Form 8870 - Information Return For Transfers Associated With Certain Personal Benefit Contracts Page 6
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66
Form 8870 (Rev. 8-2013)
Page
Part D. Transferors
To avoid filing an incomplete return or having to respond to
requests for missing information, complete all applicable line
Report in Part D all transfers made during the tax year to the
items. Make an entry (including a zero when appropriate).
organization in connection with each personal benefit contract
Column (a). Designate the first personal benefit contract you
listed in Part A.
are reporting as item No. 1. Refer to the second personal
Column (a). Identify all personal benefit contracts with the
benefit contract you are reporting as item No. 2, etc. In the
same item number you used in Part A. List these contracts in
Parts that follow, you are to provide more information for the
consecutive order.
personal benefit contract you identified as No. 1, No. 2, etc.
Column (b). Report the name, address, and ZIP code of each
Part B. Premiums Paid on Personal Benefit Contracts
transferor of funds, transferred directly or indirectly, for use as
by the Organization Or Treated as Paid by the
premiums on each personal benefit contract.
Organization
Paperwork Reduction Act Notice
If, in connection with any transfer to a charitable organization,
the organization directly or indirectly pays premiums on any
We ask for the information on this form to carry out the Internal
personal benefit contract, or there is an understanding or
Revenue laws of the United States. You are required to give us
expectation that any person will directly or indirectly pay such
the information. We need it to ensure that you are complying
premiums, the organization must report the following
with these laws.
information.
The organization is not required to provide the information
Premiums paid by the organization
requested on a form that is subject to the Paperwork Reduction
Act unless the form displays a valid OMB control number.
Note. Complete Part B for all premiums paid during the tax
year for which the organization is filing Form 8870.
Books or records relating to a form or its instructions must be
retained as long as their contents may become material in the
Column (a). Identify all personal benefit contracts by the same
administration of any Internal Revenue law. Generally, tax
item number you used in Part A. List these contracts in the
returns and tax return information are confidential, as required
consecutive order they were reported in Part A.
by 26 U.S.C. 6103.
Premiums paid by others but treated as paid by the
The time needed to complete and file this form and related
organization
schedules will vary depending on individual circumstances.
Column (f). Enter the total premiums from columns (c) and (e)
The estimated average times are:
paid by the organization, directly or indirectly, and other
Recordkeeping
.
.
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.
.
.
.
.
.
.
9 hrs., 48 min.
persons during the tax year, on each personal benefit contract.
Learning about the
Line (i). Carry this total to Form 4720, line 8, Part I, to report the
law or the form
.
.
.
.
.
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2 hrs., 22 min.
excise tax due.
Preparing, copying, assembling, and
Part C. Beneficiaries
sending the form to the IRS
.
.
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.
.
.
2 hrs., 39 min.
Column (a). Identify all personal benefit contracts by the same
If you have comments concerning the accuracy of these time
item number you used in Part A. List these contracts in
estimates or suggestions for making this form simpler, we would
consecutive order.
be happy to hear from you. You can write to the Internal
Revenue Service, Tax Products Coordinating Committee,
Column (b). Report the name, address, and ZIP code of the
SE:W:CAR:MP:T:M:S, 1111 Constitution Ave. NW, IR-6526,
beneficiary under each personal benefit contract.
Washington, DC 20224. Do not send the form to this address.
Column (c). Enter the social security number (SSN) or employer
Instead, see Where To File on page 4.
identification number (EIN) of the beneficiary, entered in column
(b), of each personal benefit contract.
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