . .  .   .       . . ▶
       Is this Form 8886 being filed with an amended tax return? . . . .          . . .  .  .     . . .  .   .       . . . .       Yes      No
C      Check the box(es) that apply. See instructions.             Initial year filer             Protective disclosure 
  1a   Name of reportable transaction 

  1 b  Initial year participated in transaction             1c  Reportable transaction or tax shelter registration number. See instructions.

  2    Identify the type of reportable transaction. Check all boxes that apply. See instructions. 
  a       Listed                  c     Contractual protection            e           Transaction of interest
  b       Confidential            d     Loss 

  3    If you checked box 2a or 2e, enter the published guidance number for the listed transaction or transaction 
       of interest  .    .  . . . .   . .       . . .  .    .  . . . . .          . . .  .  .     . . .  ▶
  4    Enter the number of “same as or substantially similar” transactions reported on this form .  . .  .   .       . . . ▶
  5    If you participated in this reportable transaction through a partnership, S corporation, trust, and foreign entity, check the applicable boxes and 
       provide the information below for the entity(ies). See instructions. (Attach additional sheets, if necessary.)
  a    Type of entity  .    . . . .   . .       . . .  .    ▶    Partnership             Trust               Partnership           Trust 
                                                                 S corporation           Foreign             S corporation         Foreign 

  b    Name  .       .   .  . . . .   . .       . . .  . ▶

  c    Employer identification number (EIN), if known  . ▶
  d    Date Schedule K-1 received from entity (enter   
       “none” if Schedule K-1 not received)  .    . .  . ▶
  6    Enter below the name and address of each individual or entity to whom you paid a fee with regard to the transaction if that individual or entity 
       promoted, solicited, or recommended your participation in the transaction, or provided tax advice related to the transaction. (Attach additional 
       sheets, if necessary.) 
  a    Name                                                                           Identifying number (if known)      Fees paid 
                                                                                                                         $
       Number, street, and room or suite no.                     City or town                                                       State  ZIP code

  b    Name                                                                           Identifying number (if known)      Fees paid 
                                                                                                                         $
       Number, street, and room or suite no.                     City or town                                                       State  ZIP code

For Paperwork Reduction Act Notice, see separate instructions.                           Cat. No. 34654G                     Form 8886 (Rev. 12-2019) 

Form 8886 (Rev. 12-2019)                                                                                                                Page  2 
7    Facts 
a    Identify the type of tax benefit generated by the transaction. Check all the boxes that apply. See instructions. 
        Deductions       Exclusions from gross income Absence of adjustments to basis                                     Tax credits
        Capital loss     Nonrecognition of gain       Deferral 
        Ordinary loss    Adjustments to basis         Other
b    Enter the total dollar amount of your tax benefits identified in 7a. See instructions  . . .    . . . . .        . . . $
c    Enter the anticipated number of years the transaction provides the tax benefits stated in 7b. See instructions .   . .
d    Enter your total investment or basis in the transaction. See instructions  . . . .       . .    . . . . .        . . . $
e    Further describe the amount and nature of the expected tax treatment and expected tax benefits generated by the transaction for all affected 
     years. Include facts of each step of the transaction that relate to the expected tax benefits including the amount and nature of your investment. 
     Include in your description your participation in the transaction and all related transactions regardless of the year in which they were entered 
     into. Also, include a description of any tax result protection with respect to the transaction. 

8    Identify all individuals and entities involved in the transaction that are tax-exempt, foreign, or related. Check the appropriate box(es). See 
     instructions. Include their name(s), identifying number(s), address(es), and a brief description of their involvement. For each foreign entity, 
     identify its country of incorporation or existence. For each individual or related entity, explain how the individual or entity is related. Attach 
     additional sheets, if necessary.
a    Type of individual or entity:   Tax-exempt       Foreign                       Related 
Name                                                                                                                  Identifying number

Address 

Description

b    Type of individual or  entity:  Tax-exempt       Foreign                       Related 
Name                                                                                                                  Identifying number

Address 

Description

                                                                                                                            Form 8886 (Rev. 12-2019)