5324, Page 2
Taxpayer FEIN
PART 2: FIgURINg INTEREST
A
B
C
D
16 TOTAL UNDERPAYMENT Add lines 13 and 14 16
17 Enter due date for the next quarter or date tax was paid,
whichever is earlier In column D, enter the due date for the
annual return or date tax was paid, whichever is earlier 17
18 Number of days from the date on line 5 to the date
on line 17
18
19 Number of days on line 18 after 04-30-16
and before 07-01-16
19
20 Number of days on line 18 after 06-30-16
and before 01-01-17
20
21 Number of days on line 18 after 12-31-16
and before 07-01-17
21
22 Number of days on line 18 after 06-30-17
and before 01-01-18
22
23 Number of days on line 19 x 4 25% (0 0425) x line 16 23
365
24
Number of days on line 20
x 4
40% (0 0440) x line 16
24
365
25 Number of days on line 21 x 4 50% (0 0450) x line 16 25
365
26 Number of days on line 22 x *% x line 16 26
365
27 Interest on underpayment
Add lines 23 through 26
27
00
28 Interest Due. Add line 27 columns
A through D
28
* Interest rate will be set at 1% above the adjusted prime rate for this period
PART 3: FIgURINg PENALTY
A
B
C
D
29 Enter the amount from line 14 29
30 Payment due dates from line 5 (MM-DD-YYYY) 30
31 Annual return due date or the date payment was made,
whichever is earlier 31
32 Number of months, counting any fractional months,
from line 30 to line 31 32
33 Multiply line 29 by line 32 33
0 01
0 01
0 01
0 01
34 Penalty rate per month 34
35 Penalty due for period Multiply line 33 by line 34 35
00
36 Penalty Due. Add line 35, columns A through D 36
37 Total Underpaid Estimate Penalty and Interest. Add lines 28 and 36 Carry to Form 5297, line 48
00
(If amending, see instructions ) 37
+
0000 2016 403 02 27 5