Schedule F Individual - Other Income - 2012

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Schedule F Individual
Rev. Feb 19 13
2012
OTHER INCOME
Taxable year beginning on _________________, _____ and ending on ________________, _____
Taxpayer's name
Social Security Number
Fill in one:
(01)
1 Taxpayer
2 Spouse
3 Both
Part I
Interest
Column D
Column A
Column B
Column C
Column E
Column F
31
Eligible interest
Interest subject
Interest subject
Interest not subject to
Interest from IRA
Account
withholding
Other
Employer
subject to
to withholding
to withholding
distributions to
Payer's name
Number
from financial
from financial
Government
interest
Identification Number
withholding
from financial
(10%)
institutions (10%)
institutions
Pensioners (10%)
institutions (17%)
(02)
00
00
00
00
00
00
(03)
00
00
00
00
00
00
(04)
00
00
00
00
00
00
(05)
00
00
00
00
00
00
(06)
00
00
00
00
00
00
(07)
00
00
00
00
00
00
(08)
00
00
00
00
00
00
(09)
00
00
00
00
00
00
(14)
(24)
(19)
(28)
(33)
00
00
00
00
00
00
1.
Subtotal of interest .................................................................................................................
(10)
(15)
(20)
(25)
(29)
00
00
00
00
00
00
(34)
2.
Less: Expenses related to the purchase of investments (See instructions) .........................................
(11)
00
00
00
00
00
00
3.
Less: Interest exemption
See instructions
(
) ....................................................................................
(16)
(21)
(26)
(30)
4.
Total interest (Subtract lines 2 and 3 from line 1, Columns A through F. Transfer the amounts from
line 4, Columns A through C and E to line 4, Column A, C and D, as applicable, of Schedule A2
00
00
00
00
00
00
Individual) ................................................................................................................................
(17)
(22)
(27)
(31)
(35)
(12)
5.
Add line 4, Columns A through F and transfer to Part 1, line 2C of the return or to line 3C of Schedule
00
(36)
CO Individual ............................................................................................................................
00
00
00
00
(23)
(18)
(32)
6.
Tax withheld (Submit the corresponding Informatives Returns) ................................................................
(13)
00
7.
Total tax withheld (Add line 6, Columns A through C and E. Enter on Schedule B Individual, Part III, line 4) ..............................................................................................................................................
(40)
Retention Period: Ten (10) Years

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