Form 4720 - Return Of Certain Excise Taxes Under Chapters 41 And 42 Of The Internal Revenue Code - 2017 Page 7

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7
Form 4720 (2017)
Page
Part II
Tax Imposed on Entity Managers (Section 4965) Continued
(b) Transaction
(c) Tax—enter $20,000 for each
(d) Manager’s total tax liability
(a) Name of entity manager
number from
transaction listed in col. (b) for each
(add amounts in col. (c))
Part I, col. (a)
manager in col. (a)
SCHEDULE K—Taxes on Taxable Distributions of Sponsoring Organizations Maintaining Donor
Advised Funds (Section 4966). See the instructions.
Part I
Taxable Distributions and Tax Computation
(a)
(b) Name of sponsoring organization and
(c) Description of distribution
Item number
donor advised fund
1
2
3
4
(f) Tax imposed on
(g) Tax on fund managers
(d) Date of distribution
(e) Amount of distribution
organization (20% of
(lesser of 5% of col. (e) or
col. (e))
$10,000)
Total—Column (f). Enter here and on Part I, line 10
.
.
.
.
.
Total—Column (g). Enter total (or prorated amount) here and in Part II, column (c), below
.
.
Part II
Summary of Tax Liability of Fund Managers and Proration of Payments
(d) Manager’s total tax liability
(b) Item no. from
(c) Tax from Part I, col. (g) or prorated
(a) Name of fund managers liable for tax
(add amounts in col. (c))
Part I, col. (a)
amount
(see instructions)
4720
Form
(2017)

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