Form 1120-Sf - U.s. Income Tax Return For Settlement Funds
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1
21120-SF
U.S. Income Tax Return for Settlement Funds
Form
(Under Section 468B)
(Rev. October 2013)
OMB No. 1545-1394
Information about Form 1120-SF and its separate instructions is at
▶
Department of the Treasury
Internal Revenue Service
For calendar year 20
Employer identification number of fund (see instructions)
Name of fund
Number, street, and room or suite no. (If a P.O. box, see instructions.)
City or town, state or province, country, and ZIP or foreign postal code
Name and address of administrator (defined on page 3 of the instructions)
Check applicable boxes:
(1)
Final return
(2)
Name change
(3)
Address change
(4)
Amended return
Part I
Income and Deductions (see instructions)
1
1
Taxable interest
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Dividends
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2
3
Capital gain net income (attach Schedule D (Form 1120)) .
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3
4
4
Items of income or gain from a partnership interest .
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5
Other income (attach schedule)
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5
6
Gross income. Add lines 1 through 5
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6
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7
Trustee/administrator fees .
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8
Taxes .
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8
9
Accounting and legal services (attach schedule) .
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9
10
10
Notification of claimants and claim processing expenses .
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11
11
Other deductions (attach schedule) .
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12
Net operating loss deduction .
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12
13
Total deductions. Add lines 7 through 12 .
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13
Part II
Tax Computation (see instructions)
14
Modified gross income. Subtract line 13 from line 6 .
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14
15
Total tax. Multiply the amount on line 14 by 39.6%
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15
16
Credits and payments:
a Overpayment from prior year allowed as
a credit
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16a
b Current year estimated tax payments
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16b
c Refund
of
overpaid
estimated
tax
applied for on Form 4466
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16c
d Subtract line 16c from the total of lines 16a and 16b
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16d
e Tax deposited with Form 7004
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16e
f
16f
Total credits and payments (add lines 16d and 16e) .
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17
Estimated tax penalty (see instructions). Check if Form 2220 is attached .
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18
Tax due. If the total of lines 15 and 17 is more than line 16f, enter amount owed .
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18
19
Overpayment. If line 16f is more than the total of lines 15 and 17, enter amount overpaid
19
20
Enter amount of line 19 you want: Credited to next year’s estimated tax
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Refunded
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20
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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.
Sign
May the IRS discuss this return
Here
with the preparer shown below
Yes
No
(see instructions)?
Title
Signature of fund administrator
Date
Print/Type preparer’s name
PTIN
Preparer’s signature
Date
Paid
Check
if
self-employed
Preparer
Firm’s name
Firm's EIN
Use Only
▶
▶
Firm’s address
Phone no.
▶
1120-SF
For Paperwork Reduction Act Notice, see separate instructions.
Form
(Rev. 10-2013)
Cat. No. 14989I
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