Form 4720 - Return Of Certain Excise Taxes Under Chapters 41 And 42 Of The Internal Revenue Code - 2017 Page 8

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8
Form 4720 (2017)
Page
SCHEDULE L—Taxes on Prohibited Benefits Distributed From Donor Advised Funds (Section 4967).
See the instructions.
Part I
Prohibited Benefits and Tax Computation
(a) Item
(b) Date of
(c) Description of benefit
number
prohibited benefit
1
2
3
4
5
(e) Tax on donors, donor advisors, or related persons
(f) Tax on fund managers (if applicable) (lesser of 10% of col.
(d) Amount of prohibited benefit
(125% of col. (d)) (see instructions)
(d) or $10,000) (see instructions)
Part II
Summary of Tax Liability of Donors, Donor Advisors, Related Persons, and Proration of Payments
(a) Names of donors, donor advisors, or
(b) Item no. from
(c) Tax from Part I, col. (e) or
(d) Donor’s, donor advisor’s, or related person’s total tax
related persons liable for tax
Part I, col. (a)
prorated amount
liability (add amounts in col. (c)) (see instructions)
Part III
Summary of Tax Liability of Fund Managers and Proration of Payments
(b) Item no. from
(c) Tax from Part I, col. (f) or
(d) Fund manager’s total tax liability (add
(a) Names of fund managers liable for tax
Part I, col. (a)
prorated amount
amounts in col. (c)) (see instructions)
4720
Form
(2017)

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