2003 IRS Publications Publication 1346

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Electronic Return File Specifications and Record Layouts for Individual IncomeTax Returns Tax Year 2002 Department of the Treasury Internal Revenue Service IRS www.irs.gov Publication 1346 (Rev. 9-2002) Catalog Number 64403B INTERNAL REVENUE SERVICE PART I Electronic Return File Specifications for Individual Income Tax Returns TAX YEAR 2002 ATTACHMENTS 1 – 10 Publication 1346 August 30, 2002 Part I Page 227 INTENTIONAL BLANK PAGE Publication 1346 August 30, 2002 Part I Page 228 ATTACHMENT 1 ERROR REJECT CODE (ERC) CROSS REFERENCES ERC 0001 o o 0002 o 0003 o DESCRIPTION Page 1 of Form 1040, Form 1040A, or Form 1040EZ must be present. The Summary Record must be present. Reserved Tax Return Record Identification Page 1 - Tax Period (SEQ 005) equal "200212". For Form 1040/1040A, Tax Period (SEQ 005) of Tax Return Record Identification Page 2 must also equal "200212". Tax Form - Primary SSN (SEQ 010) must be within the valid ranges of SSN/ITIN's and cannot equal an ATIN. It must equal all numeric characters and cannot equal all blanks, zeros, or nines. Refer to Attachment 8 for valid ranges of Social Security/Taxpayer Identification Numbers. Primary SSN (SEQ 010) is a required field. Primary SSN (SEQ 010) of the Tax Form must equal Taxpayer Identification Number (SEQ 003) of Tax Return Record Identification Page 1. Taxpayer Identification Number (SEQ 003) of Tax Return Record Identification Page 1 must be significant. Statement Record - The maximum number of Statement References within a tax return is 30. (A Statement Reference is defined as "STMbnn"; the value of "nn" refers to the Statement Number.) See Section 8 for Statement Record information. Tax Form - Only the following characters are permitted in the Primary Name Control (SEQ 050) and Spouse's Name Control (SEQ 055): alpha, hyphen, and space. The Name Control cannot contain leading or embedded spaces. The left-most position must contain an alpha character. Primary Name Control (SEQ 050) is a required field. Spouse's Name Control (SEQ 055) is a required field when Filing Status (SEQ 130) equals "2" or "3". On Form 1040EZ, Spouse's Name Control (SEQ 055) is a required field when Secondary SSN (SEQ 030) is significant. Form 8615 - Parent Name Control (SEQ 045) must be significant and correctly formatted. Form 8814 - Child Name Control (SEQ 015) must be significant and correctly formatted. See Section 7.01 for Name Control format. Pg 94 Pg 95 | | Pg 101 PAGE Pg 89 0004 o o o o 0005 o 0006 o Pg 101 155, 157 o o o o o Publication 1346 August 30, 2002 Part I Page 229 ATTACHMENT 1 ERROR REJECT CODE (ERC) CROSS REFERENCES ERC DESCRIPTION PAGE 0007 o Tax Form - Street Address (SEQ 080) is alphanumeric and cannot have leading or consecutive embedded spaces. The left-most position must contain an alpha or numeric character. The only special characters permitted are space, hyphen (-), and slash (/). See Section 7.03 for Street Address format. Street Address (SEQ 080) is a required field. Exception: This check is not performed when Address Ind (SEQ 097) is equal to “3”, indicating a foreign address.”) Form 1040/1040A - Total Box 6a and 6b (SEQ 167) must equal the number of boxes checked for Exempt Self (SEQ 160) and Exempt Spouse (SEQ 163). Filing Status (SEQ 130) is a required field. State Record - The unformatted state record exceeds the maximum length. Each field can contain only the type of data specified in its Field Description in Part II Record Layouts. Significant money amount fields must be right-justified (and zero-filled when transmitting in fixed format). Money amount fields must contain whole dollars (no cents). When a field is defined as "N (positive only)", the field must be present and must contain an amount greater than or equal to zero. For numeric fields that can contain a literal value, entries must be left-justified and blank-filled when transmitting in fixed format. When transmitting in variable format, only significant characters are transmitted. When transmitting in fixed or variable format, significant date fields must contain numeric characters in the following formats, unless otherwise specified in Part II Record Layouts: Year fields with a length of four positions = YYYY, date fields with six positions = YYYYMM, date fields with eight positions = | YYYYMMDD unless otherwise specified. | All alphanumeric fields must be left-justified (and blank-filled when transmitting in fixed format) unless otherwise specified. Form Payment - Taxpayer's Day Time Phone Number (SEQ 090) is a required field and cannot equal all zeros or all blanks. Form 1040/1040A - When Exempt Self (SEQ 160) equals "X", Total Exemptions (SEQ 360) must be greater than zero. Pg 102 o o 0008 o Pg 108 o 0009 o Pg 173, 190 Pg 89, 166 0010 o o o o o o 0011 o Pg 108 Publication 1346 August 30, 2002 Part I Page 230 ATTACHMENT 1 ERROR REJECT CODE (ERC) CROSS REFERENCES ERC DESCRIPTION PAGE 0012 o Form 1040/1040A - If Overpaid (SEQ 1260) is significant and ES Penalty Amount (SEQ 1300) is greater than Overpaid, then Amount Owed (SEQ 1290) must be significant. If Overpaid (SEQ 1260) is significant and ES Penalty Amount (SEQ 1300) is not greater than Overpaid, then Amount Owed (SEQ 1290) cannot be significant. Reserved When there is an entry in a field defined as "NO ENTRY", the return will be rejected. (See Part II Record Layouts for "NO ENTRY" fields.) Schedule A - The following literal values cannot be present in Other Expenses Type (SEQ 420, 432) or in Other Expense Type (SEQ 475): "CASUALTY", "CHILD CARE", "CHILD-CARE", "CHILDCARE", "DEPENDENT CARE", "MEDICAL", "THEFT". Tax Form - Zip Code (SEQ 095) must be within the valid ranges of zip codes listed for the corresponding State Abbreviation (SEQ 087). The zip code cannot end in "00", with the exception of 20500 (the White House zip code). Refer to Attachment 3. Exception: This check is not performed when Address Ind (SEQ 097) is equal to “3”, indicating a foreign address.”) Form 4137 - Tip Income Name (SEQ 010) and Tip Income SSN (SEQ 020) must be significant. Form 5329 - Name of Person Subject to Penalty Tax (SEQ 010) and SSN of Person Subject to Penalty Tax (SEQ 020) must be significant. Tax Form - When Direct Deposit information is present, Routing Transit Number (SEQ 1272) (RTN) must contain nine numeric characters. The first two positions must be 01 through 12, or 21 through 32; the RTN must be present on the Financial Organization Master File (FOMF); and the banking institution must process Electronic Funds Transfer (EFT). See Section 6 for optional Routing Transit Number validation. Depositor Account Number (SEQ 1278) must be alphanumeric (i.e., only alpha characters, numeric characters, and hyphens), must be left-justified with trailing blanks if less than 17 positions, and cannot equal all zeros. If Routing (SEQ 1278) (SEQ 1274) "X". Both Transit Number (SEQ 1272) or Depositor Account Number is significant, then Checking Account Indicator or Savings Account Indicator (SEQ 1276) must equal cannot equal "X". Pg 108 0013 O 0014 o Pg 89 0015 o Pg 119 0016 o Pg 102 o 0017 o Pg 145 0018 o Pg 147 0019 o Pg 107 o o Publication 1346 August 30, 2002 Part I Page 231 ATTACHMENT 1 ERROR REJECT CODE (ERC) CROSS REFERENCES ERC DESCRIPTION PAGE 0020 o Tax Form - Name Line 1 (SEQ 060) cannot have leading or consecutive embedded spaces. The only characters permitted are alpha, space, ampersand (&), hyphen (-), and less-than sign (<). The left-most position must be alpha. The less-than sign replaces the intervening space to identify the primary taxpayer's last name and cannot be preceded by or followed by a space. See Section 7.02 for Name Line 1 format. Name Line 1 (SEQ 060) is a required field. -| Pg 102 o o If the primary and the spouse have two different last names, the | second less-than sign ("<") after the primary last name must be | followed by an ampersand ("&"). | Tax Form - Name Line 2 (SEQ 070) is alphanumeric and cannot have leading or consecutive embedded spaces. The only special characters permitted are space, ampersand (&), hyphen (-), slash (/), and percent (%). See Section 7.04 for Name Line 2 Format. Tax Form - State Abbreviation (SEQ 087) must be significant and consistent with the standard state abbreviations issued by the Postal Service. Refer to Attachment 3 for State Abbreviations. State Abbreviation (SEQ 087) is a required field. Exception: This check is not performed when Address Ind (SEQ 097) is equal to “3”, indicating a foreign address.”) Tax Form - City (SEQ 083) must be left-justified and must contain a minimum of three alpha characters. This field cannot contain consecutive embedded spaces and must contain only alphabetic characters and spaces. Do not abbreviate the city name. City (SEQ 083) is a required field. Exception: This check is not performed when Address Ind (SEQ 097) is equal to “3”, indicating a foreign address.”) Tax Form - If Address Ind (SEQ 097) equals "1" (APO/FPO Address), then City (SEQ 083) must equal "APO" or "FPO", and State Abbreviation (SEQ 087) must equal "AA", "AE", or "AP" with the appropriate Zip Code (SEQ 095). If State Abbreviation (SEQ 087) equals "AA", "AE", or "AP", then Address Ind (SEQ 097) must equal "1". Refer to Attachment 4. Authentication Record - For an On-Line return (when PIN Type Code (SEQ 008) is blank), the following fields must be present: Jurat/Disclosure Code (SEQ 075) of Authentication Record and the Taxpayer Signature Date (SEQ 070) and Primary Date of Birth (SEQ 010) of the Authentication Record. Pg 103 Pg 102 Pg 102 0021 o 0022 o Pg 102 o o 0023 o o o 0024 o 0025 o Pg 168 Publication 1346 August 30, 2002 Part I Page 232 ATTACHMENT 1 ERROR REJECT CODE (ERC) CROSS REFERENCES ERC DESCRIPTION PAGE 0026 o Authentication Record - For an On-Line return (when PIN Type Code (SEQ 008) is blank), if Filing Status (SEQ 130) of the Tax Form equals "2", then the following fields must be present: Jurat/Disclosure Code (SEQ 075) of Authentication Record and the Taxpayer Signature Date (SEQ 070) and Spouse Date of Birth (SEQ 040) of the Authentication Record. Summary Record - Electronic Return Originator Name (SEQ 010) must be significant. Electronic EFIN of ERO (SEQ 020) must be significant and equal to EFIN of Originator (SEQ 008b) of Tax Return Record Identification Page 1. Tax Return Record Identification Page 1 - EFIN of Originator (SEQ 008b) must contain a valid District Office Code. Refer to Attachment 7 for District Office Codes. Tax Return Record Identification Page 1 - EFIN of Originator (SEQ 008b) must be for a valid electronic filer. Pg 168 0027 o Pg 174 o 0028 o Pg 95 0029 o Pg 95 Publication 1346 August 30, 2002 Part I Page 233 ATTACHMENT 1 ERROR REJECT CODE (ERC) CROSS REFERENCES ERC DESCRIPTION PAGE 0030 o Taxpayer Identification Number (SEQ 003) of all data records in a tax return must contain the same Primary SSN. Schedule Occurrence Number (SEQ 005 of the Schedule Record Identification) and Form Occurrence Number (SEQ 005 of the Form Record Identification) must be significant and in ascending, consecutive numerical sequence beginning with "0000001". Note: For multiple occurrences of a schedule or form, the Page Number (SEQ 002 of the Schedule or Form Record Identifications) must be sequential within each occurrence of a schedule or Form. All pages of a multiple-page schedule or form must be present. Listed below are exceptions to this rule: -Page 2 may be present without Page 1 and vice versa for the following: Schedule E, Form 4684, Form 4797, Form 8283, Form 8606, Form 8824 and Form 8853. -Page 2 need not be transmitted if there are no entries for that page (but Page 2 cannot be present without Page 1) for the following: Schedule C, Schedule D, Schedule F, Schedule H, Schedule 2, Form 2106, Form 2441, Form 4562, Form 5329, Form 6251, Form 6765, Form 8275, Form 8275-R, Form 8582-CR , Form 8606, Form 8621, Form 8697, Form 8801 and Form 8839. -Page 2 and Page 3 are optional for Form 2210 and Form 8582, but neither Page 2 nor Page 3 can be present without Page 1. -Form 4136 Page 2 may be present without Page 1, but if Page 1 is present, then Page 2 must also be present. -Pages 2-4 need not be transmitted if there are no entries for those pages (but these pages cannot be present without page 1) for the following: Form 5471, Form 5713 -Form 8865 Pages 3-7 need not be transmitted if there are no entries for those pages. But these pages cannot be present without pages 1 and 2. -State Record ST 0001 may be present without ST 0002, but ST 0002 cannot be present without ST 0001. For Form 1040, Pages 1 and 2 must be present (exception: State | Only returns), and the following cannot be present: Form 1040A | Pages 1 and 2, Schedule 1, Schedule 2, Schedule 3, Form 1040EZ. For Form 1040A, Pages 1 and 2 must be present, and the following cannot be present: Form 1040 Pages 1 and 2, Form 1040EZ. For Form 1040EZ, must be present, and the following cannot be present: Form 1040 Pages 1 and 2, Form 1040A Pages 1 and 2. Tax Return Record Identification Page 1 - Return Sequence Number (RSN) (SEQ 007) must be numeric. Tax Return Record Identification Page 1 - Declaration Control Number (DCN) (SEQ 008) must be numeric. Pg 90 o o o 0031 o Pg 95 0032 o Pg 95 Publication 1346 August 30, 2002 Part I Page 234 ATTACHMENT 1 ERROR REJECT CODE (ERC) CROSS REFERENCES ERC DESCRIPTION PAGE 0033 o Fields within a record cannot be longer than specified in Part II Record Layouts. Name Line 1 (SEQ 060) of the Tax Form can have a maximum of 35 characters; any more than 35 will be dropped. See Section 7.02 for Name Line 1 format. Record ID Group- For each record, significant data must be present in the Record ID Group. Field Sequence Numbers within each record must be in ascending order and must be valid for that record. Schedule C-EZ - Only one Schedule C-EZ is allowed for the Primary SSN and one for the Secondary SSN (a total of two Schedules C-EZ per tax return when Filing Status (SEQ 130) equals "2"). When a taxpayer files Schedule C-EZ, no Schedule C is allowed for that taxpayer. See Section 4.02.2.a for instructions for multiple occurrences of Schedules C/C-EZ. Form 1040/1040A - The number of Dependent Name Controls (SEQ 172, 182, 192, 202, 212, or in the related Statement -| Record), must equal the total of the following fields: Number of Children Who Lived with You (SEQ 240), Number of Children Not Living with You (SEQ 247), and Number of Other Dependents Listed (SEQ 350). Form 1040A - Taxable Income (SEQ 820) must be less than $50000 and only the following can be present: Schedule 1, Schedule 2, Schedule 3, Schedule EIC, Form W-2, W-2GU, Form 1099-G, Form 1099-R, Form 2120, Form 2210, Form 8379, Form 8606, Form 8615, Form 8812, Form 8815, Form 8839, Form 8862, Form 8863, Form 9465, Authentication Record, Preparer Note Record, Election Explanation Record, Regulatory Explanation Record and Form Payment. Form 1040EZ - Primary taxpayer (and secondary taxpayer when Secondary SSN (SEQ 030) is significant) must be under age 65, Taxable Interest (SEQ 380) cannot exceed $400, Taxable Income (SEQ 820) must be less than $50000, and only the following can be present: Form W-2, W-2GU, Form 1099-G, Form 8379, Form 8862, Form 9465, Authentication Record, Preparer Note Record, Election Explanation Record, Regulatory Explanation Record and Form Payment. Form 1040 – If the State Abbreviation (SEQ 0087) is equal to | "SO", then the highest sequence number present cannot be greater | than the Zip Code (SEQ 0095). | Form 1040/1040A - Dependent entries must start on Line 1 of the dependent information. No lines may be skipped when completing the dependent information. August 30, 2002 Part I Page 235 Pg 90 o 0034 o Pg 91 0035 o Pg 91 0036 o Pg 120 0037 o Pg 108 0038 o Pg 118 | 0039 o Pg 118 | 0040 o Pg 113, 180 0041 O Pg 108 Publication 1346 ATTACHMENT 1 ERROR REJECT CODE (ERC) CROSS REFERENCES ERC DESCRIPTION PAGE 0042 o State Only Returns – Only the following must be present: Form 1040 Page 1, State Generic Record, at least one Unformatted Record and a Summary Record. Form 1040/1040A – When Filing Status (SEQ 130) equals "4", at least one of the following fields must be significant: Qualifying Name for H of Household (SEQ 150) and SSN for Qual Name (SEQ 153); Number of Children Who Lived with You (SEQ 240); Number of Other Dependents Listed (SEQ 350). When Qualifying Name for H of Household (SEQ 150) is significant, SSN for Qual Name (SEQ 153) must be significant and within the valid ranges of SSN/ITIN/ATIN's and cannot equal Primary SSN (SEQ 010) or Secondary SSN (SEQ 030). Refer to Attachment 8 for valid ranges of Social Security/Taxpayer Identification Numbers. Record ID Group - The record has an invalid field in one of the Record ID Group. The error may be one of the following: -The Taxpayer Identification Number (SEQ 003) within the Record ID does not match Primary SSN (SEQ 010) of the Tax Form. -The schedule or form is invalid for electronic filing or the page number is incorrect or duplicated. -Each record must be followed by a record terminus character (#). Record ID Group - The format and content of the Record ID Group that begins each record must be exactly as defined in Part II Record Layouts and must not duplicate another Record ID Group. If the Schedule/Form Occurrence Number (SEQ 005) of Record ID is invalid, or is a duplicate, or exceeds the maximum number permitted for that