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taxes under section 4951 of the requirement to file a return for each

year (or part of a year) and pay the applicable tax. The trust must also

Instructions for Schedule A (Form 990-BL)

furnish the information required by Schedule A (Form 990-BL), Part I,

Section A (other than columns (g) and (h)) on its own return.

Initial Excise Taxes on Black Lung Benefit Trusts and

Certain Related Persons

For exceptions to the self-dealing rules, see Special Rules and

Payment of Benefits on page 3.

General Instructions

Line 24. If you answered “Yes,” complete Part I, Section B (other than

Schedule A (Form 990-BL) is not open for public inspection. If you

column (h)) and Part II of Schedule A (Form 990-BL). The trust must

attach any exhibits to Schedule A (Form 990-BL), be sure to label them

also notify any trustees who may be liable for initial taxes under section

and write “Not open for public inspection” on them.

4952 of the requirement to file Form 990-BL, Schedule A (Form

Purpose of Form. Use Schedule A (Form 990-BL) only to report initial

990-BL), and to pay the tax.

taxes under section 4951 or 4952. Schedule A (Form 990-BL) must be

attached to a completed Form 990-BL. It cannot be filed separately. If

Line 25. If you answered “No,” or if there were multiple acts or

no taxes are due under section 4951 or 4952, do not file Schedule A

transactions giving rise to Chapter 42 taxes and all of them were not

(Form 990-BL).

corrected, attach an explanation of each uncorrected act including the

names of all parties to the act, the date of the act, the amount involved,

Specific Instructions

why the act has not been corrected, and the date you expect correction

See Who Must File in the “General Instructions” and the “Specific

to be made.

Instructions” of Form 990-BL for completing the identification area of

this schedule.

Line 26. List each of the organization’s officers, directors, trustees,

and other persons having responsibilities or powers similar to those of

When Filer Is a Trust. A trust filing this schedule for a year in which

officers, directors, or trustees. List all of these persons even if they did

there are initial taxes due under section 4951 or 4952 completes Part I

not receive any compensation from the organization. Show all forms of

as follows:

compensation received by each listed officer, etc. Enter “-0-” in columns

Section A (Section 4951). Enter the information required in columns

(c), (d), and (e) if none was paid.

(b) through (f). Enter “N/A” in columns (g) and (h).

Section B (Section 4952). Enter the information required in columns

Note. If you pay any other person, such as a management service

(b) through (g). Enter “N/A” in column (h).

company, for the services provided by any of your officers, directors,

trustees, or key employees, report the compensation and other items on

When Filer Is a Self-dealer, Section A Only. A self-dealer liable for

line 26 as if you had paid the officer, etc. directly.

initial taxes under section 4951 completes this schedule by entering the

information required by columns (b) through (g) of Section A, Part I.

Column (b). In column (b), a numerical estimate of average hours per

Enter “N/A” in column (h). Enter only the “prorated” portion of column

week devoted to the position is required for a complete answer.

(g) on line 1 of Part II.

Phrases such as “as needed” or “as required” are unacceptable.

When Filer Is a Trustee, Sections A and B. A trustee liable for initial

taxes under sections 4951 and 4952 completes this schedule by

Column (c). Include all forms of deferred compensation (whether or

entering the required information in columns (b) through (h) (other than

not funded and whether or not the deferred compensation plan is a

(g)) of Section A and/or Section B, Part I. For Section A, enter the

qualified plan under section 401(a)) and payments to welfare benefit

“prorated” portion of column (h) on line 2 of Part II. For Section B, enter

plans on behalf of the officers, etc.

the “prorated” portion of column (h) on line 4 of Part II.

Column (d). Enter expense allowances or reimbursements that the

Part I—Initial Taxes on Self-dealing and Taxable

recipients must report as income on their separate income tax returns.

Expenditures

Examples include amounts for which the recipient did not account to the

organization or allowances that were more than the payee spent on

Disqualified persons and trustees who participate in acts of self-dealing

serving the organization. Include payments made under indemnification

with a section 501(c)(21) trust and who have tax years different from the

arrangements, the value of the personal use of housing, automobiles, or

trust should use their own tax years to figure the initial tax and file the

other assets owned or leased by the organization (or provided for the

return.

organization’s use without charge), as well as any other taxable and

Initial Section 4951 Taxes on Self-dealer. An initial tax of 10% of the

nontaxable fringe benefits. Get Pub. 525, Taxable and Nontaxable

amount involved is imposed for each act of self-dealing between a

Income, for details.

disqualified person and a section 501(c)(21) trust, for each year (or part

of a year) in the taxable period. The tax is paid by any disqualified

Column (e). Enter salary, fees, bonuses, and severance payments

person (other than a trustee acting only as such) who participated in the

received by each person listed.

act of self-dealing.

Black lung benefit trusts that pay salaries, wages, or other

Initial Section 4951 Taxes on Trustee. When a tax is imposed on an

compensation to officers or other employees are generally liable for

act of self-dealing, any trustee who knowingly participated in such an

filing Forms 941 and 940 to report social security, withholding, and

act must pay a tax of 2

% of the amount involved in the act of

Federal unemployment taxes.

self-dealing for each year or part of a year in the taxable period unless

participation in the act was not willful and was due to reasonable cause.

Part IV—Statement With Respect to

Initial Section 4952 Taxes on Trust. An initial tax of 10% of the

amount of the expenditure is imposed on each taxable expenditure from

Contributors, etc.

the assets of a section 501(c)(21) trust. The tax is paid by the trustee

out of the assets of the trust.

Note. This part is not open for public inspection.

Initial Section 4952 Taxes on Trustee. When a tax is imposed on the

Line 1. List the names and addresses of all persons whose

trust for a taxable expenditure, any trustee who knowingly agreed to the

contributions during the tax year totaled $5,000 or more.

expenditure must pay a tax of 2

% of the amount of the taxable

expenditure unless such agreement was not willful and was due to

In determining whether a person has contributed $5,000 or more,

reasonable cause.

include only contributions of $1,000 or more from such person.

Liability for Tax. A person’s liability for tax as a self-dealer or trustee

Separate and independent contributions need not be included if less

under sections 4951 and 4952 is joint and several. Therefore, if more

than $1,000. If a contribution is in the form of property and the fair

than one person is liable for tax on an act of self-dealing as a

market value is readily ascertainable, the description and fair market

self-dealer or trustee, they may prorate the tax among themselves. The

value must be submitted. If the fair market value of the property is not

IRS may assess a deficiency against one or more self-dealers or

readily ascertainable, you may submit an estimated value.

trustees liable for the tax under section 4951 or 4952, regardless of the

apportionment of tax shown on the return, if the amount paid by all

The term “person” includes individuals, fiduciaries, partnerships,

those who are liable for a particular transaction, is less than the total tax

corporations, associations, trusts, and exempt organizations.

due for that transaction.

Line 2. If the trust receives contributions that are more than what the

Part II—Summary of Taxes

contributor can deduct under section 192, the person making the

excess contributions may be required to file Form 6069, Return of

Generally, no more than three lines in Part II will be completed on any

Excise Tax on Excess Contributions to Black Lung Benefit Trust Under

return. However, when a trustee is liable for section 4951 initial taxes

Section 4953 and Computation of Section 192 Deduction, and pay the

both as a trustee and as a self-dealer and is also liable for section 4952

tax imposed by section 4953(a).

initial taxes because of taxable expenditure involvement, enter the

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Instructions For Form 990-Bl - Information And Initial Excise Tax Return For Black Lung Benefit Trusts And Certain Related Persons - Internal Revenue Service Page 4

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