Enlarge image | IRS Report of Cash Payments Over $10,000 FinCEN Form Form 8300 Received in a Trade or Business 8300 (Rev. December 2023) (Rev. August 2014) See instructions for definition of cash. OMB No. 1506-0018 Department of the Treasury Use this form for transactions occurring after December 31, 2023. Do not use prior versions after this date. Department of the Treasury Financial Crimes Internal Revenue Service For Privacy Act and Paperwork Reduction Act Notice, see the instructions. Enforcement Network 1 Check appropriate box(es) if: a Amends prior report; b Suspicious transaction. Part I Identity of Individual From Whom the Cash Was Received 2 If more than one individual is involved, check here and see instructions . . . . . . . . . . . . . . . . . . . . 3 Last name 4 First name 5 M.I. 6 Taxpayer identification number 7 Address (number, street, and apt. or suite no.) 8 Date of birth M M D D Y Y Y Y (see instructions) 9 City 10 State 11 ZIP code 12 Country (if not U.S.) 13 Occupation, profession, or business 14 Identifying a Describe ID b Issued by document (ID) c Number Part II Person on Whose Behalf This Transaction Was Conducted 15 If this transaction was conducted on behalf of more than one person, check here and see instructions . . . . . . . . . . . 16 Individual’s last name or organization’s name 17 First name 18 M.I. 19 Taxpayer identification number 20 Doing business as (DBA) name (see instructions) Employer identification number 21 Address (number, street, and apt. or suite no.) 22 Occupation, profession, or business 23 City 24 State 25 ZIP code 26 Country (if not U.S.) 27 Alien a Describe ID b Issued by identification (ID) c Number Part III Description of Transaction and Method of Payment 28 Date cash received 29 Total cash received 30 If cash was received in 31 Total price if different from M M D D Y Y Y Y more than one payment, item 29 $ .00 check here . . . . . $ .00 32 Amount of cash received (in U.S. dollar equivalent) (must equal item 29) (see instructions): a U.S. currency $ .00 (Amount in $100 bills or higher $ .00 ) b Foreign currency $ .00 (Country ) c Cashier’s check(s) $ .00 Issuer’s name(s) and serial number(s) of the monetary instrument(s) d Money order(s) $ .00 e Bank draft(s) $ .00 f Traveler’s check(s) $ .00 } 33 Type of transaction 34 Specific description of property or service shown in 33. a Personal property purchased f Debt obligations paid Give serial or registration number, address, docket b Real property purchased g Exchange of cash number, etc. c Personal services provided h Escrow or trust funds d Business services provided i Bail received by court clerks e Intangible property purchased j Other (specify in item 34) Part IV Business That Received Cash 35 Name of business that received cash 36 Employer identification number 37 Address (number, street, and apt. or suite no.) Social security number 38 City 39 State 40 ZIP code 41 Nature of your business 42 Under penalties of perjury, I declare that to the best of my knowledge the information I have furnished above is true, correct, and complete. Signature Title Authorized official 43 Date of M M D D Y Y Y Y 44 Type or print name of contact person 45 Contact telephone number signature IRS Form 8300 (Rev. 12-2023) Cat. No. 62133S FinCEN Form 8300 (Rev. 8-2014) |
Enlarge image | IRS Form 8300 (Rev. 12-2023) Page 2 FinCEN Form 8300 (Rev. 8-2014) Multiple Parties (Complete applicable parts below if box 2 or 15 on page 1 is checked.) Part I Continued—Complete if box 2 on page 1 is checked 3 Last name 4 First name 5 M.I. 6 Taxpayer identification number 7 Address (number, street, and apt. or suite no.) 8 Date of birth M M D D Y Y Y Y (see instructions) 9 City 10 State 11 ZIP code 12 Country (if not U.S.) 13 Occupation, profession, or business 14 Identifying a Describe ID b Issued by document (ID) c Number 3 Last name 4 First name 5 M.I. 6 Taxpayer identification number 7 Address (number, street, and apt. or suite no.) 8 Date of birth M M D D Y Y Y Y (see instructions) 9 City 10 State 11 ZIP code 12 Country (if not U.S.) 13 Occupation, profession, or business 14 Identifying a Describe ID b Issued by document (ID) c Number Part II Continued—Complete if box 15 on page 1 is checked 16 Individual’s last name or organization’s name 17 First name 18 M.I. 19 Taxpayer identification number 20 Doing business as (DBA) name (see instructions) Employer identification number 21 Address (number, street, and apt. or suite no.) 22 Occupation, profession, or business 23 City 24 State 25 ZIP code 26 Country (if not U.S.) 27 Alien a Describe ID b Issued by identification (ID) c Number 16 Individual’s last name or organization’s name 17 First name 18 M.I. 19 Taxpayer identification number 20 Doing business as (DBA) name (see instructions) Employer identification number 21 Address (number, street, and apt. or suite no.) 22 Occupation, profession, or business 23 City 24 State 25 ZIP code 26 Country (if not U.S.) 27 Alien a Describe ID b Issued by identification (ID) c Number Comments – Please use the lines provided below to comment on or clarify any information you entered on any line in Parts I, II, III, and IV IRS Form 8300 (Rev. 12-2023) FinCEN Form 8300 (Rev. 8-2014) |