record the return will be rejected. Refer to Attachment 10 for the maximum number of schedules/forms permitted in an electronically filed tax return. Schedule SE - SSN of Self-Employed (SEQ 020) on the first Schedule SE must be significant and equal to Primary SSN (SEQ 010) or Secondary SSN (SEQ 030) of Form 1040. Schedule SE - SSN of Self-Employed (SEQ 020) on the second Schedule SE must be significant and equal to Secondary SSN (SEQ 030) of Form 1040 and must not be equal to SSN of Self-Employed (SEQ 020) on the first Schedule SE. When both spouses are filing Schedule SE, the Schedule SE for the primary taxpayer must precede the Schedule SE for the secondary taxpayer. Form 2106/2106-EZ - SSN of Taxpayer with Employee Business Expense (SEQ 009) on the first Form 2106/Form 2106EZ must be significant and equal to Primary SSN (SEQ 010) or Secondary SSN (SEQ 030) of Form 1040. August 30, 2002 Part I Page 236 | | | Pg 173, 180 0043 o Pg 108 o 0044 o Pg 91 0045 o Pg 91 o 0046 o Pg 125 0047 o Pg 125 0048 o Pg 133 Publication 1346 ATTACHMENT 1 ERROR REJECT CODE (ERC) CROSS REFERENCES ERC DESCRIPTION PAGE 0049 o Form 2106/2106-EZ - SSN of Taxpayer with Employee Business Expense (SEQ 009) on the second Form 2106/Form 2106EZ must be significant and equal to Secondary SSN (SEQ 030) of Form 1040 and must not be equal to SSN of Taxpayer with Employee Business Expense (SEQ 009) on the first Form 2106/Form 2106EZ. When both spouses are filing Form 2106/Form 2106EZ, the Form 2106/Form 2106EZ for the primary taxpayer must precede the Form 2106/Form 2106EZ for the secondary taxpayer. Statement Record - The only valid entry in a Required Statement Record field (identified by an at-sign (@) in Part II Record Layouts) is a Statement Reference, i.e., "STMbnn". For Required Statement Records, Line 02 must be blank. must be present and must contain significant data. Line 03 Pg 133 0050 o Pg 94 o o For Required Statement Records, any Statement Reference number "STMbnn" occurring within a tax return must have a corresponding Statement Record. Statement Record - For Optional Statement Records (identified by an asterisk (*) in Part II Record Layouts), any Statement Reference number "STMbnn" occurring within a tax return must have a corresponding Statement Record. Statement Record - Optional Statement Records (identified by an asterisk (*) in Part II Record Layouts) are used only when the lines of data to be entered exceed spacing allowed on a schedule or form. For Optional Statement Records, Lines 01, 02, 03, and 04 must be present and must contain significant data. Statement Record - The number of Statement Records cannot exceed the number of Statement References within a tax return. Form 4137 - Tip Income SSN (SEQ 020) on the first Form 4137 must equal Primary SSN (SEQ 010) or Secondary SSN (SEQ 030) of Form 1040. Form 8606 - SSN of Taxpayer with IRAs (SEQ 010) must be significant and equal to Primary SSN (SEQ 010) or Secondary SSN (SEQ 030) of Form 1040/1040A. Form 8606 - SSN of Taxpayer with IRAs (SEQ 010) on the second Form 8606 must be significant and equal to Secondary SSN (SEQ 030) of Form 1040/1040A and must not be equal to SSN of Taxpayer with IRAs (SEQ 010) on the first Form 8606. When both spouses are filing Form 8606, the Form 8606 for the primary taxpayer must precede the Form 8606 for the secondary taxpayer. Pg 94 Pg 94 0051 o 0052 o Pg 94 o 0053 o 0054 o Pg 145 0055 o Pg 154 0056 o Pg 154 Publication 1346 August 30, 2002 Part I Page 237 ATTACHMENT 1 ERROR REJECT CODE (ERC) CROSS REFERENCES ERC DESCRIPTION PAGE 0057 o 0058 o Form 5329 - SSN of Person Subject to Penalty Tax (SEQ 020) on the first Form 5329 must be significant and equal to Primary SSN (SEQ 010) or Secondary SSN (SEQ 030) of Form 1040. Form 5329 - SSN of Person Subject to Penalty Tax (SEQ 020) on the second Form 5329 must be significant and equal to Secondary SSN (SEQ 030) of Form 1040 and must not be equal to SSN of Person Subject to Penalty Tax (SEQ 020) on the first Form 5329. When both spouses are filing Form 5329, the Form 5329 for the primary taxpayer must precede the Form 5329 for the secondary taxpayer. Form 4137 - Tip Income SSN (SEQ 020) on the second Form 4137 must equal Secondary SSN (SEQ 030) of Form 1040 and must not be equal to Tip Income SSN (SEQ 020) on the first Form 4137. When both spouses are filing Form 4137, the Form 4137 for the primary taxpayer must precede the Form 4137 for the secondary taxpayer. Tax Return Record Identification Page 1 - Return Sequence Number (RSN) (SEQ 007) must be in ascending numerical sequence within a transmission. However, the RSN's within the transmission do not have to be consecutive. Tax Return Record Identification Page 1 - Declaration Control Number (DCN) (SEQ 008) must be in ascending numerical sequence within the transmission. However, the DCN's within the transmission do not have to be consecutive. Tax Return Record Identification Page 1 - The first two digits of the Declaration Control Number (DCN) (SEQ 008) must be zeros. Tax Form - When Filing Status (SEQ 130) equals "2" or "3", both Primary SSN (SEQ 010) and Secondary SSN (SEQ 030) must be numeric. (The Filing Status of Form 1040EZ is considered to be "2" when Secondary SSN (SEQ 030) is significant.) Tax Return Record Identification Page 1 - The Year Digit of Declaration Control Number (DCN) (SEQ 008) must be "3". Form 1040/1040A - When Exempt Spouse Ind (SEQ 163) equals "X", Filing Status (SEQ 130) must equal "2". Form 1040/1040A - If any field of the following "dependent group" is significant, then all fields in that group must be significant: Dependent First Name, Dependent Last Name, Dependent Name Control, Dependent's SSN, and Relationship. (See Part II Record Layouts for Field Numbers.) Dependent Name Control (SEQ 172, 182, 192, 202, 212) must be in the correct format. See Section 7.01 for Name Control format. -| Pg 147 Pg 147 0059 o Pg 145 0060 o Pg 95 0061 o Pg 95 0062 o Pg 95 0063 o Pg 103 0064 o Pg 95 | Pg 108 0065 o 0066 o Pg 108 o Publication 1346 August 30, 2002 Part I Page 238 ATTACHMENT 1 ERROR REJECT CODE (ERC) CROSS REFERENCES ERC DESCRIPTION PAGE 0067 o Form 1040/1040A - Dependent First Name (SEQ 170, 180, 190, 200, 210) and Dependent Last Name (SEQ 171, 181, 191, 201, 211) must contain only alpha characters and spaces. A space cannot be in the first position of either Dependent First Name or Dependent Last Name. Form 1040/1040A - When Dependent's SSN (SEQ 175, 185, 195, 205, 215) is significant, it must be within the valid ranges of SSN/ITIN/ATIN's and cannot equal Primary SSN (SEQ 010) or Secondary SSN (SEQ 030) or another Dependent's SSN. It must equal all numeric characters and cannot equal all zeros or all nines. Refer to Attachment 8 for valid ranges of Social Security/Taxpayer Identification Numbers. Form 1040/1040A - When Filing Status (SEQ 130) equals "2", Name Line 1 (SEQ 060) must contain an ampersand (&). Form 1040EZ - When Secondary SSN (SEQ 030) is significant, Name Line 1 (SEQ 060) must contain an ampersand (&). Form 1040 - If Other Adjustments Literal (SEQ 720) equals "JURY PAY", then at least one Type of Other Income (SEQ 560) must equal "JURY PAY". Tax Form - When Secondary SSN (SEQ 030) is significant, it must be within the valid ranges of SSN/ITIN's, cannot equal an ATIN, and cannot equal Primary SSN (SEQ 010). It must equal all numeric characters and cannot equal all zeros or all nines. Refer to Attachment 8 for valid ranges of Social Security/Taxpayer Identification Numbers. Tax Form - When EIC Eligibility (SEQ 1183) equals "NO", Earned Income Credit (SEQ 1180) cannot be significant. Form 1040/1040A - When Schedule EIC is present, Earned Income Credit SEQ (1180) must be significant. Pg 108 -| 0068 o Pg 109 -| 0069 o Pg 103 o 0070 o Pg 113 0071 o Pg 103 0072 o Pg 103 o 0073 o Form 1040/1040A - When Year Spouse Died (SEQ 155) is significant, it must equal "2000" or "2001" (i.e., one of the | two years prior to the tax year of the return) and Filing Status (SEQ 130) must equal "5". When Filing Status (SEQ 130) equals "5", Number of Children Who Lived with You (SEQ 240) must be significant. Form 2441/Schedule 2 - Qualifying Person SSN (SEQ 214, 223) cannot equal another Qualifying Person SSN on the same Form 2441/Schedule 2 or in the related Statement Record. Pg 109 o 0074 o Pg 135 Publication 1346 August 30, 2002 Part I Page 239 ATTACHMENT 1 ERROR REJECT CODE (ERC) CROSS REFERENCES ERC DESCRIPTION PAGE 0075 o Tax Form - If Earned Income Credit (SEQ 1180) is significant, then at least one of the following must be present for the forms listed below. Form 1040: Household Help Literal (SEQ 366) and Household Help Amt (SEQ 368); Type of Other Income (SEQ 560) and Amount of Other Income (SEQ 570); Form W-2; Form W-2GU; Form 1099-R with | Distribution Code (SEQ 190) equal to "3"; Schedule C; Schedule C-EZ; Schedule E with Part/S-Corp Ind (SEQ 1172, 1210, 1270, 1330, 1390) equal to "P"; Schedule F. Form 1040A: Household Help Literal (SEQ 366) and Household Help Amt (SEQ 368); Form W-2; Form W-2GU; Form 1099-R with | Distribution Code (SEQ 190) equal to "3". Form 1040EZ: Household Help Literal (SEQ 366) and Household Help Amt (SEQ 368); Form W-2; Form W-2GU. | Form 1040/1040A - If Taxable Interest (SEQ 380) is greater than $400, or if Taxable Interest (SEQ 290) of Schedule B/Schedule 1 is significant, then Taxable Interest (SEQ 380) of Form 1040/1040A must equal Taxable Interest (SEQ 290) from Schedule B/Schedule 1. Form 1040/1040A - If Total Ordinary Dividends (SEQ 394) is greater than $400, or if Total Ordinary Dividends (SEQ 525) of Schedule B/Schedule 1 is significant, then Total Ordinary Dividends (SEQ 394) of Form 1040/1040A must equal Total Ordinary Dividends (SEQ 525) from Schedule B/Schedule 1. Form 1040 - Capital Gain/Loss (SEQ 450) must equal one of the following fields from Schedule D: Combined Net Gain/Loss (SEQ 1848) or Allowable Loss (SEQ 1849). Form 1040 - Rent/Royalty/Part/Estates/Trusts Inc (SEQ 510) must equal Total Income or Loss (SEQ 1150) or Total Supplemental Income (Loss) (SEQ 2010) from Schedule E. Form 1040 - Current Year Moving Expenses (SEQ 637) must equal Moving Exp Deduction (SEQ 180) from Form(s) 3903. Form 1040 - If F4684 Literal (SEQ 460) is not significant, then Other Gain/Loss (SEQ 470) of Form 1040 must equal Redetermined Gain/Loss (SEQ 1030) from Form 4797. Form 1040 - If Schedule A is present, then Total Itemized or Standard Deduction (SEQ 789) of Form 1040 must equal Total Deductions (SEQ 520) from Schedule A. Form 1040/1040A - Credit for Child & Dependent Care (SEQ 925) must equal Credit for Child & Dependent Care (SEQ 330) from Form 2441/Schedule 2. Form 1040/1040A - Credit for Elderly or Disabled (SEQ 930) must equal Credit (SEQ 250) from Schedule R/Schedule 3. Pg 103 0076 o Pg 96, 109 0077 o Pg 96, 109 0078 o Pg 96, 113 0079 o Pg 96, 113 0080 o Pg 96, 113 Pg 96, 113 0081 o 0082 o Pg 97, 113 0083 o Pg 97 109 0084 o Pg 97, 109 Publication 1346 August 30, 2002 Part I Page 240 ATTACHMENT 1 ERROR REJECT CODE (ERC) CROSS REFERENCES ERC DESCRIPTION PAGE 0085 o Schedule R/Schedule 3 - Taxable Disability (SEQ 150) must be significant when one of the following fields equals "X": Retire/Disabled (SEQ 020); Both Under 65, One Retired (SEQ 040); Both Under 65, Both Retired (SEQ 050); One Over 65, Other Retired (SEQ 060); Under 65, Did Not Live With Spouse (SEQ 090). Form 1040 - If Exempt/Form 4361 Box (SEQ 025) of Schedule(s) SE and Exempt SE Tax Indicator (SEQ 1035) of Form 1040 are blank, then Self Employment Tax (SEQ 1040) of Form 1040 must equal Self-Employment Tax (SEQ 160) from Schedule(s) SE. Form 1040 - Alternative Minimum Tax (SEQ 918) must equal Alternative Minimum Tax (SEQ 340) from Form 6251. Form 1040/1040A - Overpaid (SEQ 1260) must equal the total of the following fields: Refund (SEQ 1270), Applied to ES Tax (SEQ 1280), and ES Penalty Amt (SEQ 1300). Form 1040 - When Total Alimony Paid (SEQ 697) is significant, Recip Soc Sec No. (SEQ 693) must be significant, and vice versa. When Recip Soc Sec No. (SEQ 693) is significant, it must be within the valid ranges of SSN/ITIN's, cannot equal an ATIN, and cannot equal Primary SSN (SEQ 010). Refer to Attachment 8 for valid ranges of Social Security/Tax Identification Numbers. Form 2441/Schedule 2 - When Form 2441/Schedule 2 is present, at least one of the following fields must be significant: Dependent Care Benefits Literal (SEQ 371) of Form 1040/1040A; Dependent Care Benefits (SEQ 210) of Form W-2; Credit for Child & Dependent Care (SEQ 330) of Form 2441/Schedule 2 or if Form 1040/1040A (SEQ 915/860) is not significant, then the credit for Child Care (SEQ 330) of Form 2441/Schedule 2 must be zero. Pg 125 0086 o Pg 97, 113 0087 o Pg 97, 113 Pg 109 0088 o 0089 o Pg 113 o 0090 o Pg 135 0091-0093 Reserved 0094 o Form 6252 - If Line 24 Minus Line 25 (SEQ 290) or Line 35 Minus Line 36 (SEQ 460) is significant, then Schedule D or Form 4797 must be present. Pg 150 Publication 1346 August 30, 2002 Part I Page 241 ATTACHMENT 1 ERROR REJECT CODE (ERC) CROSS REFERENCES ERC DESCRIPTION PAGE 0095 o Form 2441/Schedule 2 - If Total Qualified Expenses or Limit (SEQ 230), or Credit for Child & Dependent Care (SEQ 330), or Net Allowable Amount (SEQ 460) is greater than zero, then Qualifying Person SSN - 1 (SEQ 214) must be significant. The Qualifying Person information on Line 2 is not required when Prior Year Expense Literal (SEQ 318), Prior Year Qualifying Person Name (SEQ 324), and Prior Year Qualifying Person SSN (SEQ 326) are present and there are no current year expenses. If Credit for Child & Dependent Care (SEQ 330) is significant, and Total Qualified Expenses or Limit (SEQ 230) or Net Allowable Amount (SEQ 460) is greater than zero, then Primary Earned Income (SEQ 260) (and Spouse's Earned Income (SEQ 270) when Filing Status (SEQ 130) of Form 1040/1040A equals "2") must be significant. Reserved Form 1040 – When Capital Distribution Box (SEQ 447) equals to “X”, Capital Gain/Loss (SEQ 450) must be significant, Schedule D must not be present. When Capital Distribution Box (SEQ 447) is not equal to “X” and Capital Gain/Loss (SEQ 450) is significant, Schedule D must be present. Pg 135 o 0096 o 0097 o Pg 113 0098 o Schedule C – Gross Receipts Less Returns Allowances (SEQ 220) must equal Gross Receipts/Sales (SEQ 200) minus Returns/Allowances (SEQ 210). Form 1040 - Business Income/Loss (SEQ 440) must equal the total of Net Profit (Loss) (SEQ 710) from Schedule(s) C plus Net Profit (SEQ 710) from Schedule(s) C-EZ. Schedule C - When Net Profit (Loss) (SEQ 710) is less than zero and Some Is Not At Risk (SEQ 730) equals "X", Form 6198 must be present. Form 4952 - At least one of the following fields must be greater than zero: Investment Interest Expense (SEQ 010), Carryover Disallowed Interest Expense (SEQ 020), Investment Interest Expense Deduction (SEQ 060). Schedule E - If Some is Not At Risk (SEQ 1180, 1238, 1298, 1358, 1418) equals "X" on any Schedule E, and the corresponding Part/S-Corp Nonpassive Sch K-1 Loss (SEQ 1192, 1253, 1313, 1373, 1433) is significant, then Form 6198 must be present. Pg 119 0099 o Pg 96, 113 0100 o Pg 119 0101 o Pg 146 0102 o Pg 120 Publication 1346 August 30, 2002 Part I Page 242 ATTACHMENT 1 ERROR REJECT CODE (ERC) CROSS REFERENCES ERC DESCRIPTION PAGE 0103 o Tax Form - If Withholding (SEQ 1160) is greater than $500, then at least one of the following must be present for the forms listed below. Form 1040: Other 1099 Withholding Literal (SEQ 1140); Withholding (SEQ 130) on Form W-2 or Form W-2GU; Withholding (SEQ 160) on Form 1099-R; Withholding (SEQ 050) on Form W2-G. Form 1040A: Other 1099 Withholding Literal (SEQ 1140); Withholding (SEQ 130) on Form W-2 or Form W-2GU; Withholding (SEQ 200) on Form 1099-G; Withholding (SEQ 160) on Form 1099-R. Form 1040EZ: Other 1099 Withholding Literal (SEQ 1140); Withholding (SEQ 130) on Form W-2 or Form W-2GU; Withholding (SEQ 200) on Form 1099-G. Reserved Tax Form - When Direct Deposit information is present, the following fields must be significant: Routing Transit Number (SEQ 1272); Checking Account Indicator (SEQ 1274) or Savings Account Indicator (SEQ 1276); Depositor Account Number (SEQ 1278); and RAL Indicator (SEQ 1465). Schedule E - If more than one Schedule E is present, only the first occurrence of Schedule E can contain entries in the following fields: SEQ 125, 155, 380, 1000, 1040, 1110, 1120, 1150, 1445, 1455, 1475, 1485, 1495, 1750, 1755, 1765, 1913, 1917, 1923, 1927, 1933, 1937, 1939, 1943, 1945, 1977, 1991, 2010, and 2020. Schedule SE - If SST Wages/RRT Comp (SEQ 088) or Unreported Tips (SEQ 090) is significant, then Total Wages/Unreported Tips (SEQ 100) must be significant. Form 1040/1040A - If Overpaid (SEQ 1260) is greater than zero, then Total Payments (SEQ 1250) must be greater than Total Tax (SEQ 1138). Form 1040EZ - If Refund (SEQ 1270) is greater than zero, then Total Payments (SEQ 1250) must be greater than Total Tax (SEQ 1256). Form 1040/1040A - If Primary SSN (SEQ 010) or Secondary SSN (SEQ 030) is equal to an ITIN, then Earned Income Credit (SEQ 1180) cannot be significant and Schedule EIC cannot be present. Form 1040EZ - If Primary SSN (SEQ 010) or Secondary SSN (SEQ 030) is equal to an ITIN, then Earned Income Credit (SEQ 1180) cannot be significant. Form 1040 – If both Schedule D and Schedule J are present, then Tax (SEQ 915) of Form 1040 must equal or be greater than Subtract Line 21 from Line 17 (SEQ 220) of Schedule J. Pg 103 | | | | | 0104 o 0105 o Pg 107 0106 o Pg 120 0107 o Pg 125 0108 o Pg 104 o 0109 o Pg 104 o 0110 o Pg 97, 113 Publication 1346 August 30, 2002 Part I Page 243 ATTACHMENT 1 ERROR REJECT CODE (ERC) CROSS REFERENCES ERC DESCRIPTION PAGE 0111 o Form 1040/1040A- When Must Itemize Indicator (SEQ 786) equals "X", Filing Status (SEQ 130) must equal "3". Form 1040 - When Retirement Tax Plan Literal (SEQ 1095) is blank, Tax on Retirement Plans (SEQ 1100) must equal the total of the following fields from Form(s) 5329: Total Section 72 Tax on Early Distributions (SEQ 078), Tax on Ed IRA Distrib Not Used for Educ Expenses (SEQ 091), Excess Contributions Tax on Traditional IRA (SEQ 160), Excess Contributions Tax on Roth IRA (SEQ 480), Excess Contribution Tax on Ed IRA (SEQ 570), Excess Contributions Tax on MSA (SEQ 660), and Tax on Excess Accumulations (SEQ 720). When Retirement Tax Plan Literal (SEQ 1095) equals "NO", Form 5329 does not have to be present, but Tax on Retirement Plans (SEQ 1100) of Form 1040 must be significant and Distribution Code (SEQ 190) of Form 1099-R must equal "1". Schedule A - When Non-Cash/Check Contribution (SEQ 360) is greater than $500, Form 8283 must be present. Form 1040/1040A - If Taxable Amount of Social Security (SEQ 557) is significant, then Social Security Benefits (SEQ 553) must be significant. Form then Form (SEQ 1040 - If Railroad Retire Indicator (SEQ 1070) is blank, Social Security & Medicare Tax on Tips (SEQ 1080) of 1040 must equal F1040 Social Security Medicare Tax on Tips 200) from Form(s) 4137. Pg 109 0112 o Pg 97, 114 o 0113 o Pg 119 0114 o Pg 109 0115 o Pg 97, 114 0116 o Form 1040/1040A - If Total Payments (SEQ 1250) is not equal to Total Tax (SEQ 1138), then at least one of the following fields must be significant: Overpaid (SEQ 1260), Refund (SEQ 1270), Applied to ES Tax (SEQ 1280), Amount Owed (SEQ 1290). Schedule C - At least one of the following fields must be significant: Gross Receipts/Sales (SEQ 200), Gross Income (SEQ 270), Total Expenses (SEQ 700), Tentative Profit/Loss (SEQ 702), Net Profit (Loss) (SEQ 710). Form 5329 - Name of Person Subject to Penalty Tax (SEQ 010) must contain a less-than sign immediately preceding the last name. If the name includes a suffix, another less-than sign is entered between the last name and the suffix. Allowable characters are: Alpha, hyphen (-), less-than (<), and space. The following cannot be present: Two or more consecutive embedded spaces, a space or less-than sign in the first position, a less-than sign in the last position, more than two less-than signs, a space preceding or following a less-than sign. Pg 109 0117 o Pg 119 0118 o Pg 147 o Publication 1346 August 30, 2002 Part I Page 244 ATTACHMENT 1 ERROR REJECT CODE (ERC) CROSS REFERENCES ERC DESCRIPTION PAGE 0119 o Form 1040/1040A - If Filing Status (SEQ 130) equals "3", then State Abbreviation (SEQ 087) cannot equal any of the following states: AZ (Arizona), CA (California), ID (Idaho), LA (Louisiana), NM (New Mexico), NV (Nevada), TX (Texas), WA (Washington), and WI (Wisconsin). Exception: If Filing Status equals "3" and Address Ind (SEQ 097) equals "2" (Stateside Military Address), then the State Abbreviation (SEQ 087) may equal one of the Community Property states listed above. Form 1099-G – The following fields must be significant: Payer's | Name Control (SEQ 0020), Payer's Name (SEQ 0030) and Payer's | Federal Identification Number (SEQ 0090). | Form 1040/1040A - Pensions Annuities Received (SEQ 485) cannot equal Taxable Pensions Amount (SEQ 495). Form W-2 - Employer Identification Number (SEQ 040) must be numeric, the first two digits of Employer Identification Number (SEQ 040) must equal a valid District Office Code, Employer Name Control (SEQ 045) must be significant, and W-2 Indicator (SEQ 510) must equal "N" or "S". Refer to Attachment 7 for District Office Codes. See Section 7.05 for Business Name Control format. Note: The value "N" (Non-Standard) indicates that the Form W-2 was altered, handwritten, or typed, or that a cumulative Earnings Statement or a substitute Form W-2 was used. The value "S" (Standard) identifies a Form W-2 that is a computer-produced print, an IRS form, or an IRS-approved facsimile. Form W-2 - The following fields must be significant: Employer Name (SEQ 050), Employer Address (SEQ 060), Employee Name (SEQ 090), Employee Address (SEQ 100); Employee City (SEQ 110), Employee State (SEQ 113), Employee Zip Code (SEQ 115), and Wages (SEQ 120). Exception: The check for Wages (SEQ 120) is bypassed when Combat Pay has been excluded from Wages. Exception: When a period (.) is present in the Employee State (SEQ 0113) on Form W-2, the checks for Employee City (SEQ 0110) and Employee Zip Code (SEQ 0115) are bypassed. Form W-2G - The following fields must be significant: Payer Name Control (SEQ 015), Payer Name (SEQ 020), and Payer Identification Number (SEQ 026). Form 1099-R - The following fields must be significant: Payer Name Control (SEQ 015), Payer Name (SEQ 020), and Payer Identification Number (SEQ 050). Pg 109 o 0120 o Pg 130 0121 o 0122 o Pg 109 Pg 126 o 0123 o Pg 126 o o 0124 o Pg 127 0125 o Pg 131 Publication 1346 August 30, 2002 Part I Page 245 ATTACHMENT 1 ERROR REJECT CODE (ERC) CROSS REFERENCES ERC DESCRIPTION PAGE 0126 o Tax Form – If any Paid Preparer information (SEQ 1340, 1350, 1360, 1370, 1380, 1390, 1400, 1410, 1420) is significant, then either Preparer SSN/Preparer TIN (SEQ 1360) or Preparer Firm EIN (SEQ 1380) must be significant. If Preparer SSN/Preparer TIN (SEQ 1360) is significant, it must equal all numeric characters and cannot equal all zeros or all nines; or the first position must equal “P” and the last positions must be numeric characters and cannot equal all zeros or all nines. If Preparer Firm EIN (SEQ 1380) is significant, it must equal all numeric characters and cannot equal all zeros or all nines. When Paid Preparer information (SEQ 1340-1420) is significant, Non-Paid Preparer (SEQ 1338) cannot be significant, and vice versa. Refer to Attachment 6 for more information on Non-Paid and Paid Preparers. Form 1040/1040A - If Total Payments (SEQ 1250) is greater than Total Tax (SEQ 1138), and the total of Applied to ES Tax (SEQ 1280) plus ES Penalty Amount (SEQ 1300) is equal to Overpaid (SEQ 1260), then Refund (SEQ 1270) cannot be significant. Form 1040/1040A - If Total Payments (SEQ 1250) is greater than Total Tax (SEQ 1138), and the total of Applied to ES Tax (SEQ 1280) plus ES Penalty Amount (SEQ 1300) is less than Overpaid (SEQ 1260), then Refund (SEQ 1270) must be greater than zero. Form 1040/1040A - If Total Payments (SEQ 1250) equals Total Tax (SEQ 1138), then the following fields cannot be significant: Overpaid (SEQ 1260), Refund (SEQ 1270), and Applied to ES Tax (SEQ 1280). Form 1040/1040A - If Total Itemized or Standard Deduction (SEQ 789) contains one of the following amounts: $4825, 5725, | 5850, 7000, 8050, 8750, 9200, 9650, 10550, or 11450; and | Modified Standard Deduction Ind (SEQ 787) of Form 1040 is blank; then at least one of following fields must equal "X": Self 65 or Over Box (SEQ 772), Self Blind Box (SEQ 774), Spouse 65 or Over Box (SEQ 776), Spouse Blind Box (SEQ 778). Exception for Form 1040: This check is not performed when one or more of the following forms are present: Schedule A, Form 4563. Form 1040/1040A - If Number of Children Not Living with You (SEQ 247) is significant, then at least one Relationship (SEQ 177, 187, 197, 207, 217) must equal "CHILD", "DAUGHTER", "GRANDCHILD", or "SON". Pg 104 o o o 0127 o Pg 110 0128 o Pg 110 0129 o Pg 110 0130 o Pg 110 o 0131 o Pg 110 -| Publication 1346 August 30, 2002 Part I Page 246 ATTACHMENT 1 ERROR REJECT CODE (ERC) CROSS REFERENCES ERC 0132 0133 o o DESCRIPTION Form 1040 – When Capital Distribution Box equals to “X”, Capital Gain/Loss (SEQ 450) must contain a positive amount. Schedule R/Schedule 3 - If Nontaxable SSB/RRB (SEQ 163) or Nontaxable Other (SEQ 167) is significant, then Pensions & Annuities (SEQ 170) must be significant. Form 1040 - If Exempt Self (SEQ 160) equals "X", and Must Itemize Indicator (SEQ 786), and Modified Standard Deduction Ind (SEQ 787) and Itemize Election Ind (SEQ 788) are blank, and Schedule A and Form 4563 are not present; then Total Itemized or Standard Deduction (SEQ 789) must equal a valid standard deduction. Form 1040A – If Exempt Self (SEQ 160) equals "X", and Must Itemize Indicator (SEQ 786) and Modified Standard Deduction Ind (SEQ 787) are blank; then Total Itemized or Standard Deduction (SEQ 789) must equal a valid standard deduction. Form 1040 - When F4684 Literal (SEQ 460) equals "F4684", Form 4684 must be present. Form 1040 - If Form 2210 or Form 2210F is present, then ES Penalty Amount (SEQ 1300) of Form 1040 must equal Underpayment Penalty/Short Method (SEQ 240) or Total Underpayment Penalty (SEQ 720) from Form 2210, or Underpayment Penalty/Farmers Fishermen (SEQ 180) from Form 2210F. Form 1040A - If Form 2210 is present, then ES Penalty Amount (SEQ 1300) of Form 1040A must equal Underpayment Penalty/Short Method (SEQ 240) or Total Underpayment Penalty (SEQ 720) from Form 2210. Form 2441/Schedule 2 - When SSN/EIN 1 or 2 (SEQ 040, 090) is significant, the corresponding Amount Paid 1 or 2 (SEQ 050, 100) must be significant. Form 1040/1040A - Total Exemptions (SEQ 360) must equal the total of the following fields: Total Box 6a and 6b (SEQ 167); Number of Children Who Lived with You (SEQ 240); Number of Children Not Living with You (SEQ 247); and Number of Other Dependents Listed (SEQ 350). Form W-2 - Employee SSN (SEQ 080) must equal Primary SSN (SEQ 010) or Secondary SSN (SEQ 030) of the Tax Form. Form 1040 - Farm Income (SEQ 520) must equal Net Farm Profit or Loss (SEQ 680) from Schedule(s) F. Schedule F - At least one of the following fields must be significant: Gross Income Amount (SEQ 280), Total Expenses (SEQ 650), Net Farm Profit or Loss (SEQ 680). Schedule F - Accounting Method Cash Indicator (SEQ 050) or Accounting Method Accrual Indicator (SEQ 060) must equal "X". Both indicators cannot equal "X". Schedule F - Materially Participate Yes Indicator (SEQ 100) and Materially Participate No Indicator (SEQ 110) cannot both equal "X" and cannot both equal blank. Pg 135 Pg 114 Pg 98, 110 PAGE Pg 114 Pg 125 0134 o Pg 110 o 0135 0136 o o o 0137 o 0138 o Pg 110 0139 0140 0141 o o o Pg 126 Pg 96, 114 Pg 122 0142 o Pg 122 0143 o Pg 122 Publication 1346 August 30, 2002 Part I Page 247 ATTACHMENT 1 ERROR REJECT CODE (ERC) CROSS REFERENCES ERC 0144-0145 0146 0147 o o Reserved Tax Form - When Unemployment Compensation (SEQ 552) is significant, it must be numeric and greater than zero. Form 2210 – One of the following fields must equal "X": Waiver Box (SEQ 0020), Annualized Installment Method Box (SEQ 0030), Actually Withheld Box (SEQ 0040) or Required Installment Box (SEQ 0054). Form 2210 - When Waiver Box (SEQ 020) equals "X", either Waiver Explanation/Short Method (SEQ 237) or Waiver Explanation (SEQ 717) must equal "STMbnn". Form 2210F - When Waiver of Penalty Box (SEQ 013) equals "X", Waiver Explanation (SEQ 177) must equal "STMbnn". Schedule C - When Other Clos Inv Method (SEQ 744) equals "X", Other Meth Explanation (SEQ 746) must equal "STMbnn". Form 1040 - When F4255 Literal (SEQ 1121) and F4255 Amount (SEQ 1122) are significant, Form 4255 must be present and Total Increase Tax (SEQ 530) of Form 4255 must be significant. When Form 4255 is present, F4255 Literal (SEQ 1121) and F4255 Amount (SEQ 1122) of Form 1040 must be significant. Summary Record - Number of Logical Records in Tax Return (SEQ 040) must equal the total logical record count computed by the IRS. Summary Record - Number of Forms W-2 (SEQ 050) must equal the number of Forms W-2 computed by the IRS. Summary Record - Number of Forms W-2G (SEQ 060) must equal the number of Forms W-2G computed by the IRS. Summary Record - Number of Forms 1099-R (SEQ 070) must equal the number of Forms 1099-R computed by the IRS. Summary Record - Number of Schedule Records (SEQ 080) must equal the number of schedule records computed by the IRS. Summary Record - Number of Form Records (SEQ 090) must equal the number of form records computed by the IRS. Summary Record - Number of Statement Record Lines (SEQ 100) must equal the number of statement record lines computed by the IRS. Pg 174 Pg 119 Pg 114 | | | | Pg 104 Pg 134 DESCRIPTION PAGE 0148 o Pg 134 o 0149 0150 o o o 0151 o 0152 0153 0154 0155 0156 0157 o o o o o o Pg 174 Pg 153 Pg 153 Pg 153 Pg 153 Pg 153 Publication 1346 August 30, 2002 Part I Page 248 ATTACHMENT 1 ERROR REJECT CODE (ERC) CROSS REFERENCES ERC 0158 o DESCRIPTION Form 1040/1040A - If Credit for Elderly or Disabled (SEQ 930) is significant, and Self 65 or Over Box (SEQ 772) and Spouse 65 or Over Box (SEQ 776) are blank, then one of the following fields from Schedule R/Schedule 3 must be significant: Retire/Disabled (SEQ 020); Both Under 65, One Retired (SEQ 040); Both Under 65, Both Retired (SEQ 050); Under 65, Did Not Live with Spouse (SEQ 090). Form 1040EZ - If Dependent No-Ind (SEQ 785) equals "X", then Combined Standard Deduction and Personal Exemption (SEQ 815) must equal $7700 when Secondary SSN (SEQ 030) is not significant, and must equal $13850 when Secondary SSN (SEQ 030) is significant. If Dependent Yes-Ind (SEQ 784) equals "X", then Combined Standard Deduction and Personal Exemption (SEQ 815) cannot exceed $4700 when Secondary SSN (SEQ 030) is not significant, and cannot exceed $10850 when Secondary SSN (SEQ 030) is significant. Summary Record – Number of Forms 1099-G Records (SEQ 0065) must equal the number of Forms 1099-G computed by the IRS. Form 1040EZ - Dependent Yes-Ind (SEQ 784) and Dependent No-Ind (SEQ 785) cannot both equal "X" and cannot both equal blank. Form 1040EZ - Earned Income Credit (SEQ 1180) cannot exceed $377 and Adjusted Gross Income (SEQ 750) must be less than $11060. When Dependent Yes-Ind (SEQ 784) equals "X", Earned Income Credit (SEQ 1180) cannot be significant. Schedule R/Schedule 3 – At least one of the following fields must be significant: SEQ 010, 020, 030, 040, 050, 060, 070, 080, 090. Form 1040/1040A – If Credit for Qualified Retirement Savings (SEQ 937/953) is significant, then Form 8880 must be attached. Form 8880 – If Credit Contributions (SEQ 0200) is significant, then it must equal Credit for Qualified Retirement Savings (SEQ 0937/0953) of Tax Form. Form 8880 – Total Line 6a and 6b (SEQ 0130) must be greater than zero. Form 9465 - Monthly Payment Date (SEQ 310) must be significant and must be within the 01 to 28 range. Form 9465 - Monthly Payment (SEQ 300) must be equal to or greater than $25. | | | | | | | Pg 125 | | PAGE Pg 111 0159 o Pg 118 | | o | | | | 0160 o 0161 o 0162 o Pg 175 Pg 118 Pg 118 o 0163 o 0164 o 0165 o Pg 111 Pg 165 0166 o Pg 165 0167 o 0168 o Pg 165 Pg 165 Publication 1346 August 30, 2002 Part I Page 249 ATTACHMENT 1 ERROR REJECT CODE (ERC) CROSS REFERENCES ERC 0169 o DESCRIPTION Schedule E - At least one of the following fields must be significant on the first occurrence of Schedule E: Total Rents Received (SEQ 125); Total Royalties Rec'd (SEQ 155); Rental & Royalty Deduction (SEQ 1000); Total Income (SEQ 1110); Total Losses (SEQ 1120); Part/S-Corp Name A (SEQ 1170); Tot Part/S-Corp Income (SEQ 1750); Tot Part/S-Corp Loss and Sec 179 Deduction (SEQ 1755); Tot Estate/Trust Inc (SEQ 1933); Tot Estate/Trust Loss (SEQ 1937); Total REMIC Income (SEQ 1977); Net Farm Rental Income/Loss (SEQ 1991); Farming/Fishing Share (SEQ 2020); Net Rental Real Estate Income/Loss (SEQ 2030). Schedule A - Casualty/Theft Loss (SEQ 390) must equal Line 16 Minus Line 17 (SEQ 450) from Form 4684, when either field is significant. Form 4797 - When Form 4684 is present, Gain/Loss for Entire Year (Form 4684 Sec B Gain) (SEQ 440) of Form 4797 must equal Loss Equal to or Smaller than Gain (SEQ 1120) from Form 4684. Form 9465 - Amount Owed on Tax Return (SEQ 280) cannot be greater than $25000. Reserved Form 4684 - When Line 16 minus Line 17 (SEQ 450) is significant, Line 13 more than Line 14 (SEQ 430) must be significant. Form 1040 - When Other Adjustment Amount (SEQ 730) or Total Other Adjustments (SEQ 735) is significant, Total Adjustments (SEQ 740) must be significant. Reserved Tax Form - If Earned Income Credit (SEQ 1180) is significant and Schedule E is not present, then the total of the following fields cannot exceed $2550 unless Form 4797 is attached: Taxable Interest (SEQ 380), Tax-Exempt Interest (SEQ 385), Total Ordinary Dividends (SEQ 394) of Form 1040/1040A, and Capital Gain/Loss (SEQ 450) (when greater than zero) of Form 1040. Form 1040 – When Other Form Block (SEQ 1006) equals “X”, one of the following forms must be present: Form 3468, Form 5884, Form 6478, Form 6765, Form 8586, Form 8820, Form 8826, Form 8830, Form 8834, Form 8835, Form 8844, Form 8845, Form 8846, Form 8847, Form 8861. Form 1040 – When Nonconventional Source Fuel Credit Literal (SEQ 1017) is significant, Nonconventional Source Fuel Credit Amount (SEQ 1018) must be significant and vice versa. When Nonconventional Source Fuel Credit Amount (SEQ 1018) is significant, then Nonconventional Source Fuel Credit (SEQ 1025) must contain “STMbnn”. Pg 104 | Pg 146 PAGE Pg 120 0170 o Pg 99, 119 Pg 99, 146 Pg 165 0171 o 0172 o 0173 o 0174 o 0175 o Pg 114 0176 o 0177 o 0178 o Pg 114 -| Pg 114 0179 o Publication 1346 August 30, 2002 Part I Page 250 ATTACHMENT 1 ERROR REJECT CODE (ERC) CROSS REFERENCES ERC 0180 o Form 4835 - When Income/Loss (SEQ following fields or Net Farm Rent DESCRIPTION one Form 4835 is present, Net Farm Rental 1991) of Schedule E must equal one of the from Form 4835: Net Farm Rent Profit (SEQ 610) (Loss) (SEQ 630). PAGE Pg 99, 146 o When multiple Forms 4835 are present, Net Farm Rental Income/Loss (SEQ 1991) of Schedule E must equal the sum of the following from Forms 4835: Net Farm Rent Profit (SEQ 610) (when greater than zero) minus Net Farm Rent (Loss) (SEQ 630). Note: Net Farm Rent (Loss) (SEQ 630) of Form 4835 is assumed to be a loss; the minus sign is not transmitted. Form 4835 - If Some is Not at Risk (SEQ 620) equals "X" on one or both Form(s) 4835, then Form 6198 or Form 8582 must be present. Schedule F - When Net Farm Profit or Loss (SEQ 680) is less than zero and Some Is Not at Risk Indicator (SEQ 700) equals "X", Form 6198 must be present. Schedule C - If Car/Truck Expenses (SEQ 293) is significant, then Vehicle Service Date (SEQ 820) and Business Miles (SEQ 830) must be significant, or Form 4562 must be present. Schedule E - If Net Farm Rental Income/Loss (SEQ 1991) on the first occurrence of Schedule E is present, then Form 4835 must be present. When one Form 4835 is present, Net Farm Rental Income/Loss (SEQ 1991) of Schedule E must equal one of the following fields from Form 4835: Net Farm Rent Profit (SEQ 610) or Net Farm Rent (Loss) (SEQ 630). When multiple Forms 4835 are present, Net Farm Rental Income/Loss (SEQ 1991) of Schedule E must equal the sum of the following from Forms 4835: Net Farm Rent Profit (SEQ 610) (when greater than zero) minus Net Farm Rent (Loss) (SEQ 630). Note: Net Farm Rent (Loss) (SEQ 630) of Form 4835 is assumed to be a loss; the minus sign is not transmitted. Reserved Form 8829 - Home Business Expense (SEQ 703) of Schedule C must equal Schedule C Allowable Expenses (SEQ 450) from Form 8829. Schedule C - Employer ID Number (SEQ 060) cannot equal Primary SSN (SEQ 010) or Secondary SSN (SEQ 030) of Form 1040. Form 1040/1040A - When Filing Status (SEQ 130) equals "3", Earned Income Credit (SEQ 1180) cannot be significant. Form 1040 - If Total Adjustments (SEQ 740) is significant, then at least one of the following fields must be significant: SEQ 623, 626, 628, 630, 632, 637, 640, 645, 650, 680, 697, 730, 735. Reserved | Pg 99, 158 Pg 119 Pg 111 Pg 114 | -| Pg 146 o 0181 o 0182 o Pg 122 0183 o Pg 119 0184 o Pg 99, 121 o o o 0185 o 0186 o 0187 o 0188 o 0189 o 0190 o Publication 1346 August 30, 2002 Part I Page 251 ATTACHMENT 1 ERROR REJECT CODE (ERC) CROSS REFERENCES ERC 0191 o DESCRIPTION Form 1040 - Total Credits (SEQ 1020) must equal the total of the following fields: Foreign Tax Credit (SEQ 922), Credit for Child & Dependent Care (SEQ 925), Credit for Elderly or Disabled (SEQ 930), Education Credits (SEQ 935), Credit for Qualified Retirement Savings (SEQ 937), Child Tax Credit (SEQ 940), Adoption Credit (SEQ 960), Credits from Form 8396 and Form 8859 (SEQ 995), Other Credits (SEQ 1015), and Nonconventional Source Fuel Credit Amount (SEQ 1018). Form 1040A - Total Credits (SEQ 1020) must equal the total of the following fields: Credit for Child & Dependent Care (SEQ 925), Credit for Elderly or Disabled (SEQ 930), Child Tax Credit (SEQ 955), Education Credits (SEQ 950), Credit for Qualified Retirement Savings (SEQ 953) and Adoption Credit (SEQ 960) 0192 o Tax Form - At least one of the following fields must be significant for the forms listed below. Form 1040/1040A: Total Income (SEQ 600), Adjusted Gross Income (SEQ 750), AGI Repeated (SEQ 770), Tax (SEQ 915/860), Total Credits (SEQ 1020), Total Tax (SEQ 1138), Total Payments (SEQ 1250). Form 1040EZ: Adjusted Gross Income (SEQ 750), Taxable Income (SEQ 820), Withholding (SEQ 1160), Total Tax (SEQ 1256), Refund (SEQ 1270), Amount Owed (SEQ 1290). Form 8829 - Total Hours Available (SEQ 065) cannot exceed the maximum number of available hours (24 hrs x the number of days in the year). Form 1040EZ - If Taxable Interest (SEQ 380) is not significant, then Adjusted Gross Income (SEQ 750) must equal the total of Wages, Salaries, Tips (SEQ 375) plus Unemployment Compensation (SEQ 552). Schedule SE - When Self-Employment Tax (SEQ 160) is significant, Deduction for 1/2 of Self Employment Tax (SEQ 165) must be significant, and vice versa. If Self-Employed Deduction Schedule SE (SEQ 640) of Form 1040 is significant, it must equal Deduction for 1/2 of Self Employment Tax (SEQ 165) from Schedule(s) SE. If Deduction for 1/2 of Self Employment Tax (SEQ 165) of Schedule SE is significant, and Exempt-Notary Literal (SEQ 050) is not significant, then Self-Employed Deduction Schedule SE (SEQ 640) of Form 1040 must be significant. Form 1040 - When Social Security & Medicare Tax on Tips (SEQ 1080) is significant, Form 4137 must be present. When F1040 Social Security Medicare Tax on Tips (SEQ 200) of Form 4137(s) is significant, Social Security & Medicare Tax on Tips (SEQ 1080) of Form 1040 must be significant. Schedule A - When Other Expense Amount (SEQ 485) is significant, Total Other Expenses Limit (SEQ 495) must be significant. Pg 119 Pg 115 PAGE Pg 111 | | | | | | Pg 104 0193 o Pg 158 0194 o Pg 118 0195 o Pg 96, 125 o 0196 o o 0197 o Publication 1346 August 30, 2002 Part I Page 252 ATTACHMENT 1 ERROR REJECT CODE (ERC) CROSS REFERENCES ERC 0198 o DESCRIPTION Form 1040 - Total Payments (SEQ 1250) must equal the total of the following fields: Withholding (SEQ 1160), ES Payments (SEQ 1170), Earned Income Credit (SEQ 1180), Additional Child Tax Credit (SEQ 1186), F4868 Amount (SEQ 1190), Excess SS Tax (SEQ 1184), and Other Payments (SEQ 1210). Form 1040A – Total Payments (SEQ 1250) must equal the total of the following fields: Withholding (SEQ 1160), ES Payments (SEQ 1170), Earned Income Credit (SEQ 1180), Additional Child Tax Credit (SEQ 1186), F4868 Amount (SEQ 1190), and Excess SS Tax (SEQ 1200). Form 1040/1040A – Educator Expenses (SEQ 0623) cannot be greater than $500 if filing status is “2” and $250 for all other filing statuses. Form 1040/1040A - When Earned Income Credit (SEQ 1180) is greater than $376, Schedule EIC must be present. Schedule EIC - If any field of the following "qualifying child group" is significant, then all fields in that group must be significant: Qualifying Child Name Control (SEQ 007, 077); Qualifying Child First Name (SEQ 010, 080); Qualifying Child Last Name (SEQ 011, 081); Year of Birth (SEQ 020, 090); Qualifying SSN (SEQ 015, 085); Relationship (SEQ 060, 130); and Number of Months (SEQ 070, 140). Qualifying Child Name Control (SEQ 007, 077) must be in the correct format. See Section 7.01 for Name Control format. Schedule EIC - Year of Birth (SEQ 020, 090) cannot be greater than current tax year. Schedule EIC - Relationship (SEQ 060, 130) must equal one of the following: "CHILD", "DAUGHTER", "FOSTERCHILD", "GRANDCHILD", or "SON". Form 1040/1040A - If Earned Income Credit (SEQ 1180) is significant and Schedule EIC is not present, then the primary taxpayer and/or the secondary taxpayer must be at least age 25 but not older than age 64. Form 1040EZ - If Earned Income Credit (SEQ 1180) is significant, then the primary taxpayer and/or the secondary taxpayer must be at least age 25 but not older than age 64. Schedule EIC - When Qualifying SSN (SEQ 015, SEQ 085) is significant, it must be within the valid ranges of SSN's. It must equal all numeric characters and cannot equal all zeros or all nines. Refer to Attachment 8 for valid ranges of Social Security Numbers. Schedule EIC - If Year of Birth (SEQ 020, 090) is greater than "1978" and less than "1984", then the corresponding Student "Yes" Box (SEQ 030, 100) or the corresponding Disabled "Yes" Box (SEQ 040, 110) must equal "X". | Pg 121 Pg 121 Pg 121 | | Pg 111 | | Pg 111 Pg 121 PAGE Pg 111 o 0199 o 0200 o 0201 o o 0202 o 0203 o 0204 o Pg 105 o 0205 o 0206 o Pg 121 Publication 1346 August 30, 2002 Part I Page 253 ATTACHMENT 1 ERROR REJECT CODE (ERC) CROSS REFERENCES ERC 0207 o DESCRIPTION Schedule EIC - If Relationship (SEQ 060, 130) equals "CHILD", "DAUGHTER", "GRANDCHILD", or "SON" and Year of Birth (SEQ 020, 090) does not equal "2002", then Number of Months (SEQ 070, 140) must be equal to or greater than "07". If Relationship (SEQ 060, 130) does not equal one of the above literal values and Year of Birth (SEQ 020, 090) does not equal "2002", then Number of Months (SEQ 070, 140) must equal "12". Schedule H - Cash Wages Over $1300 Paid Yearly - Yes (SEQ 040) and Cash Wages Over $1300 Paid Yearly – No (SEQ 045) cannot both equal "X" and cannot both equal blank. Schedule H - Employer SSN (SEQ 020) on the first Schedule H must be significant and equal to Primary SSN (SEQ 010) or Secondary SSN (SEQ 030) of Form 1040. Schedule H - Employer SSN (SEQ 020) on the second Schedule H must be significant and equal to Secondary SSN (SEQ 030) of Form 1040 and must not be equal to Employer SSN (SEQ 020) on the first Schedule H. When both spouses are filing Schedule H, the Schedule H for the primary taxpayer must precede the Schedule H for the secondary taxpayer. Schedule H - Employer Identification Number (SEQ 030) cannot equal Primary SSN (SEQ 010) or Secondary SSN (SEQ 030) of Form 1040. Schedule H - Name of State Where Unemplymnt Cntrbtns Paid (SEQ 200) must equal a standard state abbreviation. Refer to Attachment 3 for Standard Postal Service State Abbreviations. Schedule H - Employer SSN (SEQ 020) and Employer Identification Number (SEQ 030) must be significant, must equal all numeric characters and cannot equal all blanks or all zeros. Schedule H - When two Schedules H are present, Employer Identification Number (SEQ 030) of the second Schedule H cannot equal Employer Identification Number of the first Schedule H. Schedule H - Federal Income Tax Withheld - Yes (SEQ 050) and Federal Income Tax Withheld – No (SEQ 055) cannot both equal "X". Cash Wage Over $1000 Paid Qtrly - No (SEQ 060) and Cash Wage Over $1000 Paid Qtrly - Yes (SEQ 065) cannot both equal "X". Cash Wages Over $1000 Paid Qtrly - No (SEQ 150) and Cash Wages Over $1000 Paid Qtrly - Yes (SEQ 155) cannot both equal "X". Schedule EIC - Qualifying SSN - 1 (SEQ 015) cannot equal Qualifying SSN - 2 (SEQ 085). Qualifying SSN - 1 and - 2 (SEQ 050, 120) cannot equal Primary SSN (SEQ 010) or Secondary SSN (SEQ 030) of Form 1040/1040A. Schedule EIC - When Year of Birth (SEQ 020, 090) is less than "1979", the corresponding Disabled "Yes" Box (SEQ 040, 110) must equal "X". | Pg 122 PAGE Pg 122 | o | Pg 123 0208 o 0209 o Pg 123 0210 o Pg 123 0211 o Pg 123 0212 o Pg 123 0213 o Pg 123 0214 o Pg 123 0215 o Pg 123 o o 0216 o 0217 o Pg 122 Publication 1346 August 30, 2002 Part I Page 254 ATTACHMENT 1 ERROR REJECT CODE (ERC) CROSS REFERENCES ERC 0218 o DESCRIPTION Schedule EIC - When Year of Birth (SEQ 020, 090) equals "2002", the corresponding Number of Months (SEQ 070, 140) must equal "12". Schedule H - Page 2 must be present when all of the following fields equal "X": Cash Wage Over $1300 Paid Yearly - No (SEQ 045), Federal Income Tax Withheld - No (SEQ 055), and Cash Wage Over $1000 Paid Qtrly - Yes (SEQ 065). Schedule H - When all of the following fields equal "X", Schedule H cannot be filed: Cash Wage Over $1300 Paid Yearly No (SEQ 045), Federal Income Tax Withheld - No (SEQ 055), and Cash Wage Over $1000 Paid Qtrly - No (SEQ 060). Form 1040/1040A - Advanced EIC Payments (SEQ 1105) must equal the total of Advance EIC Payment (SEQ 200) from Form(s) W-2 and/or W-2GU. Schedule EIC - If Qualifying SSN - 1 (SEQ 015) is significant and Qualifying SSN - 2 (SEQ 085) is not significant, then Earned Income Credit (SEQ 1180) of Form 1040/1040A cannot exceed $2506 and Adjusted Gross Income (SEQ 750) of Form 1040/1040A must be less than $29201. If Qualifying SSN - 1 (SEQ 015) and Qualifying SSN - 2 (SEQ 085) are significant, then Earned Income Credit (SEQ 1180) of Form 1040/1040A cannot exceed $4140 and Adjusted Gross Income (SEQ 750) of Form 1040/1040A must be less than $33178. Schedule H - When Federal Income Tax Withheld - Yes (SEQ 050) equals "X", Federal Income Tax Withheld (SEQ 110) must be significant. Schedule H - If Cash Wage Over $1300 Paid Yearly - No (SEQ 045) and Federal Income Tax Withheld - Yes (SEQ 050) equal "X", then Cash Wage Over $1000 Paid Qtrly - No (SEQ 060) and Cash Wage Over $1000 Paid Qtrly - Yes (SEQ 065) must be blank. Schedule H - When Cash Wage Over $1300 Paid Yearly - Yes (SEQ 040) equals "X", Social Security Wages (SEQ 070) and Medicare Wages (SEQ 090) must each be equal to or greater than $1300. Schedule H - When Cash Wage Over $1300 Paid Yearly - Yes (SEQ 040) equals "X", the following fields must be blank: Federal Income Tax Withheld - Yes (SEQ 050), Federal Income Tax Withheld - No (SEQ 055), Cash Wage Over $1000 Paid Qtrly - No (SEQ 060), and Cash Wage Over $1000 Paid Qtrly - Yes (SEQ 065). Schedule H - When Page 2 is present, Cash Wages Over $1000 Paid Qtrly - No (SEQ 150) cannot equal "X". When Page 2 is not present, Cash Wages Over $1000 Paid Qtrly Yes (SEQ 155) cannot equal "X". Schedule H - Social Security Wages (SEQ 070) cannot be greater than Medicare Wages (SEQ 090). Pg 124 PAGE | Pg 122 0219 o Pg 123 0220 o Pg 123 0221 o Pg 98, 111 | Pg 122 | | 0222 o o | | Pg 123 0223 o 0224 o Pg 123 0225 o Pg 124 0226 o Pg 124 0227 o o 0228 o Pg 124 Publication 1346 August 30, 2002 Part I Page 255 ATTACHMENT 1 ERROR REJECT CODE (ERC) CROSS REFERENCES ERC 0229 o DESCRIPTION Schedule H - When Page 2 is present, Total Taxes from Line 8 (SEQ 520) must equal Total Taxes Less Advance EIC Payments (SEQ 140) from Page 1. Form 1116 – When only one Form 1116 is present, Smaller of Tax From Return or Foreign Tax Credit (SEQ 1185) must equal Gross Foreign Tax Credit (SEQ 1090) and the following fields must be blank: SEQs 1100, 1110, 1120, 1130, 1135, 1160, 1175, 1177 and 1180. Form 1116 – If more than one Form 1116 is present, then only the first occurrence of Form 1116 can have significant data in Foreign Tax Credit (SEQ 1200). For subsequent occurrences of Form 1116, significant data can be present in Foreign Tax Credit (SEQ 1200) only when Alt. Min. Tax Literal (SEQ 010) of that occurrence is equal to “AMT”. Form 1116 - On each Form 1116, only one of the following fields can equal "X": SEQ 020, 030, 040, 050, 060, 070, 080, 093, 096 098. When more than one Form 1116 is present, the same box (SEQ 020 through 098) cannot equal "X" on more than one Form 1116. Exception: The same box (SEQ 020 through 098) can equal "X" on two Forms 1116 if Alt. Min. Tax Literal (SEQ 010) is significant on one of the two Forms 1116. 0233-0234 Reserved 0235 o 0236 o Schedule H - When Page 2 is present, Total Taxable Wages for FUTA (Section A) (SEQ 230) must be significant. Form 1040 - Household Employment Taxes (SEQ 1107) must equal the total of the following fields from Schedule(s) H: Total Taxes Less Advance EIC Payments (SEQ 140) plus FUTA Tax (SEQ 240). Pg 124 Pg 98, 115 PAGE Pg 124 0230 o Pg 131 0231 o Pg 131 0232 o Pg 131 o o 0237-0239 Reserved 0240 o Schedule C-EZ - Total Expenses (SEQ 700) cannot be greater than $2500 and Net Profit (SEQ 710) cannot be less than zero. Schedule C-EZ - At least one of the following fields must be significant: Gross Receipts/Sales (SEQ 200), Total Expenses (SEQ 700), Net Profit (SEQ 710). Schedule C-EZ - Employer ID Number (SEQ 060) cannot equal Primary SSN (SEQ 010) or Secondary SSN (SEQ 030) of Form 1040. Pg 120 0241 o Pg 120 0242 o Pg 120 Publication 1346 August 30, 2002 Part I Page 256 ATTACHMENT 1 ERROR REJECT CODE (ERC) CROSS REFERENCES ERC 0243 o DESCRIPTION Form 1040 - If Schedule A is not present and Must Itemize Indicator (SEQ 786) equals "X" or Itemized Election Ind (SEQ 788) equals “IE”, then Total Itemized or Standard Deduction (SEQ 789) must equal zero. Form 1040A - If Must Itemize Indicator (SEQ 786) equals "X", then Total Itemized or Standard Deduction (SEQ 789) must equal zero. Reserved Form 1040 - When Form 8396 Block (SEQ 985) equals "X", Form 8396 must be present. Form 1040 - When Form 3800 Block (SEQ 1000) equals "X", Form 3800 must be present. | Pg 115 | PAGE Pg 111 o 0244 o 0245 o o 0246-0249 Reserved 0250 o Schedule D - When Investment Capital Gain (SEQ 1870) is significant, Form 4952 must be present. Investment Capital Gain (SEQ 1870) of Schedule D must equal Investment Capital Gain (SEQ 036) from Form 4952. Form 8615 - Child Taxable Income (SEQ 100) must equal Taxable Income (SEQ 820) from Form 1040/1040A. Form 1040/1040A - When Form 8615 is present, Tax (SEQ 915) of Form 1040 or Tax (SEQ 860) of Form 1040A must equal Form 8615 Tax (SEQ 290) from Form 8615. Form 8615 - Parent Filing Status (SEQ 060) must equal "1", "2", "3", "4", or "5". Reserved Form 8615 - Gross Unearned Income (SEQ 070) must be greater than $1500. Form 8615 - Child Name (SEQ 010) must equal Name Line 1 (SEQ 060) of Form 1040/1040A. Form 8615 - Parent Name (SEQ 040) and Parent SSN (SEQ 050) must be significant. Form 8615 - Child SSN (SEQ 020) must be significant and within the valid ranges of SSN/ITIN's. Refer to Attachment 8 for valid ranges of Social Security/Taxpayer Identification Numbers. Tax Form - When Workfare Payments Literal (SEQ 376) equals "WP", Workfare Payments Amount (SEQ 377) must be significant, and vice versa. Form 1040 - When Form 8814 is present, Form 8814 Block (SEQ 853) of Form 1040 must equal "X" and Form 8814 Amount (SEQ 857) of Form 1040 must be significant. When Form 8814 Block (SEQ 853) equals "X", Form 8814 must be present and Form 8814 Amount (SEQ 