Form 14454 - Attachment To Offshore Voluntary Disclosure Letter

Download a blank fillable Form 14454 - Attachment To Offshore Voluntary Disclosure Letter in PDF format just by clicking the "DOWNLOAD PDF" button.

Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.

Complete Form 14454 - Attachment To Offshore Voluntary Disclosure Letter with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.

Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.

ADVERTISEMENT

Department of the Treasury–Internal Revenue Service
14454
OMB Number
Form
Attachment to Offshore Voluntary Disclosure Letter
1545-2241
(December 2017)
(One attachment is required for each financial institution)
Please ensure all pages of Form 14454 include your name, the last four digits of your taxpayer identification number, the name of the
foreign financial institution, and the account number for which you are responding.
For each foreign financial account of which you have control or are a beneficial owner, provide the following information.
Taxpayer Name
Last Four Digits of Taxpayer Identification Number
1a. Foreign Financial Institution Name
1b. Account Number
2. Address, including country, where the account was established
3. Date the account was opened DO NOT LEAVE BLANK
(If different, address,
including country, where account is currently located)
(if unsure, please estimate)
4a. Is the account still open?
Yes
No
4b. If “No,” when was the account closed
5. Identify the individual(s), affiliates and/or organization(s)
who advised or
(e.g., banks, independent financial advisors, trust or corporate service providers)
assisted you in opening and using/maintaining the account. Include contact information for individual(s), affiliates, and/or organization(s)
6a. Explain all communications you had regarding the opening and use/maintenance of the account. Identify the individuals
(whether affiliated with the
, dates, and form
of the communication.
foreign financial institution or independent from the financial institution)
(e.g., face-to-face meeting, phone, email, fax, etc.)
6b. Any meetings, phone calls, faxes, emails, or any other communications from these individuals to you in the U.S.?
Taxpayer
Yes
No
Spouse
Yes
No
Related entities
Yes
No
If “Yes,” where
6c. Are any of the individuals a business person (advisor), accountant, attorney, or return preparer in the U.S.?
Taxpayer
Yes
No
Spouse
Yes
No
Related entities
Yes
No
If “Yes,” identify which organization(s)
7. With respect to communications you had about your foreign financial account, provide the following:
7a. Did a representative of the foreign financial institution or advisor visit you in the United States regarding the offshore account?
Taxpayer
Yes
No
Spouse
Yes
No
Related entities
Yes
No
7b. Did a representative of the foreign financial institution or advisor suggest to you the use of offshore accounts, offshore investments, offshore
entities, or particular foreign countries as a way of avoiding the disclosure of your ownership of the account or avoiding taxes?
Taxpayer
Yes
No
Spouse
Yes
No
Related entities
Yes
No
If “Yes,” provide the dates and locations for all meetings
14454
Form
(Rev. 12-2017)
Catalog Number 61606G

ADVERTISEMENT

00 votes

Related Articles

Related forms

Related Categories

Parent category: Financial
Go
Page of 5