Form 8725 - Excise Tax On Greenmail
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38725
Excise Tax on Greenmail
Form
OMB No. 1545-1049
(Rev. December 2015)
Information about Form 8725 and its instructions is at
Department of the Treasury
▶
Internal Revenue Service
Date of initial receipt of greenmail
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Identifying number
Name of person receiving greenmail
Please
Number, street, and room or suite no. (If a P.O. box, see instructions.)
Type
or
Print
City or town, province or state, country, and ZIP or foreign postal code
A
Enter the date you entered into the agreement to transfer the stock
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B
Enter the name of the corporation whose stock is being acquired from you
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Tax Computation (see instructions)
1
1
Net sales price .
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2
(a) Date acquired
(b) Number of shares
(c) Cost or other basis
a
b
c
d
e
f
Column (b) total .
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g Column (c) total .
2g
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3
Gain. Subtract line 2g from line 1. If zero or less, enter -0- .
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3
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Other income
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4
5
5
Total gain and other income. Add lines 3 and 4. See instructions .
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6
Tax. Multiply line 5 by 50% (.50)
6
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Less: Tax paid with Form 7004 .
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7
8
Tax due. Subtract line 7 from line 6. If zero or less, enter -0- .
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Overpayment. Subtract line 6 from line 7
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9
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is
true, correct, and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge.
Signature(s)
Date
Title (if any)
Print/Type preparer’s name
Preparer's signature
Date
PTIN
Paid
Check
if
self-employed
Preparer
Firm’s name
Firm's EIN
Use Only
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Firm's address
Phone no.
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8725
For Privacy Act and Paperwork Reduction Act Notice, see instructions.
Form
(Rev. 12-2015)
Cat. No. 64873D
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