Form 1041-N - U.s. Income Tax Return For Electing Alaska Native Settlement Trusts Page 4

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Form 1041-N (Rev. 12-2017)
Page
Schedule K
Distributions to Beneficiaries
Page
of
(a) Beneficiary’s name, street address, city, state, and ZIP code
(b) Beneficiary’s SSN
(g) Total distributions
(Add amounts in (c) through (f))
(c) Tier I distributions
(d) Tier II distributions
(e) Tier III distributions
(f) Tier IV distributions
(a) Beneficiary’s name, street address, city, state, and ZIP code
(b) Beneficiary’s SSN
(g) Total distributions
(Add amounts in (c) through (f))
(c) Tier I distributions
(d) Tier II distributions
(e) Tier III distributions
(f) Tier IV distributions
(a) Beneficiary’s name, street address, city, state, and ZIP code
(b) Beneficiary’s SSN
(g) Total distributions
(Add amounts in (c) through (f))
(c) Tier I distributions
(d) Tier II distributions
(e) Tier III distributions
(f) Tier IV distributions
(a) Beneficiary’s name, street address, city, state, and ZIP code
(b) Beneficiary’s SSN
(g) Total distributions
(Add amounts in (c) through (f))
(c) Tier I distributions
(d) Tier II distributions
(e) Tier III distributions
(f) Tier IV distributions
(a) Beneficiary’s name, street address, city, state, and ZIP code
(b) Beneficiary’s SSN
(g) Total distributions
(Add amounts in (c) through (f))
(c) Tier I distributions
(d) Tier II distributions
(e) Tier III distributions
(f) Tier IV distributions
(a) Beneficiary’s name, street address, city, state, and ZIP code
(b) Beneficiary’s SSN
(g) Total distributions
(Add amounts in (c) through (f))
(c) Tier I distributions
(d) Tier II distributions
(e) Tier III distributions
(f) Tier IV distributions
1041-N
Form
(Rev. 12-2017)

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