857) must be significant. Pg 155 Pg 155 Pg 155 Pg 155 Pg 99, 120 0251 o 0252 o Pg 97, 99, 155 Pg 97, 112 Pg 155 0253 o 0254 o 0255 o 0256 o 0257 o 0258 o 0259 o Pg 105 0260 o Pg 115 Publication 1346 August 30, 2002 Part I Page 257 ATTACHMENT 1 ERROR REJECT CODE (ERC) CROSS REFERENCES ERC 0261 o Form 8814 Indicator Form 8814 the first DESCRIPTION - When one Form 8814 is present, Multiple F8814 (SEQ 030) cannot be significant. When more than one is present, Multiple F8814 Indicator (SEQ 030) of Form 8814 must be significant. PAGE Pg 97, 157 o 0262 o 0263 o Form 8814 Amount (SEQ 857) of Form 1040 must equal Form 8814 Tax (SEQ 220) from Form(s) 8814. Form 8814 - Child Taxable Unearned Income (SEQ 170) must be greater than $750 and less than $7500. Form 1040 - If Form 1040 Other Income (SEQ 200) of Form 8814 is significant, then Type of Other Income (SEQ 560) of Form 1040 must equal "FORM 8814" and Total Other Income (SEQ 590) of Form 1040 must be significant. Form 8814 - When Tax Exempt Literal (SEQ 040) is significant, Tax Exempt Amount (SEQ 050) must be significant. When Nominee Dist. Literal 1 (SEQ 060) is significant, Nominee Dist. Amount 1 (SEQ 070) must be significant. When Non-Taxable Literal (SEQ 080) is significant, Non-Taxable Amount (SEQ 090) must be significant. Form 8814 - When Nominee Dist. Literal 2 (SEQ 120) is significant, Nominee Dist. Amount 2 (SEQ 130) must be significant. Form 8814 - Child Name (SEQ 010) must be significant. Child SSN (SEQ 020) must be must be significant and within the valid ranges of SSN/ITIN/ATIN's. Refer to Attachment 8 for valid ranges of Social Security/Taxpayer Identification Numbers. Form 8814 - Tax Amount Basis (SEQ 210) cannot be less than zero. When Tax Amount Basis (SEQ 210) is greater than zero and less than $750, Form 8814 Tax (SEQ 220) must be significant. When Tax Amount Basis (SEQ 210) is equal to or greater than $750, Form 8814 Tax (SEQ 220) must equal $75. Pg 157 Pg 157 Pg 115 0264 o o o 0265 o Pg 157 0266 o Pg 157 0267 o Pg 157 0268-0269 Reserved 0270 o 0271 o Form 1040 - When Form 4972 Block (SEQ 880) equals "X", Form 4972 must be present. Form 4972 - None of the following fields can equal "X": Distribution of Qualified Plan No Box (SEQ 026), Rollover Yes Box (SEQ 030), Prior Yr Distribution Yes Box (SEQ 190), and Beneficiary Distribution Yes Box (SEQ 201). All of the following fields must equal "X": Distribution of Qualified Plan Yes Box (SEQ 024), Rollover No Box (SEQ 040), and Prior Yr Distribution No Box (SEQ 200). Form 4972 - Only one of the following fields can equal "X": Beneficiary of Qual Participant No Box (SEQ 044) or Qual Age Five Yr Member No Box (SEQ 086). Reserved Pg 147 Pg 115 Pg 146 o 0272 o 0273-274 Publication 1346 August 30, 2002 Part I Page 258 ATTACHMENT 1 ERROR REJECT CODE (ERC) CROSS REFERENCES ERC 0275 o DESCRIPTION Form 4972 – At least one of the following fields must be significant: Capital Gain Election (SEQ 220), Ordinary Income (SEQ 240), 10 Yr Method Average Tax (SEQ 690). Form 4972 - Recipient SSN (SEQ 020) from the second Form 4972 cannot equal Recipient SSN (SEQ 020) of the first Form 4972. Form 1040 - When Other Tax Literal (SEQ 1110) equals "ADT", Form 4970 must be present, and vice versa. Reserved Form 4972 - For each of the following, one box must equal "X", but both cannot equal "X": Beneficiary of Qual Participant Yes Box (SEQ 042)/Beneficiary of Qual Participant No Box (SEQ 044); Qual Age - Five Yr Member Yes Box (SEQ 084)/Qual Age - Five Yr Member No Box (SEQ 086). Schedule B/Schedule 1 - When Excludable Savings Bond Interest (SEQ 289) is significant, Form 8815 must be present. Excludable Savings Bond Interest (SEQ 289) of Schedule B/Schedule 1 must equal Excludable Savings Bond Interest (SEQ 290) from Form 8815. Form 1040/1040A - When Filing Status (SEQ 130) equals "3", Form 8815 cannot be present. Form 8815 - Taxable Expenses (SEQ 190) must be greater than zero. Form 8815 - If Filing Status (SEQ 130) of Form 1040/1040A equals "2" or "5", then Modified AGI (SEQ 240) of Form 8815 must be less than $116400. If Filing Status equals "1" or "4", then Modified AGI (SEQ 240) must be less than $72600. Reserved Form 1040 - If schedule D is present and no Schedule J is present, and Tax (SEQ 2236) of Schedule D is significant, then Tax (SEQ 915) of Form 1040 must equal or be greater than Tax (SEQ 2236) of Schedule D. Schedule E - When Non Passive Activity Literal (SEQ 1130) is present, Non Passive Activity Amount (SEQ 1140) must be present, and vice versa. Form 1040 - When F8828 Literal (SEQ 1123) equals "FMSR", Form 8828 must be present. When F8828 Amount (SEQ 1124) is significant, Recapture Tax Due (SEQ 280) of Form 8828 must be significant, and vice versa. Form 8828 - Original Loan Closing Date (SEQ 100) cannot be before January 1, 1991 (01011991). Form W-2 - When Advance EIC Payment (SEQ 200) is significant, taxpayer cannot file Form 1040EZ. Pg 158 Pg 126 Pg 115 PAGE Pg 147 0276 o 0277 o 0278 o 0279 o Pg 147 Pg 115 Pg 146 Pg 147 0280 o Pg 99, 119 0281 o 0282 o 0283 o Pg 112 Pg 157 Pg 157 | | 0284 o 0285 o 0286 o Pg 121 0287 o o 0288 o 0289 o Pg 115 Publication 1346 August 30, 2002 Part I Page 259 ATTACHMENT 1 ERROR REJECT CODE (ERC) CROSS REFERENCES ERC 0290 o DESCRIPTION Form W-2 - Employer State (SEQ 073) and Employer Zip Code (SEQ 075) must be significant and valid. Employer Zip Code (SEQ 075) must be consistent with Employer State (SEQ 073). Form W-2G - Payer's State (SEQ 024) and Payer's Zip Code (SEQ 025) must be significant and valid. Payer's Zip Code (SEQ 025) must be consistent with Payer's State (SEQ 024). Form W-2GU - Employer State (SEQ 073) and Employer Zip Code (SEQ 075) must be significant and valid. Employer Zip Code (SEQ 075) must be consistent with Employer State (SEQ 073). Form 1099-G - Payer's State (SEQ 070) and Payer's Zip Code (SEQ 080) must be significant and valid. Payer's Zip Code (SEQ 080) must be consistent with Payer's State (SEQ 070). Form 1099-R - Payer's State (SEQ 042) and Payer's Zip Code (SEQ 044) must be significant and valid. Payer's Zip Code (SEQ 044) must be consistent with Payer's State (SEQ 042). Exception: This check is not performed when Employer State (SEQ 073) of Form W-2 and/or W-2GU, Payer’s State (SEQ 024) of Form W-2G, Payer’s State (SEQ 070) of Form 1099-G and/or Payer’ State (SEQ 042) of Form 1099-R contain a period (.), indicating a foreign address. See Section 7.06 for foreign address format. Form W-2 - Employer City (SEQ 070) must contain at least three characters. | | | | | | | | PAGE Pg 126, 127,130, 131 o o o o o 0291 o Pg 126 0292-0293 Reserved 0294 o 0295 o Form 1099-G – Tax Year Other Than Current Year (SEQ 0190) cannot equal the current processing year. Form W-2 – Neither Withholding (SEQ 130) nor Social Security Tax (SEQ 150) of the combined W-2(s) and/or W-2GU(s) can be greater than 1/2 (50%) of Wages (SEQ 120). Exception: This check is bypassed when Combat Pay has been excluded from Wages. Form W-2G – Withholding (SEQ 050) cannot be greater than 1/2 (50%) of Gross Winnings, etc. (SEQ 040). Form 1099-G – Withholding (SEQ 200) cannot be greater than ½ (50%) of the sum of unemployment compensation (SEQ 170), State or Local Income Tax Refunds, Credits or Offsets (SEQ 180), Taxable Grants (SEQ 220) and Agriculture Payments (SEQ 230). Form 1099-R - Withholding (SEQ 160) cannot be greater than 1/2 (50%) of Gross Distribution (SEQ 110). Form 2441/Schedule 2 - If any field of the following "qualifying person group" is significant, then all fields in that group must be significant: Qualifying Person First Name (SEQ 110, 217); Qualifying Person Last Name (SEQ 115, 218); Qualifying Person Name Control (SEQ 120, 221); and Qualifying Person SSN (SEQ 214, 223). Reserved Pg 135 | | | | | | Pg 130 Pg 126, | 127,130, 131 o o o 0296 o 0297 o Publication 1346 August 30, 2002 Part I Page 260 ATTACHMENT 1 ERROR REJECT CODE (ERC) CROSS REFERENCES ERC 0298 o DESCRIPTION Form 2441/Schedule 2 - When Qualifying Person SSN (SEQ 214, 223) is significant, it must be within the valid ranges of SSN/ITIN/ATIN's. Refer to Attachment 8 for valid ranges of Social Security/Taxpayer Identification Numbers. Tax Form - RAL Indicator (SEQ 1465) must equal "Y" or "N". RAL Indicator (SEQ 1465) is a required field. PAGE Pg 136 0299 o o Pg 105 0300-0302 Reserved 0303 o Form 1040/1040A - If Amount Owed (SEQ 1290) is greater than zero and ES Penalty Amount (SEQ 1300) is not significant, then Total Tax (SEQ 1138) must be greater than Total Payments (SEQ 1250). Form 1040EZ - If Amount Owed (SEQ 1290) is greater than zero, then Total Tax (SEQ 1256) must be greater than Total Payments (SEQ 1250). Pg 105 o 0304-0349 Reserved for Electronically Transmitted Documents (ETD) 0350 o o o 0351 o Form 8853 - Policyholder SSN (SEQ 289) must be numeric and within the valid range for an SSN or an ITIN. Insured SSN (SEQ 310) must be numeric and within the valid range for an SSN or an ITIN. Refer to Attachment 8 for valid ranges of Social Security/Taxpayer Identification Numbers. Form 8853 - MSA Acct Holder SSN (SEQ 009) must equal either the Primary SSN (SEQ 010) or the Secondary SSN (SEQ 030) of Form 1040. Pg 161 Pg 160 0352-0354 Reserved 0355 o Form 8853 – If Employer Contributions - Yes (SEQ 140) equals "X", then Total Employer Contributions for Current Tax Year (SEQ 160) must be significant. If Total Employer Contributions for Current Tax Year (SEQ 160) is significant, then Employee Contributions-Yes (SEQ 140) must equal “X”. Form 8853 - If Employer Contributions - Yes (SEQ 140) equals "X", then Employer Contributions - No (SEQ 150) must be blank, and vice versa. Both cannot be blank. Form 1040 – Archer MSA Deduction (SEQ 632) must equal Medical Savings Account Deduction (SEQ 200) from Form 8853, when either field is significant. Reserved Pg 160 0356 o Pg 161 0357 o Pg 96, 115 0358 o Publication 1346 August 30, 2002 Part I Page 261 ATTACHMENT 1 ERROR REJECT CODE (ERC) CROSS REFERENCES ERC 0359 o DESCRIPTION Form 8853 - One box of the following pairs must equal "X", both cannot equal "X", and both cannot equal space: - Payments or Death Benefits - Yes (SEQ 320) - Payments or Death Benefits - No (SEQ 330) and - Insured Terminally Ill - Yes (SEQ 340) - Insured Terminally Ill - No (SEQ 350). Form 1040 - If Type of Other Income (SEQ 560) equals "MSA" and the corresponding Amount of Other Income (SEQ 570) is present, then Form 8853 must be present. If Taxable MSA Distributions (SEQ 250) of Form 8853 is significant, then Type of Other Income (SEQ 560) of Form 1040 must equal "MSA" and the corresponding Amount of Other Income (SEQ 570) of Form 1040 must be present. Form 1040 - If Other Tax Literal (SEQ 1110) equals "MSA" and the corresponding Other Tax Amount (SEQ 1112) is present, then Form 8853 must be present. If Total Taxable MSA Distributions (SEQ 270) of Form 8853 is significant, then Other Tax Literal (SEQ 1110) of Form 1040 must equal "MSA" and the corresponding Other Tax Amount (SEQ 1112) of Form 1040 must be present. Form 8853 – If Taxable MSA Distributions (SEQ 250) is significant, then the Exceptions to 15% Tax box (SEQ 260) or Total Taxable MSA Distributions (SEQ 270) must be significant. Form 8853 - If Taxable MSA Distributions (SEQ 250) is significant, then either Exceptions to 15% Tax Box (SEQ 260) or Total Taxable MSA Distributions (SEQ 270) must be significant. Form 1040 - If Type of Other Income (SEQ 560) equals "LTC" and the corresponding Amount of Other Income (SEQ 570) is present, then Form 8853 must be present. If Taxable Payments (SEQ 450) of Form 8853 is greater than zero, then Type of Other Income (SEQ 560) must equal "LTC" and the corresponding Amount of Other Income (SEQ 570) must be present. Pg 161 Pg 116 -| PAGE Pg 161 0360 o Pg 115 o 0361 o o 0362 o 0363 o Pg 161 0364 o Pg 116 o 0365-0369 Reserved 0370 o Form 1040/1040A - When any occurrence of Eligibility for Child Pg 112 Tax Credit (SEQ 178, 188, 198, 208, 218) is significant, the -| corresponding Relationship (SEQ 177, 187, 197, 207, 217) must -| equal either CHILD, SON, DAUGHTER, GRANDCHILD, or FOSTERCHILD and the Dependent's age must be under 17. Reserved Form 1040/1040A - When Child Tax Credit (SEQ 940/SEQ 955) is significant, at least one Eligibility for Child Tax Credit (SEQ 178, 188, 198, 208, 218) must equal "X". Pg 112 -| 0371 o 0372 o Publication 1346 August 30, 2002 Part I Page 262 ATTACHMENT 1 ERROR REJECT CODE (ERC) CROSS REFERENCES ERC 0373 o DESCRIPTION Form 1040/1040A - When Additional Child Tax Credit (SEQ 1186) is significant, one or more Eligibility for Child Tax Credit (SEQ 178, 188, 198, 208, 218) must equal "X" and Form 8812 must be present. PAGE Pg 112 -| o When Form 8812 is present, Additional Child Tax Credit (SEQ 1186) must be significant and one or more Eligibility for Child Tax Credit (SEQ 178, 188, 198, 208, 218) must equal "X". -| Form 1040/1040A - When Form 8812 is present, Additional Child Tax Credit (SEQ 1186) of Form 1040/1040A must equal Additional Child Tax Credit (SEQ 140) from Form 8812. Pg 98, 112 0374 o 0375-0378 Reserved 0379 o Form 8863 - The student entries in Part I and in Part II must begin on Line 1 in each part. No lines may be skipped when completing the student information in either part. Form 8863 - Student's SSN (SEQ 035, 105, 175, 275, 315, 355, 395, 435) may be used only once to claim an education credit (Hope or Lifetime Earning). No Student's SSN may be used in Part I (Hope Credit) and Part II (Lifetime Learning Credit). Student's SSN must be within the valid ranges of SSN/ITIN/ATIN's. Refer to Attachment 8 for valid ranges of Social Security/Taxpayer Identification Numbers. Form 8863 - When student data is present in either Part I or Part II, each of the following fields must be significant for each student: Student's First Name, Student's Last Name, Student's Name Control, Student's SSN. (See Part II Record Layouts for Field Numbers.) Form 1040/1040A - If Education Credits (SEQ 935/950) is significant, Form 8863 must be present. If Form 8863 is present, Education Credits (SEQ 935/950) must be significant. Pg 162 0380 o Pg 162 0381 o Pg 162 0382 o Pg 112 0383 o Pg 162 Form 8863 - To be eligible for Education Credit, the student must be either the Primary taxpayer, Spouse or a dependent. On Form 8863, each Student's SSN must equal either the Primary SSN (SEQ 010), the Secondary SSN (SEQ 030) or one of the -| Dependent SSN's (SEQ 175, 185, 195, 205, 215). When the dependent information is on a statement, the Dependent SSN's from the statement are part of the requirement. Form 1040/1040A - When the filing status is "Married Filing Joint" and Education Credits (SEQ 935/950) is significant, the Adjusted Gross Income (SEQ 750) must be less than $102,000. When the filing status is "Single" or "Head of Household" and Education Credits (SEQ 935/950) is significant, the Adjusted Gross Income (SEQ 750) must be less than $51,000. Form 8863 - Qualified Expenses Paid in the Current Tax Year (SEQ 040, 110, 180) for each student may not be over $2000. Pg 112 | | Pg 162 0384 o 0385 o Publication 1346 August 30, 2002 Part I Page 263 ATTACHMENT 1 ERROR REJECT CODE (ERC) CROSS REFERENCES ERC 0386 o DESCRIPTION Form 1040/1040A - When Adjusted Gross Income (SEQ 750) plus Student Loan Interest Deduction (SEQ 628) is more than $130,000 for "Married Filing Joint" or is more than $65,000 for "Single" or "Head of Household" or "Qualifying Widow(er)", the Student Loan Interest Deduction (SEQ 628) is not allowed. Form 1040/1040A - The Education Credits cannot exceed $5500. Form 8863 - Hope Scholarship Credit (SEQ 240) cannot exceed $4500. Lifetime Learning Credit (SEQ 470) cannot exceed $1000. Form 1040/1040A - When Student Loan Interest Deduction (SEQ 628) is significant, the filing status cannot equal "Married Filing Separately". Form 1040/1040A - Student Loan Interest Deduction (SEQ 628) must not exceed $2500. Schedule J – Amount from Line 6 (SEQ 100) must equal One-third Elected Farm Income (SEQ 060). One-third Elected Farm Income (SEQ 140) must equal One-third Elected Farm Income (SEQ 060). Schedule J – The following fields must contain an amount greater than or equal to zero: SEQ 040, SEQ 060, SEQ 070, SEQ 080, SEQ 120, SEQ 160, SEQ 180, SEQ 190, SEQ 200, and SEQ 210. Schedule J – Taxable Income (SEQ 010) must equal Taxable Income (SEQ 820) of Form 1040. Schedule J - When Add Lines 4,8,12,and 16 (SEQ 170) is greater than zero, then one of the following fields must be greater than zero: Tax on Line 3 (SEQ 040) or Tax on Line 7 (SEQ 080) or Tax on Line 11 (SEQ 120) or Tax on Line 15 (SEQ 160). Reserved Pg 124 Pg 112 PAGE Pg 112 | 0387 o o Pg 112, 162 0388 o 0389 o 0390 o o Pg 112 Pg 124 0391 o 0392 o 0393 o Pg 97, 124 Pg 124 0394 o Publication 1346 August 30, 2002 Part I Page 264 ATTACHMENT 1 ERROR REJECT CODE (ERC) CROSS REFERENCES ERC 0395 o o 0396 o DESCRIPTION Form Payment - Primary SSN (SEQ 010) must equal Primary SSN (SEQ 010) of the Tax Form. When Filing Status (SEQ 130) equals "2", Secondary SSN (SEQ 020) must equal Secondary SSN (SEQ 030) of the Tax Form. Form Payment - Routing Transit Number (SEQ 030) (RTN) must contain numeric characters. The first two positions must be 01 through 12, or 21 through 32; the RTN must be present on the Financial Organization Master File (FOMF); and the banking institution must process Electronic Funds Transfer (EFT). See Section 6 for optional Routing Transit Number validation. Bank Account Number (SEQ 040) must be present, must be alphanumeric (i.e., only alpha characters, numeric characters, and hyphens), must be left-justified with trailing blanks if less than 17 positions, and cannot equal all zeros or all blanks. Type of Account (SEQ 050) must equal "1" or "2". Form Payment – (Balance Due Payments) When the return is transmitted to the IRS on or before April 15 of the current processing year, the Requested Payment Date (SEQ 080) cannot be later than April 15. When the return is transmitted to IRS after April 15, the Requested Payment Date (SEQ 080) cannot be later than the current processing date. The year of the Requested Payment Date (SEQ 080) must equal the current processing year. The Requested Payment Date cannot be prior to the current processing date minus five days. Form Payment (Estimated Payments) – The Requested Payment Date (SEQ 080) must be one of the following: 20030415 or 20030616, or | 20030915. If the process date is before April 23 of the current processing year, the Requested Payment Date (SEQ 080) must be 20030415, or 20030616, or 20030915. | If the process date is April 23 through June 23, 2003 of the current processing year, the Requested Payment Date (SEQ 080) must be 20030616, or 20030915. If the process date is June 23, 2003 through September 22, 2003 of the current processing year, the Requested Payment Date (SEQ 080) must be 20020915. The process date cannot be greater than September 23, 2003. The year of the Requested Payment Date (SEQ 080) must equal the current processing year. | | | | | Pg 167 Pg 167 Pg 166 PAGE Pg 166 o o 0397 o o o o 0398 o o o o o o Publication 1346 August 30, 2002 Part I Page 265 ATTACHMENT 1 ERROR REJECT CODE (ERC) CROSS REFERENCES ERC DESCRIPTION PAGE 0399 o 0400 o o 0401 o State Record (State Only Returns) – The Primary SSN (SEQ 0010) must match the Primary SSN (SEQ 0010) of Form 1040. State Record – The Generic Record must be present in the state data packet. An Unformatted Record was present without the Generic Record, or the Unformatted Record preceded the Generic Record. State Record – The State Code (SEQ 010) in the Header Section of the Generic Record must be valid for the processing service center. The State Code must be consistent throughout Generic and associated Unformatted Records for the return. State Record – All “Required Entry” fields in the Entity Section of the Generic Record (SEQ 060, 075, 085, 095, 100) must be present. State Record – Any entry present in the Consistency Section of the Generic Record must equal the corresponding federal Tax Form entry. State Record – The DCN (SEQ 020) of the Generic Record must equal the DCN of the federal Tax Form. The DCN (SEQ 020) of the Generic Record must equal the DCN (SEQ 020) of the Unformatted Record. State Record Form W-2 – Each Form W-2 associated with a State Record must contain a valid State Abbreviation in State Name (SEQ 370, 440) when there is a significant entry in State Income Tax (SEQ 400, 470). The EFIN cannot contain an “out of service center” District Office (DO). The DO contained in the EFIN of Originator (SEQ 8b) must be valid for the Processing Site (SEQ 040) of the TRANS Record A (TRANA) of the transmission. Exception: An “out of service center” District Office (DO) is permitted when State Data is present; or when Processing Site equals “C” (Andover) and at least one of the following is present: Form 2555, Form 2555-EZ, Form 4563, Form 5074, Form 8689, and/or Form W-2GU an Address Ind (SEQ 097) of the Tax Form equal to “3”; a State Abbreviation (SEQ 087) of the Tax Form equal to “AS”, “GU”, “MP”, “PR”, or “VI”. State Record – The Return Sequence Number (RSN) (SEQ 023) of the Generic Record must equal the RSN of the Federal Tax Form. State Record – When On-Line-State-Return (SEQ 049) of the Generic Record is equal to “O”, the Transmission Type Code (SEQ 170) of the TRANS Record A (TRANA) must equal “O”, and vice versa. | | Pg 173 Pg 173, 190 Pg 173, 190 o 0402 o Pg 173, 190 Pg 173 190 Pg 173, 191 0403 o 0404 o o 0405 o Pg 173, 191 0406 o o Pg 136, 145, 147, 156, 174 191 | 0407 o 0408 o Pg 174, 191 Pg 174, 191 Publication 1346 August 30, 2002 Part I Page 266 ATTACHMENT 1 ERROR REJECT CODE (ERC) CROSS REFERENCES ERC 0409 o DESCRIPTION Tax Form – When Foreign Employer Compensation Literal (SEQ 0378) | equals “FEC”, then Foreign Employer Compensation Total (SEQ | 0379) must be significant and the FEC Record must be present. | When the FEC Record is present, then Foreign Employer Compensation Literal (SEQ 0378) must equal “FEC” and Foreign Employer Compensation Total (SEQ 0379) must be significant. 0410 o 0411 o | | | Pg 174 Pg 128 PAGE Pg 105, 178 State Only Record – If the RTN is present, it must be present on | the Financial Organization Master File (FOMF). | FEC Record – The SSN or ITIN of Employee of Foreign Employer (SEQ 0010) must match the Primary SSN (SEQ 0010) of the Tax Form and the Employee Name Control (SEQ 0020) must match the Primary Name Control (SEQ 0050) of the Tax Form or The SSN or ITIN of Employee of Foreign Employer (SEQ 0010) must match the Secondary SSN (SEQ 0030) of the Tax Form and the Employee Name Control (SEQ 0020) must match the Spouse’s Name Control (SEQ 0055) of the Tax Form. FEC Record – The following fields must be significant: Address (SEQ 0050) and City (SEQ 0060), and The following fields must be significant: State Abbreviation (SEQ 0070) and Zip Code (SEQ 0080) or Foreign Country (SEQ 0110). Street | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | 0412 o Pg 128 0413 o FEC Record – The Foreign Employer's Name (SEQ 0140) and the Foreign Employer's Street Address (SEQ 0160), Foreign Employer's City (SEQ 0170), and Foreign Employer's Country (SEQ 0200) must be significant. FEC Record – The Post of Duty Code (SEQ 0130) must be significant and either equal to a valid Post of Duty Code or “00” . FEC Record – If Services Performed While Residing in U.S. Yes Ind (SEQ 0120) is equal to “X”, then the Post of Duty Code (SEQ 0130) must equal “00” and If the Post of Duty Code (SEQ 0130) is equal to “00”, then Services Performed While Residing in U.S. Yes Ind (SEQ 0120) must equal “X”. Pg 128 0414 o Pg 128 0415 o Pg 128 0416 o Summary Record – Number of FEC Records (SEQ 0075) must equal the | number of FEC Records computed by the IRS. | Pg 175 Publication 1346 August 30, 2002 Part I Page 267 ATTACHMENT 1 ERROR REJECT CODE (ERC) CROSS REFERENCES ERC DESCRIPTION PAGE 0417 o Tax Form – If Earned Income Credit (SEQ 1180) is significant, then the FEC Record cannot be present and Foreign Employer Compensation Literal (SEQ 0378) and Foreign Employer Compensation Total (SEQ 0379) must be blank. Tax Form – Foreign Employer Compensation Total (SEQ 0379) must equal the total of Foreign Employer Compensation Amount (SEQ 220) from the FEC Record(s). State Record – If Address Ind (SEQ 0097) on the Tax Return is equal to “3” (indicating a foreign country), then the following fields must be present: Name Line (SEQ 0060), Foreign Street Address (SEQ 0077), Foreign City, State or Province, Postal Code (SEQ 0087), and Foreign Country (SEQ 0098); and the following fields cannot be present: Name Line 2 (SEQ 0065), Street Address (SEQ 0080), City (SEQ 0085), State Abbreviation (SEQ 0095) and Zip Code (SEQ 0100). If Address Ind (SEQ 0097) on the Tax Return is not equal to “3”, then the following fields cannot be present: Name Line (SEQ 0060), Foreign Street Address (SEQ 0077), Foreign City, State or Province, Postal Code (SEQ 0087), and Foreign Country (SEQ 0098). Form 1040 – When Form 4136 Block (SEQ 1205) is equal to “X”, Form 4136 must be present, and vice versa. | | | | | | | | | | | | | | | | | | | | Pg 105 0418 o Pg 105 0419 o Pg 174 o 0420 o 0421 o Pg 116 Pg 174, 180 State Record (State Only Returns) – The Secondary SSN (SEQ 0055) | must match the Secondary SSN (SEQ 0030) of Form 1040. | Publication 1346 August 30, 2002 Part I Page 268 ATTACHMENT 1 ERROR REJECT CODE (ERC) CROSS REFERENCES ERC 0422 o DESCRIPTION Form 4136 – When any of the “amount of credit” fields is greater than zero, then at least one of the associated “gallons” fields must be significant. For example: When Nontaxable Use of Gasoline Credit Amount (SEQ 070) is greater than zero, at least one of the following must be significant: SEQ 010 or 020 or 040 or 060. When Nontaxable Use of Gasohol 10% Credit Amount (SEQ 100) is greater than zero, Gasohol 10% Alcohol Gallons (SEQ 090) must be significant. When Nontaxable Use of Gasohol 7.7% Credit Amount (SEQ 130) is greater than zero, Gasohol 7.7% Alcohol Gallons (SEQ 120) must be significant. When Nontaxable Use of Gasohol 5.7% Credit Amount (SEQ 160) is greater than zero, Gasohol 5.7% Alcohol Gallons (SEQ 150) must be significant. When Nontaxable Use of Commercial Aviation Gas Tax Credit Amt (SEQ 180) is greater than zero, then Commercial Aviation Gasoline Gallons (SEQ 170) must be significant. When Nontaxable Use of Aviation Gas Tax Credit Amount (SEQ 230) is greater than zero, then (SEQ 200 or 220) must be significant. When Nontaxable Use of Diesel Fuel Credit Amount (SEQ 300) is greater than zero, then at least one of the following must be significant: (SEQ 270 or 290). When Nontaxable Diesel Fuel Train Use Credit Amount (SEQ 320) is greater than zero, then Diesel Fuel Train Use Gallons (SEQ 310) must be significant. When Diesel Fuel Certain Intercity and Local Bus Use Credit Amount (SEQ 340) is greater than zero, then Diesel Fuel Certain Intercity and Local Bus Use Gallons (SEQ 330) must be significant. When Nontaxable Use of Kerosene Credit Amount (SEQ 410) is greater than zero, then at least one of the following must be significant: (SEQ 380 or 400). When Nontaxable Kerosene Train Use Credit Amount (SEQ 430) is greater than zero, then Kerosene Train Use Gallons (SEQ 420) must be significant. When Kerosene Certain Intercity and Local Bus Use Credit Amount (SEQ 455) is greater than zero, then Kerosene Certain Intercity and Local Bus Use Gallons (SEQ 440) must be significant. PAGE Pg 141, 142 o o o o o o o o o o o o Publication 1346 August 30, 2002 Part I Page 269 ATTACHMENT 1 ERROR REJECT CODE (ERC) CROSS REFERENCES ERC 0422 o o (continued) When Nontaxable Use of Commercial Aviation Fuel Credit Amount (SEQ 470) is greater than zero, then Commercial Aviation fuel Gasoline Gallons (SEQ 460) must be significant. When Nontaxable Use of Aviation Fuel Other $.219 Credit Amount (SEQ 500) is greater than zero, then Nontaxable Use of Aviation Fuel Gallons – 1 (SEQ 490) must be significant. When Nontaxable Use of Aviation Fuel Tax Credit Amount (SEQ 530) is greater than zero, then Nontaxable Use of Aviation Fuel Gallons – 2 (SEQ 520) must be significant. When Sales by Vendors of Undyed Diesel Credit Amount (SEQ 600) is greater than zero, then at least one of the following must be significant: (SEQ 580 or 590). When Sales by Vendors of Undyed Kerosene Credit Amount (SEQ 680) is greater than zero, then at least one of the following must be significant: (SEQ 650, 660, or 670). When Use of LPG in Certain Intercity and Local Buses Credit Amt (SEQ 700) is greater than zero, then Certain Intercity and Local Buses Gallons (SEQ 690) must be significant. When Use of LPG in Qualified Local and School Buses Credit Amount (SEQ 720) is greater than zero, then Qualified Local and School Buses Gallons (SEQ 710) must be significant. When Gasohol Blenders 10% Credit Amount (SEQ 750) is greater than zero, then Gasohol Blenders 10% Alcohol Gallons (SEQ 740) must be significant. When Gasohol Blenders 7.7% Credit Amount (SEQ 780) is greater than zero, then Gasohol Blenders 7.7% Alcohol Gallons (SEQ 770) must be significant. When Gasohol Blenders 5.7% Credit Amount (SEQ 810) is greater than zero, then Gasohol Blenders 5.7% Alcohol Gallons (SEQ 800) must be significant. 0423 o Form 4136 – If Evidence of Dyed Diesel Fuel Exception Box (SEQ 250) equals “X”, Evidence of Dyed Diesel Fuel Explanation (SEQ 240) must equal “STMbnn” and vice versa. Pg 142 DESCRIPTION PAGE o o o o o o o o Publication 1346 August 30, 2002 Part I Page 270 ATTACHMENT 1 ERROR REJECT CODE (ERC) CROSS REFERENCES ERC 0424 o DESCRIPTION Form 4136 – If Evidence of Dyed Diesel Fuel Exception Box (SEQ 570) equals “X”, then the Evidence of Dyed Diesel Fuel Explanation (SEQ 560) must equal “STMbnn” and the Undyed Diesel Fuel UV Registration No (SEQ 550) must be significant. If Evidence of Dyed Diesel Fuel Explanation (SEQ 560) equal “STMbnn”, then the Evidence of Dyed Diesel Fuel Exception Box (SEQ 570) must equal “X”, and the Undyed Diesel Fuel UV Registration No (SEQ 550) must be significant. If Evidence of Dyed Kerosene Exception Box (SEQ 640) equals “X”, then Evidence of Dyed Kerosene Explanation (SEQ 630) must equal “STMbnn” and at least one of the following must be significant: Undyed Kerosene UV Registration No (SEQ 610), or Undyed Kerosene UP Registration No (SEQ 620). If Evidence of Dyed Kerosene Explanation (SEQ 630) equals “STMbnn”, then Evidence of Dyed Kerosene Exception Box (SEQ 640) must equal “X”, and at least one of the following must be significant: Undyed Kerosene UV Registration No (SEQ 610) or Undyed Kerosene UP Registration No (SEQ 620). Note: For Error Code 424 only; when both an Explanation and the Exception Box are met, then there must be a Registration Number. Form 4136 – If Total Income Tax Credit Amount (SEQ 820) is significant, then at least one of the “credit amounts” (SEQ 070, 100, 130, 160, 180, 230, 240, 300, 320, 340, 410, 430, 455, 470, 500, 530, 600, 680, 700, 720, 750, 780 or 810) must be significant. Form 1040 – Other Payments (SEQ 1210) must equal the total of Tax Paid by Regulated Investment Company (SEQ 230) from Form 2439 plus Total Income Tax Credit Amount (SEQ 820) from Form 4136. Pg 143 PAGE Pg 143 o o o o 0425 o 0426 o Pg 98, 116 Publication 1346 August 30, 2002 Part I Page 271 ATTACHMENT 1 ERROR REJECT CODE (ERC) CROSS REFERENCES ERC 0427 o DESCRIPTION Form 4136 – When any of the “gallons” fields is greater than zero, then the associated “type of use” field must be significant. For example: When Nontaxable Use of Gasoline Gallons (SEQ 040 or 060) is greater than zero, then Nontaxable Use of Gasoline Type (SEQ 030 or 050) must be significant. When Gasohol 10% Alcohol Gallons (SEQ 090) is greater than zero, then Gasohol 10% Alcohol Type (SEQ 080) must be significant. When Gasohol 7.7% Alcohol Gallons (SEQ 120) is greater than zero, then Gasohol 7.7% Alcohol Type (SEQ 110) must be significant. When Gasohol 5.7% Alcohol Gallons (SEQ 150) is greater than zero, then Gasohol 5.7% Alcohol Type (SEQ 140) must be significant. When Nontaxable Use of Aviation Gasoline Gallons (SEQ 200 or 220) is greater than zero, then Nontaxable Use of Aviation Gasoline Type (SEQ 190 or 210) must be significant. When Nontaxable Use of Diesel Fuel Gallons (SEQ 270 or 290) is greater than zero, then Nontaxable Use of Diesel Fuel Type (SEQ 260 or 280) must be significant. When Nontaxable Use of Kerosene Gallons (SEQ 380 or 400) is greater than zero, then Nontaxable Use of Kerosene Type (SEQ 370 or 390) must be significant. When Nontaxable Use of Aviation Fuel Gallons (SEQ 490 or 520) is greater than zero, then Nontaxable Use of Aviation Fuel Type (SEQ 480 or 510) must be significant. PAGE Pg 144 o o o o o o o o 0428-0429 Reserved 0430 o 0431 o 0432 o Reserved Reserved Form 8271 – When Form 8271 is present, one of the following Tax Shelter group items must be present on the first occurrence: Tax Shelter Name – 1 (SEQ 030) or Tax Shelter Registration Number –1 (SEQ 040) or Name of Person Who Applied for Registration –1 (SEQ 050) or Tax Shelter Identifying Number –1 (SEQ 060). Pg 151 0433-0434 Reserved 0435 o o Form 8582-CR - When Multiply Line 11 by 50% (SEQ 200) is significant, it cannot be greater then $25,000. When Multiply Line 23 by 50% (SEQ 330) is significant, it cannot be greater then $25,000. Pg 153 Publication 1346 August 30, 2002 Part I Page 272 ATTACHMENT 1 ERROR REJECT CODE (ERC) CROSS REFERENCES ERC 0436 o DESCRIPTION Form 8582-CR - When Special Allowance for Rental Activity (SEQ 210) is significant, Form 8582 must be present. When Special Allowance for Rental Activity (SEQ 340) is significant, Form 8582 must be present. 0437 o Form 8582-CR – Modified Adjusted Gross Income (SEQ 310) cannot be less than zero. Summary Record – For On-Line Returns, the IP Address (SEQ 190) must be present and must contain at least one period and cannot contain alpha characters. Pg 153 PAGE Pg 153 0438 o Pg 175 0439-0445 Reserved 0446 o Form 4136 – When Undyed Diesel Fuel UV Registration No (SEQ 550) is present, then Use of Undyed Diesel for Farming Purpose Gallons (SEQ 580) or Use of Undyed Diesel by State or Local Gov Gallons (SEQ 590) must be present, and vice versa. Form 4136 – When Undyed Kerosene UV Registration No (SEQ 610) is present, then Use of Undyed Kerosene for Farming Purpose Gallons (SEQ 650) or Use of Undyed Kero by State or Local Gov Gallons (SEQ 660) must be present, and vice versa. When Other Sales of Undyed Kerosene Gallons (SEQ 670) is present, then Undyed Kerosene UP Registration No (SEQ 620) must be present and vice versa. 