Form 8883 - Asset Allocation Statement Under Section 338 Page 2

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Form 8883 (Rev. 10-2017)
Page
Part V
Original Statement of Assets Transferred
9
Assets
Aggregate fair market value (actual amount for Class I)
Allocation of AGUB or ADSP
Class I
$
$
Class II
$
$
Class III
$
$
Class IV
$
$
Class V
$
$
Class VI and VII
$
$
Total
$
$
Part VI
Supplemental Statement of Assets Transferred—Complete if amending an original statement or previously filed
supplemental statement because of an increase or decrease in AGUB or ADSP.
10
Enter the tax year and tax return form number with which the original Form 8023 or Form 8883 and any supplemental
statements were filed.
11
Assets
Allocation of sales price as previously reported
Increase or (decrease)
Redetermined allocation of AGUB or ADSP
Class I
$
$
$
Class II
$
$
$
Class III
$
$
$
Class IV
$
$
$
Class V
$
$
$
Class VI and VII
$
$
$
Total
$
$
12
Reason(s) for increase or decrease. Attach additional sheets if more space is needed.
8883
Form
(Rev. 10-2017)

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