Form 8870 - Information Return For Transfers Associated With Certain Personal Benefit Contracts - 2009

Download a blank fillable Form 8870 - Information Return For Transfers Associated With Certain Personal Benefit Contracts - 2009 in PDF format just by clicking the "DOWNLOAD PDF" button.

Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.

Complete Form 8870 - Information Return For Transfers Associated With Certain Personal Benefit Contracts - 2009 with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.

Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.

ADVERTISEMENT

Information Return for Transfers Associated
8870
OMB No. 1545-1702
Form
With Certain Personal Benefit Contracts
(Rev. February 2009)
Page 1 of ___
Department of the Treasury
(Under section 170(f)(10))
Internal Revenue Service
For the accounting period beginning
,
, and ending
,
.
Employer identification number
Name of organization
Print or
type.
Number and street (or P.O. box if mail is not delivered to street address)
Room/suite
Telephone number
See
Specific
(
)
Instruc-
City or town, state or country, and ZIP
Check
if exemption application
tions.
is pending
Type of organization:
Organization exempt under section 501(c)(
)
(insert number)
Section 4947(a)(1) nonexempt charitable trust
Section 664(d)(2) charitable remainder unitrust
Other section 170(c) organization
Section 664(d)(1) charitable remainder annuity trust
Part A. Personal Benefit Contracts
(a)
(b)
(c)
Item
Contract Issuer
Policy number
number
Name, address, and ZIP code
No. 1
No. 2
No. 3
No. 4
No. 5
Part B. Premiums Paid on Personal Benefit Contracts by the Organization Or Treated as Paid by the Organization
(b)
(c)
(e)
(a)
(d)
(f)
Date premium
Amount of premium
Amount of
Item number
Date premium
Total of amounts in
paid by the
paid by the
premium paid by
from Part A
paid by others
columns (c) and (e)
organization
organization
others
No. ____
No. ____
No. ____
No. ____
No. ____
(g)
(g)
Total of amounts in column (f)
(h)
(h)
Amount from line (g) of Part B of the Continuation Schedule
(i)
Total. (Add lines (g) and (h). Enter total here and include this amount on line 8 of Part I of the
(i)
Form 4720.)
8870
For Paperwork Reduction Act Notice, see page 6 of the instructions.
Cat. No. 28906R
Form
(Rev. 2-2009)

ADVERTISEMENT

00 votes

Related Articles

Related forms

Related Categories

Parent category: Legal
Go
Page of 3