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prepared by the settlor summarizing his or her wishes, and any

3. A description of the property transferred, including the

similar documents.

estimated FMV and the adjusted basis of the property.

4. A description of the consideration received by the trust,

Lines 3a through 3g. If a foreign trust with a U.S. owner does

including its estimated FMV, and for stock or securities, the

not have a U.S. agent, the IRS may determine the amounts

class or type, amount, and characteristics of the interest

required to be taken into account with respect to the foreign

received. If no consideration was received by the trust, indicate

trust by the U.S. owner. See section 6048(b)(2). In order to

whether the trust or a U.S. owner exercises any powers over

avoid this, a U.S. owner of a foreign trust should ensure that the

the entity to which the property was transferred (including a

foreign trust appoints a U.S. person to act as the foreign trust’s

description of such powers), and identify the name, U.S.

limited agent for purposes of applying sections 7602, 7603, and

taxpayer identification number (if any), and country of

7604 with respect to a request by the IRS to examine records or

organization or residence of all beneficial owners of such entity.

produce testimony, or a summons by the IRS for such records

5. To the extent known, a description of any subsequent

or testimony. Any U.S. citizen, resident alien, or domestic

transfer of the property, including the name, U.S. taxpayer

corporation (including a U.S. grantor or U.S. beneficiary of a

identification number (if any), and country of organization or

foreign trust) may act as the U.S. agent of the trust.

residence of the person to whom the property was

In order to authorize a U.S. person to act as an agent under

subsequently transferred.

section 6048(b), the trust and the agent must enter into a

The statement must also contain a description of the trust

binding agreement substantially in the format that follows.

ownership structure setting forth the name, U.S. taxpayer

Attach a copy of the authorization to Form 3520-A.

identification number (if any), and country of organization of all

Do not enter a PTIN on the authorization form.

entities in which the trust has an ownership interest, including

an ownership chart showing the trust’s position in the chain of

ownership and the percentages of ownership.

CAUTION

Note. The term “person” includes an individual or an entity,

whether U.S. or foreign. See page 2 for the definition of U.S.

person. A foreign person is an individual or entity that is not a

AUTHORIZATION OF AGENT

U.S. person.

[ Name of foreign trust ] hereby expressly authorizes [ name of

Part II—Foreign Trust Income Statement

U.S. agent ] to act as its agent solely for purposes of sections

Include all income from U.S. and non-U.S. sources. This

7602, 7603, and 7604 of the Internal Revenue Code with respect to

financial statement must reasonably reflect the trust’s income

any request to examine records or produce testimony related to the

under U.S. income tax principles.

proper treatment of amounts required to be taken into account

Income

under the rules of section 6048(b)(1)(A) or to any summons for such

records or testimony. I certify that I have the authority to execute

Line 1. Interest. Report all taxable interest income that was

this authorization of agent to act on behalf of [ name of foreign

received during the tax year. Examples of taxable interest

trust ].

include, but are not limited to, interest from:

•

Accounts (including certificates of deposit and money market

accounts) with banks, credit unions, and thrift institutions.

•

Notes, loans, and mortgages.

Signature of trustee

(title)

(date)

•

U.S. Treasury bills, notes, and bonds.

(or other authorized person)

•

U.S. savings bonds.

•

Original issue discount.

•

Income received as a regular interest holder of a real estate

Your Name (type or print)

mortgage investment conduit (REMIC).

For taxable bonds acquired after 1987, amortizable bond

premium is treated as an offset to the interest income instead of

Identification Number (if any)

as a separate interest deduction. See Pub. 550, Investment

Income and Expenses.

Address

Line 2. Dividends. Report all ordinary dividends received

during the tax year.

[ Name of agent ] accepts this appointment to act as agent

Note. Report capital gain distributions on line 5.

for [ name of foreign trust ] for the above purpose. I certify that I

Line 4. Income (loss) from partnerships, fiduciaries, etc.

have the authority to execute this authorization of agent to act on

Enter the trust’s share of income or (losses) from partnerships,

behalf of [ name of foreign trust ] and agree to accept service of

S corporations, estates, other trusts, and REMICS.

process for the above purposes.

If the trust received a Schedule K-1 from a partnership, S

corporation, or other flow-through entity, use the corresponding

lines on Form 3520-A to report the interest, dividends, capital

Signature of agent

(title)

(date)

gains, etc., from the flow-through entity.

Line 5. Capital gains (losses). For capital gains (losses)

attributable to a U.S. owner, use Schedule D (corporate or

individual, whichever applies).

Your Name (type or print)

Line 6. Ordinary gains (losses). Enter the ordinary gain or

(loss) from the sale or exchange of property other than capital

Identification Number (if any)

assets and also from involuntary conversions (other than

casualty or theft).

Line 7. Other income. Enter other items of income not

Address

included on lines 1 through 6. List the types and amounts on an

attached schedule if the trust has more than one item.

Items to be reported on line 7 include any part of a total

Line 5. Attach a statement that provides the following

distribution shown on Form 1099-R, Distributions From

information concerning the transfer:

Pensions, Annuities, Retirement or Profit-Sharing Plans, IRAs,

1. Name, U.S. taxpayer identification number (if any), and

Insurance Contracts, etc., that is treated as ordinary income.

country of organization or residence of the person to whom the

For more information, see the separate instructions for

property was transferred.

Form 4972, Tax on Lump-Sum Distributions.

2. A general description of the transfer, and any broader

Expenses

transaction of which it forms a part, including a chronology of

the transfers involved and an identification of the other parties

Line 9. Interest expense. Enter the amount of interest (subject

to the transaction to the extent known.

to limitations) paid or incurred by the trust on amounts borrowed

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Instructions For Form 3520-A - Annual Information Return Of Foreign Trust With A U.s. Owner - 2005 Page 3

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