0448-0449 Reserved 0450 o 0451 o Form 8606 – Nondeductible IRA Name (SEQ 009) and SSN of Taxpayer with IRAs (SEQ 010) must be significant. Form 8606 – Nondeductible IRA Name (SEQ 009) must contain a less-than sign immediately preceding the last name. If the name includes a suffix, another less-than sign is entered between the last name and the suffix. Allowable characters are: Alpha, hyphen (-), less-than (<), and space. Nondeductible IRA Name (SEQ 009) cannot contain the following: Two or more consecutive embedded spaces, a space or less-than sign in the first position, a less-than sign in the last position, more than two less-than signs, a space preceding or following a less-than sign. Form 2555/2555EZ – When only one Form 2555/2555EZ is present, Taxpayer SSN (SEQ 007) must equal Primary SSN (SEQ 010) or Secondary SSN (SEQ 030) of Form 1040. When two Forms 2555/2555EZ are present, Taxpayer SSN (SEQ 007) of the first Form 2555/2555EZ must equal Primary SSN (SEQ 010) of Form 1040 and Taxpayer SSN (SEQ 007) of the second Form 2555/2555EZ must equal Secondary SSN (SEQ 030) of Form 1040. One occurrence of either Form 2555 or Form 2555EZ can be present for the Primary SSN (SEQ 010). One occurrence of either Form 2555 or Form 2555EZ can be present for the Secondary SSN (SEQ 030). Pg 136 Pg 154 Pg 154 Pg 144 0447 o Pg 144 o 0452 o o Publication 1346 August 30, 2002 Part I Page 273 ATTACHMENT 1 ERROR REJECT CODE (ERC) CROSS REFERENCES ERC 0453 o 0454 o 0455 o DESCRIPTION Form 2555EZ – Total Foreign Earned Income (SEQ 1210) cannot exceed $80,000. Form 1040 – Earned Income Credit (SEQ 1180) cannot be significant when Form 2555 or Form 2555EZ is present. Form 2555 – Foreign Earned Income Exclusion (SEQ 1220) cannot exceed Foreign Earned Income (SEQ 1050). Foreign Earned Income Repeated (SEQ 1070) must equal Foreign Earned Income (SEQ 1050). Form 2555EZ – Max. Of Foreign Earned Inc. Exclusion (SEQ 1260) cannot exceed $80,000 Total Foreign Earned Income (SEQ 1210). Form 1040 – When Housing/Foreign Earned Income Exclusion Literal (SEQ 574) equals “FORM 2555”, Form 2555 must be present. When Housing/Foreign Earned Income Exclusion Literal (SEQ 574) equals “FORM 2555-EZ”, Form 2555EZ must be present. Form 1040 – The absolute value of Housing/Foreign Earned Income Exclusion Amount (SEQ 577) must equal the total of the following fields: Max. of Housing and Foreign Earned Inc. Exclusions (SEQ 1260) from Form 2555(s) plus Max. of Foreign Earned Inc. Exclusion (SEQ 1260) from Form(s) 2555EZ. Form 1040 – When Other Adjustments Literal (SEQ 720) equals “FORM 2555”, Form 2555 must be present. Form 1040 – If Other Adjustments Literal (SEQ 720) equals “FORM 2555”, then Other Adjustment Amount (SEQ 730) must equal Total Housing Deduction (SEQ 1310) from Form(s) 2555. Pg 96, 116 | Pg 116 | Pg 116 Pg 136 PAGE Pg 136 o 0456 o o 0457 o 0458 o 0459 o Pg 116 Pg 96, 116 Publication 1346 August 30, 2002 Part I Page 274 ATTACHMENT 1 ERROR REJECT CODE (ERC) CROSS REFERENCES ERC 0460 o DESCRIPTION Form 2555/2555-EZ – Taxpayers must qualify for the Foreign Exclusion under the Bona Fide Residence or Physical Presence test. Both tests will be verified prior to the return being accepted. This Error Reject Code will be set in any case where the taxpayer did not qualify under either of the tests. Form 2555 – When the taxpayer is qualifying under Bona Fide Residence: When Date Bona Fide Residence Ended (SEQ 225) is equal to 1231 of the current tax year or is equal to “CONTINUE”, then Date Bona Fide Residence Began (SEQ 220) must equal 0101 of the current tax year or must be prior to the current tax year or When Date Bona Fide Residence Ended (SEQ 225) is prior to 1231 of the current tax year (i.e., 10312002), then Date Bona Fide Residence Began (SEQ 220) must equal 0101 of the previous tax year or earlier than the previous tax year (i.e., 01012001). Form 2555 – When the taxpayer is qualifying under Physical Presence: The difference, in number of days, between Physical Presence Test From (SEQ 530) and Physical Presence Test Through (SEQ 540) minus the total of Number of Days in US on Business – 1 through – 4 (SEQ 610, 670, 730, 790) must be at least 330 days. Form 2555EZ – When the taxpayer is qualifying under Bona Fide Residence: When Date Bona Fide Residence Ended (SEQ 040) is equal to 1231 of the current tax year or is equal to “CONTINUE”, then Date Bona Fide Residence Began (SEQ 030) must equal 0101 of the current tax year or must be prior to the current tax year Or When Date Bona Fide Residence Ended (SEQ 040) is prior to 1231 of the current tax year (i.e., 10312002), then Date Bona Fide Residence Began (SEQ 030) must equal 0101 of the previous tax year or earlier than the previous tax year (i.e., 01012001). Form 2555EZ – When the taxpayer is qualifying under Physical Presence: The difference, in number of days, between Physical Presence Test From (SEQ 070) and Physical Presence Test Through (SEQ 080) minus the total of Number of Days in US on Business – 1 through – 9 (SEQ 310, 350, 390, 430, 470, 510, 550, 590, 630) must be at least 330 days. Form 2555 – Statement to Authorities – Yes (SEQ 300) and Req’d to Pay Income Tax – No (SEQ 330) cannot both be significant. Form 2555 – If No Travel Statement (SEQ 560) is significant, then the following fields cannot be significant: Country Name (SEQ 570), Arrival Date (SEQ 580), Departure Date (SEQ 590), Full Days in Country (SEQ 600), Number of Days in US on Business (SEQ 610), and Income Earned in the US on Business (SEQ 620). Pg 137 Pg 138 PAGE Pg 137 o o o o o 0461 o 0462 o Publication 1346 August 30, 2002 Part I Page 275 ATTACHMENT 1 ERROR REJECT CODE (ERC) CROSS REFERENCES ERC 0463 o DESCRIPTION Form 2555 – Foreign Address (SEQ 010) must be significant. Post of Duty (SEQ 015) must be significant and equal to a valid Post of Duty code. Form 2555EZ – Foreign Address (SEQ 110) must be significant. Post of Duty (SEQ 115) must be significant and equal to a valid Post of Duty code. Refer to Attachment 9 for Post of Duty Codes. Form 2555 – If Separate Foreign Residence – Yes (SEQ 170) is significant, then Yes – City & Country of Foreign Residence (SEQ 190) and Number of Days at That Address (SEQ 200) must be significant. Form 2555 – Housing Exclusion (SEQ 1140) cannot be greater than Employer-Provided Amounts (SEQ 1120). Form 2555 – Total Housing and Foreign Earned Income Exclusions (SEQ 1230) must equal the total of Housing Exclusion (SEQ 1140) plus Foreign Earned Income Exclusion (SEQ 1220). Form 2555EZ – If Bona Fide Residence – Yes (SEQ 010) is significant, then Date Bona Fide Residence Began (SEQ 030) and Date Bona Fide Residence Ended (SEQ 040) must be significant. Form 2555EZ – If Physically Present – Yes (SEQ 050) is significant, then Physical Presence Test From (SEQ 070) and Physical Presence Test Through (SEQ 080) must be significant. Form 2555EZ – Tax Home Test – Yes (SEQ 090) must be significant. Form 2555EZ – For each of the following, only one box can equal “X”: Bona Fide Residence – Yes (SEQ 010) or Bona Fide Residence – No (SEQ 020); Physically Present – Yes (SEQ 050) or Physically Present – No (SEQ 060); Revoked Exclusions – Yes (SEQ 220) or Revoked Exclusions – No (SEQ 230). If no Form 2555/2555EZ Box (SEQ 0210) is checked, then Revoked Exclusions -Yes (SEQ 0220) and Revoked Exclusions - No (SEQ 230) should not be significant. Form 2555 – Part II or Part III must be present, but not both. Form 2555/2555EZ – Must be processed at the Andover Service Center. | | | Pg 138 Pg 138 Pg 138 PAGE Pg 138 o o 0464 o 0465 o 0466 o Pg 138 Pg 138 0467 o Pg 138 0468 o Pg 138 0469 o 0470 o Pg 138 Pg 138 o 0471 o 0472 o 0473-0474 Reserved 0475 o 0476 o Reserved Schedule EIC – The following fields cannot equal “X”: Disabled “No” Box – 1 (SEQ 045) or Disabled “No” Box – 2 (SEQ 115). Pg 157 Pg 122 0477-0479 Reserved Publication 1346 August 30, 2002 Part I Page 276 ATTACHMENT 1 ERROR REJECT CODE (ERC) CROSS REFERENCES ERC DESCRIPTION PAGE 0480 o Form 8839 – When Identifying Number Child (SEQ 080, 160) is significant, it must be within the valid ranges of SSN/ITIN/ATIN’s. Refer to Attachment 8 for valid ranges of Social Security/Taxpayer Identification Numbers. Form 8839 – Eligible Child First Name – 1 (SEQ 010), Eligible Child Last Name – 1 (SEQ 020), Eligible Child Name Control – 1 (SEQ 030), Year of Birth – 1 (SEQ 040), and Identifying Number Child – 1 (SEQ 080) must be significant. If any field of the following “eligible child group” is significant, then all fields in that group must be significant: Eligible Child First Name (SEQ 010, 090); Eligible Child Last Name (SEQ 020, 100); Eligible Child Name Control (SEQ 030, 110); Year of Birth (SEQ 040, 120); and Identifying Number Child (SEQ 080, 160). Eligible Child Name Control (SEQ 030, 110) must be in the correct format. See Section 7.01 for Name Control format. Form 8839 – Year of Birth – 1 (SEQ 040) and Year of Birth – 2 (SEQ 120) cannot be greater than current tax year. Form 8839 – Identifying Number equal Identifying Number Child Number Child – 1 (SEQ 080) and (SEQ 160) cannot equal Primary (SEQ 030) of Form 1040/1040A. Child – 2 (SEQ 160) cannot – 1 (SEQ 080). Identifying Identifying Number Child – 2 SSN (SEQ 010) or Secondary SSN Pg 159 0481 o Pg 159 o o 0482 o 0483 o Pg 159 Pg 159 0484 o Form 8839 – If Year of Birth – 1 or – 2 (SEQ 040, 120) is prior to “1984”, then the corresponding Disabled Over 18 Box – 1 or –2 (SEQ 049, 129) must equal “X”. Form 8839 – Modified AGI (SEQ 240) must be less than $190,000. Form 1040/1040A – When Adoption Credit (SEQ 960) is significant, Form 8839 must be present. Reserved Pg 159 | | Pg 159 Pg 112 | Pg 160 0485 o 0486 o 0487 o 0488-0489 Reserved 0490 o Summary Record – If Year of the Electronic Postmark Date (SEQ 260) is present, Year of Electronic Postmark Date must equal the current processing year. Pg 175 Publication 1346 August 30, 2002 Part I Page 277 ATTACHMENT 1 ERROR REJECT CODE (ERC) CROSS REFERENCES ERC DESCRIPTION PAGE 0491 o Summary Record – If one of the three fields is present, then all of the following fields must be present: Electronic Postmark Date (SEQ 260), Electronic Postmark Time (SEQ 270), Electronic Postmark Time Zone (SEQ 280). Reserved Summary Record – Software Identification Number (SEQ 230) must be present. Form 1040 – If Form 8689 Amount (SEQ 1246) is significant, then Form 8689 must be present. Form 1040 – If Filing Status (SEQ 0130) is not equal to “2”, then only one Form 4563 can be present. Form 1040 – If Filing Status (SEQ 0130) is equal to “2”, then two Forms 4563 can be present. Form 4563 – When only one Form 4563 is present, Taxpayer Identification Number (SEQ 0003) must equal Primary SSN (SEQ 0010) or Secondary SSN (SEQ 0030) of Form 1040. When two Forms 4563 are present, Taxpayer Identification Number (SEQ 0003) of the first Form 4563 must equal Primary SSN (SEQ 0010) of Form 1040 and Taxpayer Identification Number (SEQ 0003) of the second Form 4563 must equal Secondary SSN (SEQ 0030) of Form 1040. Pg 175 0492 o 0493 o Pg 175 0494 o Pg 116 0495 o Pg 116 o 0496 o Pg 145 o 0497-0499 Reserved 0500 o 0501 o Primary SSN (SEQ 010) and Primary Name Control (SEQ 050) of the Tax Form must match data from the IRS Master File. Qualifying SSN (SEQ 015, 085) of Schedule EIC and the corresponding Year of Birth (SEQ 020, 090) must match data received from the Social Security Administration. Qualifying SSN (SEQ 015, 085) of Schedule EIC and the corresponding Qualifying Child Name Control (SEQ 007, 077) must match data from the IRS Master File. Employer Identification Number (SEQ 040) of Form W-2 and/or W-2GU, Payer Identification Number (SEQ 026) of Form W-2G, Payer Identification Number (SEQ 090) of Form 1099-G and Payer Identification Number (SEQ 050) of Form 1099-R must match data from the IRS Master File. Secondary SSN (SEQ 030) and Spouse’s Name Control (SEQ 055) of the Tax Form must match data from the IRS Master File. Dependent’s SSN (SEQ 175, 185, 195, 205, 215) of Form 1040/1040A and corresponding Dependent Name Control (SEQ 172, 182, 192, 202, 212) must match data from the IRS Master File. | Pg 91 | | Pg 91 Pg 91 o 0502 o 0503 o 0504 o Pg 91 -| Pg 91 -| Publication 1346 August 30, 2002 Part I Page 278 ATTACHMENT 1 ERROR REJECT CODE (ERC) CROSS REFERENCES ERC 0505 o DESCRIPTION Employer Identification Number (SEQ 040) of Form W-2 and/or | W-2GU, or Payer Identification Number (SEQ 026) of Form W-2G, | Payer Identification Number (SEQ 090) of Form 1099-G or Payer | Identification Number (SEQ 050) of Form 1099-R was issued in the current processing year. Qualifying SSN (SEQ 015, 085) of Schedule EIC was previously used for the same purpose. PAGE Pg 91 0506 o Pg 91 0507 o Dependent’s SSN (SEQ 175, 185, 195, 205, 215) of Form 1040/1040A -| Pg 92 was previously used for the same purpose. Primary SSN (SEQ 010) has been used as a Secondary SSN (SEQ 030) on another return with filing status 2-Married filing joint status (SEQ 130); or Secondary SSN (SEQ 030) has been used as a Primary SSN on another return. Secondary SSN (SEQ 030) was previously used as a Dependent’s SSN or as a Schedule EIC Qualifying SSN on a previous or current return; or Dependent’s SSN was used as a Secondary SSN on a previous or current return; or Schedule EIC Qualifying SSN was used as a Secondary SSN on a current or previous return. Primary SSN (SEQ 010) and/or Secondary SSN (SEQ 030) where the SSN was claimed as an exemption (SEQ 160) on the return and was also used as a Dependent’s SSN (SEQ 175, 185, 195, 205, 215) on another return. Primary SSN (SEQ 010) was used with the Filing Status (SEQ 130) other than “3” or “4”, and was also used as a Secondary SSN (SEQ 030) on another return with filing status value “3”. Student’s Name Control (SEQ 030, 100, 170, 270, 310, 350, 390, 430) of Form 8863 and corresponding Student’s SSN (SEQ 035, 105, 175, 275, 315, 355, 395, 435) of Form 8863 must match data from the IRS Master File. Secondary SSN (SEQ 030) was used as a Secondary SSN more than once. Insured Name Control (SEQ 295) and Insured SSN (SEQ 310) of Form 8853 must match data from the IRS Master File. Primary SSN (SEQ 010) was used as a Primary SSN more than once. Pg 92 0508 o 0509 o Pg 92 0510 o Pg 92 -| 0511 o Pg 92 0512 o Pg 92 0513 o 0514 o 0515 o Pg 92 Pg 92 Pg 92 Publication 1346 August 30, 2002 Part I Page 279 ATTACHMENT 1 ERROR REJECT CODE (ERC) CROSS REFERENCES ERC DESCRIPTION PAGE 0516 o Primary SSN (SEQ 0010) and the Primary Name Control (SEQ 0050) | | of the State-Only 1040 Return must match data from the IRS | Master File. Secondary SSN (SEQ 0030) and the Secondary Name Control (SEQ 0055) of the State-Only 1040 Return must match data from the IRS Master File. Form 1310 – The Name Control of Person Claiming Refund (SEQ 0050) and the SSN of Person Claiming Refund (SEQ 0070) must match data from the IRS Master File. Form 8697 - Employer Identification Number of Entity (SEQ 150) and Employee Name Control (SEQ 155) on Form 8697, must match data from the IRS Master File. Employer Name Control (SEQ 015) and Employer Identification Number (SEQ 030) of Schedule H must match data from the IRS Master File. | | | | | | Pg 92, 180 Pd 92, 180 Pg 132 0517 o 0518 o 0519 o Pg 156 0520 o Pg 92 0521 o Year of Birth for the following cannot equal the current Pg 92 processing year: Primary SSN (SEQ 010) and Secondary SSN (SEQ 030) of the Tax Form; Dependent's SSN (SEQ 175, 185, 195, 205, 215) of Form 1040/1040A; and Qualifying SSN - 1 (SEQ 015) -| and Qualifying SSN - 2 (SEQ 085) of Schedule EIC. Primary Date of Birth (SEQ 010) in the Authentication Record of an On-Line Return does not match data from the IRS Master File. Spouse Date of Birth (SEQ 040) in the Authentication Record of an On-Line Return does not match data from the IRS Master File. Qualifying Person Name Control - 1, - 2 (SEQ 120, 221) and Qualifying Person SSN - 1, - 2 (SEQ 214, 223) of Form 2441/Schedule 2 do not match data from the IRS Master File. Eligible Child Name Control - 1, - 2 (SEQ 030, 110) and Identifying Number Child - 1, - 2 (SEQ 080, 160) of Form 8839 do not match data from the IRS Master File. Qualifying Person SSN - 1, - 2 (SEQ 214, 223) of Form 2441/Schedule 2 was previously used for same purpose. Identifying Number Child - 1, - 2 (SEQ 080, 160) of Form 8839 was previously used for same purpose. Student's SSN (SEQ 035, 105, 175, 275, 315, 355, 395, 435) of Form 8863 was previously used to claim Education Credit on another tax return. Pg 168 0522 o 0523 o Pg 168 0524 o Pg 92 0525 o Pg 93 0526 o 0527 o 0528 o Pg 93 Pg 93 Pg 93 0529-0599 Reserved 0600 o Tax Form - IRS Master File indicates that the taxpayer must file Form 8862 to Claim Earned Income Credit after disallowance. Form 8862 is missing from the tax return and it is required. Pg 93 Publication 1346 August 30, 2002 Part I Page 280 ATTACHMENT 1 ERROR REJECT CODE (ERC) CROSS REFERENCES ERC 0601 o 0602 o 0603 o Reserved Form 8862- Year for Which You Are Filing This Form (SEQ 010) must equal the current tax year. Form 8862 - Qualifying Child of Another Person (SEQ 030) must equal "X". If Qualifying Child of Another Person (SEQ 030) does not equal "X", the taxpayer is not eligible to file Form 8862 and claim Earned Income Credit. Form 8862 - When Schedule EIC is not present, Beginning Date Your Home in the USA (SEQ 040) or Beginning Date Your Spouse Home in the USA (SEQ 050) of Form 8862 must be present. Form 8862 - When Schedule EIC is present, Relationship Yes Box–1 (SEQ 060) or Relationship No Box-1 (SEQ 070) of Form 8862 must be present. Tax Form – IRS Master File indicates that the taxpayer is not allowed to claim the Earned Income Credit for this tax year. Form 8866 – If more than one Form 8866 is present, then only the first occurrence of Form 8866 can have significant data in Total Interest Due on Increase (SEQ 430) or Total Interest to be Refunded on Decrease (SEQ 440). Pg 161 Pg 161 DESCRIPTION PAGE 0604 o Pg 161 0605 o Pg 161 0606 o 0607 o Pg 105 Pg 165 0608-0609 Reserved 0610 o Tax Form - If Address Ind (SEQ 097) is equal to "3" (indicating a foreign country), then the following fields must be present: Foreign Street Address (SEQ 062), Foreign City, State or Province, Postal Code (SEQ 064), and Foreign Country (SEQ 066); and the following fields cannot be present: Name Line 2 (SEQ 070), Street Address (SEQ 080), City (SEQ 083), State Abbreviation (SEQ 087), and Zip Code (SEQ 095). If Address Ind (SEQ 097) is not equal to "3", then the following fields cannot be present: Foreign Street Address (SEQ 062), Foreign City, State or Province, Postal Code (SEQ 064), and Foreign Country (SEQ 066). 