2
Form 3520-A (2004)
Page
Foreign Trust Income Statement
Part II
Enter totals from books and records of foreign trust (see instructions).
1
Interest
2
Dividends
3
Gross rents and royalties
4
Income (loss) from partnerships and fiduciaries
5
Capital gains:
a
Net short-term capital gain (loss)
b
Net long-term capital gain (loss)
6
Ordinary gains (losses)
7
Other income (attach schedule)
8
Total income (add lines 1 through 7)
9
Interest expense
10a
Foreign taxes (attach schedule)
b
State and local taxes
11
Amortization and depreciation (depletion)
12
Trustee and advisor fees
13
Charitable contributions
14
Other expenses (attach schedule)
15
Total expenses (add lines 9 through 14)
16
Net income (loss) (subtract line 15 from line 8)
17a
Enter the fair market value (FMV) of total distributions from the trust to all persons, whether U.S. or foreign
b
Distributions to U.S. owners:
(i) Name of owner
(ii) Identification number
(iii) Date of distribution
(iv) FMV
c
Distributions to U.S. beneficiaries:
(i) Name of beneficiary
(ii) Identification number
(iii) Date of distribution
(iv) FMV
Part III
Foreign Trust Balance Sheet
Beginning of Tax Year
End of Tax Year
(a)
(b)
(c)
(d)
Assets
1
Cash
2
Accounts receivable
3
Mortgages and notes receivable
4
Inventories
5
Government obligations
6
Other marketable securities
7
Other nonmarketable securities
8a
Depreciable (depletable) assets
b
Less: accumulated depreciation (depletion)
9
Real property
10
Other assets (attach schedule)
11
Total assets
Liabilities
12
Accounts payable
13
Contributions, gifts, grants, etc., payable
14
Mortgages and notes payable
15
Other liabilities (attach schedule)
16
Total liabilities
Net Worth
17
Contributions to trust corpus
18
Accumulated trust income
19
Other (attach schedule)
20
Total net worth (add lines 17 through 19)
21
Total liabilities and net worth (add lines 16 and 20)
3520-A
Form
(2004)