Form 8329 - Lender'S Information Return Form For Mortgage Credit Certificates

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8329

Lender’s Information Return for

Form

Mortgage Credit Certificates (MCCs)

OMB No. 1545-0922

(Rev. January 2009)

Department of the Treasury

For calendar year ending

Internal Revenue Service

Part I

Reporting Authority

Lender’s name

Employer identification number

Room/suite

Lender’s address (number, street, or P.O. box no., if mail is not delivered to street address)

City, town, or post office, state, and ZIP code

Issuing Authority

Part II

Issuer’s name

Employer identification number

Room/suite

Issuer’s address (number, street, or P.O. box no., if mail is not delivered to street address)

Election date

City, town, or post office, state, and ZIP code

Nonissued bond amount

Part III

Recipients of Mortgage Credit Certificates (If more than five recipients, see instructions.)

(b)

(a)

(c)

Address

Name(s)

Social Security Number(s)

Do not use a P.O. box number.

Part IV

Computation of the Total Amount of Mortgage Credit Certificates (Note: Match the information

entered on each line with information entered on each corresponding line in Part III.)

(e)

(g)

(d)

(f)

Certified Indebtedness Amount

Amount of MCC Issued

Date of Issue of MCC

Certificate Credit Rate

of Each MCC Issued

(column (e)

column (f))

Total amount of MCCs issued. (See instructions.)

Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge

and belief, it is true, correct, and complete. Declaration of preparer (other than representative of lender) is based on all information of which preparer has any

knowledge.

Sign

Here

Signature of authorized representative of lender

Date

Title

Date

Preparer’s SSN or PTIN

Preparer’s

Check if

Paid

signature