Form 8330 - Issuer'S Quarterly Information Return For Mortgage Credit Certificates (Mccs)

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8330
Issuer's Quarterly Information Return
Form
for Mortgage Credit Certificates (MCCs)
OMB No. 1545-0922
(Rev. October 2012)
Department of the Treasury
Information about Form 8330 and its instructions is at
Internal Revenue Service
Calendar quarter ending:
March
June
September
December
Year
Reporting Authority
Part I
Issuer’s name
Employer identification number
Issuer’s address (number and street or P.O. box no., if mail is not delivered to street address)
Room/suite
Election date
City, town, or post office, state, and ZIP code
Nonissued bond amount
Is this the final return to be filed for this MCC program? .
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Yes
No
Computation of the Total Amount of Mortgage Credit Certificates
Part II
(a)
(c)
(b)
Certified Indebtedness Amount of
Amount of Mortgage Credit Certificates
Certificate Credit Rate
Mortgage Credit Certificates
Issued (column (a) x column (b))
1
2
3
4
5
6
7
Total amount of MCCs issued during the current calendar quarter (add lines 1 through 6)
8
Total amount of MCCs issued for all prior quarters for the MCC program related to
the nonissued bond amount in Part I .
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9
Aggregate amount of MCCs issued for this MCC program (add lines 7 and 8)
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10
Does line 9 exceed 25% of the nonissued bond amount in Part I? (If “Yes,” see instructions.) .
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Yes
No
Revocation of Qualified Mortgage Credit Certificates
Part III
Name
Address
Social Security Number
Under penalties of perjury, I declare that I have examined this return and accompanying schedules and statements, and to the best of my knowledge and
belief, they are true, correct, and complete. Declaration of preparer (other than representative of issuer) is based on all information of which preparer has any
Sign
knowledge.
Here
Signature of authorized representative of issuer
Date
Title
Print/Type preparer’s name
Preparer's signature
Date
PTIN
Paid
Check
if
self-employed
Preparer
Use Only
Firm’s name
Firm's EIN
Firm's address
Phone no.
8330
For Paperwork Reduction Act Notice, see instructions.
Form
(Rev. 10-2012)
Cat. No. 13905M

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