Form 13586 - Additional Information And Documentation For Announcement 2004-46, Settlement Initiative - 60-Day Response

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Department of the Treasury – Internal Revenue Service
Tax Year
13586
Additional Information and Documentation for Announcement
Form
(May 2004)
2004-46, Settlement Initiative — 60-Day Response
INSTRUCTIONS — Under penalties of perjury
, the taxpayer must submit all information requested on this form to the IRS within 60 days from the date shown on
(see Form 13586-A)
the transmitting Letter 3873.
•
Prepare a Form 13586
for each year
you derived a benefit from a Notice 2000-44
(or substantially similar)
transaction. This requirement also applies to any year for which the statute
of limitation for assessment is closed.
•
If more space is needed than what is provided
on this form, then attach a separate sheet
and print your name, TIN
, and the tax year at the top. Be sure to
in any area
(s)
(EIN / SSN)
reference the specific section and line item on all additional sheets.
•
Check the completed form
for accuracy and, when more than one year is involved, total all entries
any numbers to the appropriate lines specified on Form
(s)
before transferring
13586-A, Announcement 2004-46 Settlement Initiative Declaration.
Section I.
Taxpayer Data
1. Taxpayer name
2. Social security number
3. Partnership name
4. Employer identification
(s)
(SSN)
(Complete Section II, if applicable)
number
(EIN)
Section II.
Additional Related Entities
1.
Name
2.
EIN
3.
Type of Return
(s)
Section III.
Tax Benefits Claimed on Tax Return(s)
Transactions Reported
"x" if not
Tax Return
1.
Amount
Ordinary
Capital
Additional Entities
(Loss)
(Form, Schedule, Line Item)
claimed
a.
b.
c.
d.
e.
Total (Losses)
Other Items Claimed on Return
2.
Income Received / Accrued
(e.g. Interest, Dividends, etc.)
a.
b.
c.
d.
e.
Total Other Income
Other Losses Claimed on Return
3.
(e.g., STCL (Net Foreign Currency Loss))
a.
b.
c.
Total Other Losses
Catalog No. 38515U
Sheet 1 of 2
13586
Form
(5-2004)

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