Form 3520-A - Annual Information Return Of Foreign Trust With A U.s. Owner - 2004

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Annual Information Return of Foreign
3520-A
OMB No. 1545-0160
Form
Trust With a U.S. Owner
2004
(Under section 6048(b))
Department of the Treasury
Internal Revenue Service
See separate instructions.
Note: All infor mation must be in English. Show all amounts in U.S. dollars.
For calendar year 2004, or tax year beginning
, 2004, ending
, 20
.
Check appropriate boxes.
Initial return
Final return
Amended return
Part I
General Information (see instructions)
1a Name of foreign trust
b
Employer identification number
c Number, street, and room or suite no. (if a P.O. box, see instructions)
d City or town
e State or province
f ZIP or postal code
g
Country
2
Did the foreign trust appoint a U.S. agent (defined on page 2 of the instructions) who can provide the IRS with all
Yes
No
relevant trust information?
If “Yes,” skip lines 2a through 2e and go to line 3.
If “No,” you are required to attach a copy of all trust documents as indicated below. If these documents have been attached to a Form
3520-A filed within the previous 3 years, attach only relevant updates.
Attached
Year
Have you attached a copy of:
Yes
No
Previously
Attached
a Summary of all written and oral agreements and understandings relating to the trust?
b The trust instrument?
c Memoranda or letters of wishes?
d Subsequent variances to original trust documents?
e Other trust documents?
3a Name of U.S. agent
b
Identification number
c Number, street, and room or suite no. (if a P.O. box, see instructions)
d City or town
e State or province
f ZIP or postal code
g
Country
4a Name of trustee
b
Identification number, if any
c Number, street, and room or suite no. (if a P.O. box, see instructions)
d City or town
e State or province
f ZIP or postal code
g
Country
5
Did the trust transfer any property (including cash) to another person (see instructions for definition) during the tax
Yes
No
year? If “Yes,” attach statement (see instructions).
6
Enter the number of Foreign Grantor Trust Owner Statements (page 3) included with this Form 3520-A
Under penalties of perjury, I declare that I have examined this return, including any accompanying reports, schedules, or statements, and to the best of my knowledge
and belief, it is true, correct, and complete.
Trustee’s
Signature
Title
Date
Preparer’s
Signature
Preparer’s SSN or PTIN
Date
3520-A
For Privacy Act and Paperwork Reduction Act Notice, see page 4 of instructions.
Cat. No. 19595G
Form
(2004)

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