SCHEDULE B                                                                                                                    OMB No. 1545-0074
(Form 1040)                                    Interest and Ordinary Dividends
Department of the Treasury         Go to www.irs.gov/ScheduleB for instructions and the latest information.                   2022
                                                                                                                              Attachment   
Internal Revenue Service                              Attach to Form 1040 or 1040-SR.                                         Sequence No. 08 
Name(s) shown on return                                                                                                 Your social security number

Part I               1      List  name  of  payer.  If  any  interest  is  from  a  seller-financed  mortgage  and  the         Amount
                            buyer used the property as a personal residence, see the instructions and list this
Interest                    interest first. Also, show that buyer’s social security number and address:
(See instructions 
and the 
Instructions for  
Form 1040, 
line 2b.)  
Note: If you  
received a 
Form 1099-INT,                                                                                                            1 
Form 1099-OID, 
or substitute  
statement from 
a brokerage firm, 
list the firm’s 
name as the 
payer and enter 
the total interest 
shown on that 
form. 
                     2      Add the amounts on line 1 .    . .   .  . .  . .    .  .   .  . . .  .     .   . . .          2 
                     3      Excludable  interest  on  series  EE  and  I  U.S.  savings  bonds  issued  after  1989. 
                            Attach Form 8815   .  . .      . .   .  . .  . .    .  .   .  . . .  .     .   . . .          3 
                     4      Subtract line 3 from line 2. Enter the result here and on Form 1040 or 1040-SR, line 2b       4 
                   Note: If line 4 is over $1,500, you must complete Part III.                                                  Amount 
Part II              5      List name of payer:

Ordinary  
Dividends
(See instructions 
and the 
Instructions for 
Form 1040, 
line 3b.)                                                                                                                 5 
Note: If you 
received a 
Form 1099-DIV 
or substitute 
statement from 
a brokerage firm, 
list the firm’s 
name as the 
payer and enter 
the ordinary 
dividends shown      6      Add the amounts on line 5. Enter the total here and on Form 1040 or 1040-SR, line 3b          6 
on that form.      Note: If line 6 is over  $1,500, you must complete Part III. 
Part III           You must complete this part if you ( )ahad over $1,500 of taxable interest or ordinary dividends; ( ) hadb   a foreign 
                   account; or (c) received a distribution from, or were a grantor of, or a transferor to, a foreign trust. 
Foreign  
Accounts                                                                                                                           Yes  No
and Trusts           7 a    At any time during 2022, did you have a financial interest in or signature authority over a financial
Caution: If                 account (such as a bank account, securities account, or brokerage account) located in a foreign
required, failure to        country? See instructions  .   . .   .  . .  . .    .  .   .  . . .  .     .   . . .        . . . . .
file FinCEN Form 
114 may result in           If  “Yes,”  are  you  required  to  file  FinCEN  Form  114,  Report  of  Foreign  Bank  and  Financial
substantial                 Accounts (FBAR), to report that financial interest or signature authority? See FinCEN Form 114
penalties.                  and its instructions for filing requirements and exceptions to those requirements  .        . . . . .
Additionally, you 
may be required          b  If you are required to file FinCEN Form 114, list the name(s) of the foreign country(-ies) where the
to file Form 8938,          financial account(s) are located:
Statement of 
Specified Foreign 
Financial Assets.    8      During 2022, did you receive a distribution from, or were you the grantor of, or transferor to, a 
See instructions.           foreign trust? If “Yes,” you may have to file Form 3520. See instructions .    . . .        . . . . .
For Paperwork Reduction Act Notice, see your tax return instructions.                Cat. No. 17146N                    Schedule B (Form 1040) 2022