Schedule B (Form 1040a Or 1040) - Interest And Ordinary Dividends - 2014
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1
2SCHEDULE B
OMB No. 1545-0074
Interest and Ordinary Dividends
2014
(Form 1040A or 1040)
Attach to Form 1040A or 1040.
▶
Department of the Treasury
Attachment
Information about Schedule B and its instructions is at
08
▶
Internal Revenue Service (99)
Sequence No.
Name(s) shown on return
Your social security number
Part I
Amount
1
List name of payer. If any interest is from a seller-financed mortgage and the
buyer used the property as a personal residence, see instructions on back and list
Interest
this interest first. Also, show that buyer’s social security number and address
▶
(See instructions
on back and the
instructions for
Form 1040A, or
1
Form 1040,
line 8a.)
Note. If you
received a Form
1099-INT, Form
1099-OID, or
substitute
statement from
a brokerage firm,
list the firm’s
name as the
2
Add the amounts on line 1 .
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2
payer and enter
3
Excludable interest on series EE and I U.S. savings bonds issued after 1989.
the total interest
3
Attach Form 8815 .
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shown on that
form.
4
Subtract line 3 from line 2. Enter the result here and on Form 1040A, or Form
4
1040, line 8a
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Amount
Note. If line 4 is over $1,500, you must complete Part III.
Part II
5
List name of payer
▶
Ordinary
Dividends
(See instructions
on back and the
instructions for
Form 1040A, or
Form 1040,
5
line 9a.)
Note. If you
received a Form
1099-DIV or
substitute
statement from
a brokerage firm,
list the firm’s
name as the
payer and enter
the ordinary
6
Add the amounts on line 5. Enter the total here and on Form 1040A, or Form
dividends shown
1040, line 9a
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6
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on that form.
Note. If line 6 is over $1,500, you must complete Part III.
You must complete this part if you (a) had over $1,500 of taxable interest or ordinary dividends; (b) had a
Yes No
foreign account; or (c) received a distribution from, or were a grantor of, or a transferor to, a foreign trust.
7a At any time during 2014, did you have a financial interest in or signature authority over a financial
Part III
account (such as a bank account, securities account, or brokerage account) located in a foreign
Foreign
country? See instructions .
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Accounts
If “Yes,” are you required to file FinCEN Form 114, Report of Foreign Bank and Financial
and Trusts
Accounts (FBAR), to report that financial interest or signature authority? See FinCEN Form 114
and its instructions for filing requirements and exceptions to those requirements .
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(See
instructions on
b If you are required to file FinCEN Form 114, enter the name of the foreign country where the
back.)
financial account is located
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During 2014, did you receive a distribution from, or were you the grantor of, or transferor to, a
foreign trust? If “Yes,” you may have to file Form 3520. See instructions on back .
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Cat. No. 17146N
Schedule B (Form 1040A or 1040) 2014
For Paperwork Reduction Act Notice, see your tax return instructions.
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