Form 480.80(F) - Revocable Trust Or Grantor Trust Informative Income Tax Return (Page 2 of 8) in pdf

Form 480.80(F) Rev. 05.13

Revocable Trust or Grantor Trust

- Page 2

Charitable Contributions

Name and address of institutions to which payment was made

Employer Identification Number

Amount

____________________________________________________________________________________________________________________________

___________________________________________________________________________________________________________________________

____________________________________________________________________________________________________________________________

1. Total (Transfer to Part II, line 2A) ................................................................................................................................................

(1)

____________________________________________________________________________________________________________________________

Medical Expenses (includes the purchase of technological assistance equipment and the amount paid in the purchase of medicines through medical prescription)

Name and address of institutions to which payment was made

Employer Identification Number

Amount

____________________________________________________________________________________________________________________________

1. Total (Transfer to Part II, line 2B) ................................................................................................................................................

(1)

Home Mortgage Interest on Qualified Residential Property Located in Puerto Rico

Name and address of institutions to which payment was made

Employer Identification Number

Amount

____________________________________________________________________________________________________________________________

1. Total (Transfer to Part II, line 2C) ................................................................................................................................................

(1)

Casualty Loss on Real Property that Constitutes the Grantor's Principal Residence

1. Total (Transfer to Part II, line 2D) ................................................................................................................................................

(1)

Loss of Personal Property as a Result of Certain Casualties

1. Total (Transfer to Part II, line 2E) ................................................................................................................................................

(1)

Contributions to the Trust by the Grantors

Amount contributed to the

Share percentage in

Trustee's name

Trustee's address

Social Security Number

____________________________________________________________________________________________________________________________

the Corpus of the Trust

Trust during the year

____________________________________________________________________________________________________________________________

Distributions to Beneficiaries