Delete all form data except for material advisor and contact person information                                                     Delete all form data

Form   8918                                Material Advisor Disclosure Statement                                                    OMB No. 1545-0865
(Rev. November 2021)
Internal Revenue Service 
Department of the Treasury                                            ▶  See separate instructions.                                 FOR IRS USE ONLY
Note. The reportable transaction number will be sent to the material advisor’s address below. 
Material Advisor’s Name (see instructions)                                            Individual        Identifying number          Telephone number 
                                                                                      Entity
Number, street, and room or suite no. 

City or town                                                             State                                                      ZIP code 

A         Contact person name (last name, first name, middle initial)    Title                                                      Telephone number 

B        Is this a protective disclosure? (see instructions) Yes         No          If “Yes,” see line 6a instructions. 
C        Is this the original Form 8918 for this reportable transaction?       Yes    No 
If “Yes,” go to line 1. If “No,” enter the reportable transaction number previously issued for this reportable transaction or tax shelter. 
Reportable Transaction Number ▶
 1    Name of reportable transaction (see instructions) 

 2    Identify the type of reportable transaction. Check all the box(es) that apply (see instructions). 
    a    Listed             b Confidential      c            Contractual protection d Loss          e   Transaction of interest 
 3    If you checked box 2a or 2e, enter the published guidance number for the listed transaction or transaction of interest  ▶
 4    Enter the date the Material Advisor became a material advisor with respect to the reportable transaction (see instructions)  ▶
 5    If you are a party to a designation agreement, identify the other parties (see instructions). 
Name                                                                                                                     Individual Identifying number (if known) 
                                                                                                                         Entity
Address (Number, street, and room or suite no.) 

City or town                                                             State                                                      ZIP code 

Contact name                                                                                                                        Telephone number 

 6a  Provide a brief description of the type of material aid, assistance, or advice you provided (see instructions). 

    b Describe the role of any other entity(ies) or individual(s) who you know or have reason to know provided material aid, assistance, or advice to
      this transaction and include each entity’s and individual’s complete name, identifying number (if known), and address. 

    Hide Warning

For Privacy Act and Paperwork Reduction Act Notice, see separate instructions.        Catalog Number 39533A                         Form 8918 (Rev. 11-2021) 

Delete all form data except for material advisor and contact person information                                Delete all form data
Form 8918 (Rev. 11-2021)                                                                                                         Page 2
7a To obtain the intended tax benefits generated by the transaction: 
   Is a related entity(ies) or individual(s) needed? Yes             No 
   Is a foreign entity(ies) or individual(s) needed? Yes             No 
   Is a tax-exempt entity(ies) needed?               Yes             No 
b If you answered “Yes” to any of the above questions, describe the role of each individual or entity. Also identify the individual’s or entity’s country 
   of existence if a particular country is required to obtain the intended tax benefits. 

8a To obtain the intended tax benefits generated by the transaction, is income or gain from the transaction allocated directly or indirectly to an  
   individual(s) or entity(ies) that has a net operating loss and/or unused loss or credits? Yes No 
b If “Yes,” describe the role of each individual or entity in the transaction. 

9  Identify the types of financial instruments used in this transaction (see instructions). 

10 Estimated Tax Benefits—Identify the type of tax benefit generated by the transaction that you expect the taxpayer to claim in each year.  
   Check all boxes that apply (see instructions). 
   Deductions                                        Capital loss                                Ordinary loss 
   Exclusions from gross income                      Nonrecognition of gain                      Adjustments to basis 
   Tax credits                                       Deferral                                    Absence of adjustments to basis 
   Other 
11 Timing of Tax Benefits—If you checked one or more boxes on line 10, check the applicable box(es) below to identify the period in which such 
   tax benefits are claimed. Check each box that applies. 
   Tax benefits generated by the transaction are required to be claimed in the first year of participation by the taxpayer. 
   Tax benefits may be claimed in another year by the taxpayer. 
12 Enter the Internal Revenue Code section(s) used to claim tax benefit(s) generated by the transaction. (Attach additional sheets if necessary.) 

Catalog Number 39533A                                         www.irs.gov                                      Form 8918 (Rev. 11-2021) 

Delete all form data except for material advisor and contact person information       Delete all form data
Form 8918 (Rev. 11-2021)                                                                                                                                       Page 3
13    Describe the reportable transaction for which you provided material aid, assistance or advice, including but not limited to the following: the 
      nature of the expected tax treatment and expected tax benefits generated by the transaction for all affected years, the years the tax benefits 
      are expected to be claimed, the role of the entities or individuals mentioned in lines 7a or 8a (if any) and the role of the financial instruments 
      mentioned in line 9 (if any). Explain how the Internal Revenue Code sections listed in line 12 are applied and how they allow the taxpayer to 
      obtain the desired tax treatment. Also, include a description of any tax result protection with respect to the transaction. 

        Under penalties of perjury, I declare that I have examined this return, and to the best of my knowledge and belief, it is true, correct, and complete. 
Please   ▲
Sign      Signature of Material Advisor Date                                    Title 
Here     ▲
          Print name 
Catalog Number 39533A                   www.irs.gov                                   Form 8918 (Rev. 11-2021) 

Form 8918 (Rev. 11-2021)                      Page 4

Catalog Number 39533A    www.irs.gov Form 8918 (Rev. 11-2021)