0611 o Tax Form - Foreign Street Address (SEQ 062) is alphanumeric and cannot have leading or consecutive embedded spaces. The only special characters permitted are space, hyphen (-), and slash (/). Tax Form - Foreign City, State or Province, Postal Code (SEQ 064) is alphanumeric and cannot have leading or consecutive embedded spaces. The left-most position must contain an alpha or numeric character. The only special characters permitted are space, hyphen (-), and slash (/). Tax Form - Foreign Country (SEQ 066) must be left justified and must contain a minimum of three alpha characters. This field cannot contain consecutive embedded spaces and must contain only alpha characters and spaces. Do not abbreviate the country name. Pg 105 Pg 105 0612 o Pg 106 0613 o Pg 106 Publication 1346 August 30, 2002 Part I Page 281 ATTACHMENT 1 ERROR REJECT CODE (ERC) CROSS REFERENCES ERC 0614 o DESCRIPTION Tax Form - Earned Income Credit (SEQ 1180) cannot be significant when State Abbreviation (SEQ 087) equals "AS", "GU", "MP", "PR", or "VI", or when Address Ind (SEQ 097) equals "3". Tax Form - If State Abbreviation (SEQ 087) equals "AS", "GU", "MP", "PR", or "VI"; or Address Ind (SEQ 097) equals "3"; or any of the following forms are present: Form 4563, Form 5074, Form 8689 and/or Form W-2GU, then the return must be processed at Andover Service Center. Form W-2 – When Employee Address Continuation (SEQ 105) is significant, then a period (.) must be present in Employee State (SEQ 113). Form W-2G – When Winner’s Address Continuation (SEQ 143) is significant, then a period (.) must be present in Winners’ State (SEQ 146). Form W-2GU – When Employee Address Continuation (SEQ 105) is significant, then a period (.) must be present in Employee State (SEQ 113). Form 1099-G – When Recipient’s Address Continuation (SEQ 125) is significant, then a period (.) must be present in Recipient's State (SEQ 140). Form 1099R – When Recipient’s Address Continuation (SEQ 080) is significant, then a period (.) must be present in Recipient’s State (SEQ 092). | | | | | | PAGE Pg 106 0615 o Pg 106 0616 o Pg 126, 127, 130 o o o o 0617-0618 Reserved 0619 o Form 8379 – First Injured Spouse Box (SEQ 030) and Second Injured Spouse Box (SEQ 060) cannot both equal "X" and cannot both equal blank. Form 8379 – When Form 8379 is present, the following fields must be significant: either First Injured Spouse Box (SEQ 030) or Second Injured Spouse Box (SEQ 060), and either Community Property State–Yes Box (SEQ 150) or Community Property State–No Box (SEQ 160). Pg 151 0620 o Pg 151 Publication 1346 August 30, 2002 Part I Page 282 ATTACHMENT 1 ERROR REJECT CODE (ERC) CROSS REFERENCES ERC DESCRIPTION PAGE 0621 o Form 8379 – When Community Property State Yes Box (SEQ 150) is equal to “X”, one or more of the following community state’s abbreviation must be significant: SEQ 161 SEQ 162 SEQ 163 SEQ 164 SEQ 165 SEQ 166 SEQ 167 SEQ 168 and/or SEQ 169 Community Community Community Community Community Community Community Community Property Property Property Property Property Property Property Property State State State State State State State State Abbreviation Abbreviation Abbreviation Abbreviation Abbreviation Abbreviation Abbreviation Abbreviation for for for for for for for for Arizona; California; Idaho; Louisiana; Nevada; New Mexico; Texas; Washington; Pg 152 Community Property State Abbreviation for Wisconsin. o 0622 o See Attachment 5 – Community Property States Abbreviations Form 8379 – When Total Other Income-Joint Return (SEQ 210) is significant, then the sum of Total Other Income-Injured Spouse (SEQ 220) and Total Other Income-Other Spouse (SEQ 230) must equal Total Other Income-Joint Return (SEQ 210). Form 8379 – When Standard Deduction-Joint Return (SEQ 510) is significant, then the following cannot be present: Itemized Deduction-Joint Return (SEQ 540), Itemized Deduction-Injured Spouse (SEQ 550) or Itemized Deduction-Other Spouse (SEQ 560). Form 8379 – When Itemized Deduction-Joint Return (SEQ 540) is significant, then the sum of Itemized Deduction-Injured Spouse (SEQ 550) and Itemized Deduction-Other Spouse (SEQ 560) must equal Itemized Deduction-Joint Return (SEQ 540). Form 8379 – When Exemptions-Joint Return (SEQ 570) is present, then either Exemptions-Injured Spouse (SEQ 580) or ExemptionsOther Spouse (SEQ 590) must be present and Exemptions-Joint Return (SEQ 570) must equal Total Exemptions (SEQ 360) of Form 1040/1040A. Form 8379 – When Credits-Joint Return (SEQ 600) is present, then the sum of Credits-Injured Spouse (SEQ 610) and Credits-Other Spouse (SEQ 620) must equal Credits-Joint Return (SEQ 600). Form 8379 – When Estimated Tax Payments-Joint Return (SEQ 690) is significant, the sum of Estimated Tax Payments-Injured Spouse (SEQ 700) and Estimated Tax Payments-Other Spouse (SEQ 710) must equal Estimated Tax Payments-Joint Return (SEQ 690). Form 8379 – When Form 8379 is present, Form 2555/2555EZ must not be present. Pg 152 0623 o Pg 152 0624 o Pg 152 0625 o Pg 152 0626 o Pg 152 0627 o Pg 152 0628 o Pg 152 Publication 1346 August 30, 2002 Part I Page 283 ATTACHMENT 1 ERROR REJECT CODE (ERC) CROSS REFERENCES ERC 0629 o DESCRIPTION Form 8379 – When Form 8379 is present, the following fields on Form 1040/1040A/1040EZ must not be present: Foreign Street Address (SEQ 062), Foreign City, State or Province (SEQ 064), or Foreign Country (SEQ 066). Form 8379 – When Form 8379 is present, the State Abbreviation (SEQ 087) of Form 1040/1040A/1040EZ cannot equal “AS”, “GU”, “MP”, “PR”, or “VI”. Form 8379 – When 8379 is present, Filing Status (SEQ 130) of Form 1040/1040A must equal “2” (Married Filing Joint) or Secondary SSN (SEQ 030) of Form 1040EZ must be present. PAGE Pg 152 0630 o Pg 153 0631 o Pg 153 Publication 1346 August 30, 2002 Part I Page 284 ATTACHMENT 1 ERROR REJECT CODE (ERC) CROSS REFERENCES ERC DESCRIPTION PAGE 0632 o Form 5471 – When Category of Filer-3 (SEQ 135) is significant, Category 3 Attachment (SEQ 136) must equal "STMbnn". When Other Income (Functional Currency) (SEQ 2110) or Other Income (U.S. Dollars) (SEQ 2130) is significant, Attach Schedule-Other Income (SEQ 2140) must equal "STMbnn". When Other Deductions (Functional Currency) (SEQ 2290) or Other Deductions (U.S. Dollars) (SEQ 2310) is significant, Attach Schedule-Other Deductions (SEQ 2320) must equal "STMbnn". When Other Current Assets – Beginning (SEQ 2770) or Other Current Assets - End (SEQ 2790) is significant, Other Current Assets (Attach Schedule) (SEQ 2800) must equal "STMbnn". When Investment In Subsidiaries – Beginning (SEQ 2830) or Investment In Subsidiaries – End (SEQ 2850) is significant, Investment In Subsidiaries (Attach Schedule)(SEQ 2860) must equal "STMbnn". When Other Investments – Beginning (SEQ 2870) or Other Investments – End (SEQ 2890) is significant, Other Investments (Attach Schedule) (SEQ 2900) must equal "STMbnn". When Other Assets – Beginning (SEQ 3090) or Other Assets – End (SEQ 3110) is significant, Other Assets (Attach Schedule) (SEQ 3120) must equal "STMbnn". When Other Current Liabilities – Beginning (SEQ 3170) or Other Current Liabilities – End (SEQ 3190) is significant, Other Current Liabilities (Attach Schedule) (SEQ 3200) must equal "STMbnn". When Other Liabilities – Beginning (SEQ 3230) or Other Liabilities – End (SEQ 3250) is significant, Other Liabilities (Attach Schedule) (SEQ 3260) must equal "STMbnn". When Paid-in or Capital Surplus – Beginning (SEQ 3305) or Paid-in or Capital Surplus – End (SEQ 3315) is significant, Paid-in or Capital Surplus (Attach Reconciliation) (SEQ 3320) must equal "STMbnn". When Own 10% Interest in a Partnership – Yes (SEQ 3410) is significant, Own 10% Yes Attachment (SEQ 3425) must equal "STMbnn". When Own Foreign Entities – Yes (SEQ 3450) is significant, Own Foreign Entities Yes Attachment (SEQ 3465) must equal "STMbnn". When Other Earnings (Net Additions) (SEQ 3620) or Other Earnings (Net Subtractions) (SEQ 3630) is significant, Other Earnings (Attach Schedule) (SEQ 3635) must equal "STMbnn". Pg 148, o o o o o o o o o o o o Publication 1346 August 30, 2002 Part I Page 285 ATTACHMENT 1 ERROR REJECT CODE (ERC) CROSS REFERENCES ERC o o (continued) When Income of Foreign Corporation Blocked (Yes Box) (SEQ 3790) or Did Any Become Unblocked (Yes Box) (SEQ 3800) is significant, Statement (If Yes, Explain) (SEQ 3810) must equal "STMbnn". Form 5471 – The following fields must be positive: SEQs 2730, 2740, 2930, 2940, 2970, 2980, 3070, 3080, 3350 and 3360. Schedule N (Form 5471) – If Deduction for Dividends Paid During Tax Year (SEQ 750) is significant, then Deduction for Dividends Paid During Tax Year (SEQ 750) must equal Deduction for Dividends Paid (SEQ 640). Reserved Form 8865 – When Category 2 Filer (SEQ 090) is significant, at least one Schedule K-1 (Form 8865) must be present. Form 8865 – Business Activity Code (SEQ 690) must be within the valid range (111100 – 813000). Form 8865 – When Owns Direct Interest (SEQ 1040) is significant, all of the following fields must be significant: Name Constructive Ownership (SEQ 1050), Address Constructive Ownership (SEQ 1060), City Constructive Ownership (SEQ 1070), State Constructive Ownership (SEQ 1080), Zip Code Constructive Ownership (SEQ 1090) and Identifying Number Constructive Ownership (SEQ 1100). Form 8865 – When Total (SEQ 2240) is significant, Gross Receipts or Sales (SEQ 2220) or Less Returns and Allowances (SEQ 2230) must be significant. Form 8865 – When Gross Profit (SEQ 2260) is significant, Total (SEQ 2240) or Cost of Goods Sold (SEQ 2250) must be significant. Form 8865 – When Net Farm Profit (Loss) (SEQ 2280) is significant, Schedule F (Form 1040) must be present. Form 8865 – When Total Income (Loss) (SEQ 2310) is significant, one of the following fields must be significant: Gross Profits (SEQ 2260), Ordinary Income (Loss) (SEQ 2270), Net Farm Profit (Loss) (SEQ 2280), Net Gain (Loss)(SEQ 2290) or Other Income (Loss) (SEQ 2300). | -| Pg 149 DESCRIPTION PAGE 0633 o 0634 o Pg 149 0635 o 0636 o Pg 162 Pg 162 0637 o 0638 o Pg 162 Pg 162 0639 o Pg 162 0640 o Pg 162 0641 o Pg 163 0642 o Pg 163 Publication 1346 August 30, 2002 Part I Page 286 ATTACHMENT 1 ERROR REJECT CODE (ERC) CROSS REFERENCES ERC 0643 o DESCRIPTION Form 8865 – When Total Deductions (SEQ 2450) is significant, one of the following fields must be significant: Salaries & Wages (SEQ 2320), Guaranteed Payments to Partners (SEQ 2330), Repairs & Maintenance (SEQ 2340), Bad Debts (SEQ 2350), Rent(SEQ 2360), Taxes & Licenses (SEQ 2370), Interest (SEQ 2380), Depreciation (SEQ 2390), Less Depreciation Reported on Schedule A (SEQ 2400), Depletion (SEQ 2410), Retirement Plans (SEQ 2420), Employee Benefit Programs (SEQ 2430) or Other Deductions (SEQ 2440). Form 8865 – When Net Short-Term Capital Gain or (Loss) (SEQ 2750) is significant, Net Short-Term Capital Gain or (Loss) (SEQ 3230) or Other Income (Loss) (SEQ 3300) must be significant. Form 8865 – When Combine Lines 6-10 in Column (g) (SEQ 3120) is significant, 28% Rate Gain (Loss) (SEQ 3250) or Other Income (Loss) (SEQ 3300) must be significant. Form 8865 – When Net Long-Term Capital Gain or (Loss) (SEQ 3130) is significant, Net Long-Term Capital Gain or (Loss)(SEQ 3240) or Other Income (Loss) (SEQ 3300) must be significant. Form 8865 – When Net Section 1231 Gain (Loss) (SEQ 3290) is significant, Form 4797 must be present. Form 8865 – When Expenditures Related to Rental Real Estate (SEQ 3390) is significant, Form 3468 must be present. Form 8865 – When Total Foreign Taxes (SEQ 3690) is significant, Foreign Taxes (Paid) (SEQ 3670) or Foreign Taxes (Accrued) (SEQ 3680) must be significant. Form 8865 – Only one of the following fields can be significant: Foreign Taxes (Paid) (SEQ 3670) or Foreign Taxes (Accrued) (SEQ 3680). Form 8586 - If "Eligible Basis of Building(s)" (SEQ 030) is significant, 1 or more Forms 8609 must be present. Form 8586 - If "Qualified Basis of Low-Income Buildings" (SEQ 040) is significant, 1 or more Forms 8609 must be present. Form 8586 - If "Current Year Credit" (SEQ 110) is significant, one or more Forms 8609 must be present. Form 8586 - If "Number of Forms 8609 Attached" (SEQ 020) is significant, a matching number of Forms 8609 must be present and a matching number of Schedules A (Form 8609) must be present Form 8865 – If File Form 1065 (SEQ 0800) is equal to "X", then the EIN Foreign Partnership (SEQ 0650) must be numeric and the first two positions must be equal to a valid District Office Code. Refer to Attachment 7 for EIN's Prefix Codes. | | | | PAGE Pg 163 0644 o Pg 163 0645 o Pg 163 0646 o Pg 163 0647 o Pg 163 0648 o Pg 163 0649 o Pg 163 0650 o Pg 163 0651 o Pg 153 0652 o Pg 153 0653 o Pg 153 0654 o Pg 153 0655 o Pg 163 Publication 1346 August 30, 2002 Part I Page 287 ATTACHMENT 1 ERROR REJECT CODE (ERC) CROSS REFERENCES ERC 0656 o 0657 o Reserved Form 8586 – Flow-through Entity EIN (SEQ 115) must be numeric and the first two digits must equal a valid District Office Code. Refer to Attachment 7 for District Office Codes. Pg 154 DESCRIPTION PAGE 0658-0659 Reserved 0660 o Form 8586 – When Passive Activity or Total Current Year Credit (SEQ 0140) and Net Income Tax (SEQ 300) both contain an entry greater than zero, Form 6251 must be present. Form 8865 – When Number of Foreign Disregarded Entities (SEQ 960) is significant, Attach List of Entities (SEQ 965) must equal "STMbnn". When Ordinary Income (Loss)(SEQ 2270) is significant, Ordinary Income (Loss)(Attach Schedule)(SEQ 2275) must equal "STMbnn". When Other Income (Loss) (SEQ 2300) is significant, Other Income (Loss)(Attach Schedule)(SEQ 2305) must equal "STMbnn". When Other Deductions (SEQ 2440) is significant, Other Deductions (Attach Schedule) (SEQ 2445) must equal "STMbnn". When Expenses From Other Rental Activities (SEQ 3180) is significant, Expenses (Attach Schedule)(SEQ 3185) must equal "STMbnn". When Other Portfolio Income (Loss) (SEQ 3270) is significant, Other Portfolio (Attach Schedule) (SEQ 3275) must equal STMbnn". When Other Income (Loss) (SEQ 3300) is significant, Other Income (Loss) (Attach Schedule) (SEQ 3305) must equal "STMbnn". When Charitable Contributions (SEQ 3310) is significant, Charitable Contributions (Attach Schedule) (SEQ 3315) must equal "STMbnn". When Deductions Related to Portfolio Income (SEQ 3330) is significant, Deductions Related to Portfolio Income (Itemize) (SEQ 3335) must equal "STMbnn". When Other Deductions (SEQ 3340) is significant, Other Deductions (Attach Schedule) (SEQ 3345) must equal "STMbnn". When Other Adjustments & Tax Preference Items (SEQ 3540) is significant, Other Adjustments (Attach Schedule) (SEQ 3545) must equal "STMbnn". Pg 154 0661 o Pg 164, 165 o o o o o o o o o o Publication 1346 August 30, 2002 Part I Page 288 ATTACHMENT 1 ERROR REJECT CODE (ERC) CROSS REFERENCES ERC 0661 o o (continued) When Other Current Assets BOY (SEQ 3940) or Other Current Assets EOY (SEQ 3950) is significant, Other Current Assets (Attach Schedule) (SEQ 3955) must equal "STMbnn". When Other Investments BOY (SEQ 3980) or Other Investments EOY (SEQ 3990) is significant, Other Investments (Attach Schedule) (SEQ 3995) must equal "STMbnn". When Other Assets BOY (SEQ 4200) or Other Assets EOY (SEQ 4210) is significant, Other Assets (Attach Schedule) (SEQ 4215) must equal "STMbnn". When Other Current Liabilities BOY (SEQ 4280) or Other Current Liabilities EOY (SEQ 4290) is significant, Other Current Liabilities (Attach Schedule) (SEQ 4295) must equal "STMbnn". When Other Liabilities BOY (SEQ 4340) or Other Liabilities EOY (SEQ 4350) is significant, Other Liabilities (Attach Schedule) (SEQ 4355) must equal "STMbnn". When Listed Categories BOY (SEQ 4460) or Listed Categories EOY (SEQ 4470) is significant, Listed Categories (Attach Schedule) (SEQ 4475) must equal "STMbnn". When Total Other Increases (SEQ 4690) is significant, Other Increases (Itemize) (SEQ 4685) must equal "STMbnn". When Total Other Decreases (SEQ 4730) is significant, Other Decreases (Itemize) (SEQ 4725) must equal "STMbnn". Form 8865 – The following fields must be positive: SEQs 2320, 2330, 2360, 2370, 2380 and 3100. Schedule K-1 (Form 8865) – The following fields must be positive: SEQs 320, 370, 380, 390, 440 and 480. Authentication Record - When the Transmission Type Code (SEQ 0170) of the TRANA Record is equal to "O", then the PIN Type Code (SEQ 008) must equal either "O" or Blank. Authentication Record - When the Transmission Type Code (SEQ 0170) of the TRANA Record is equal to Blank, then the PIN Type Code (SEQ 008) must equal "P", or "S". Form 8801 - Total Tax Credits (SEQ 220) must be greater than zero. Form 1040 – If Form 8801 Block (SEQ 1005) is equal to “X”, then Form 8801 must be present. Pg 156 Pg 165 DESCRIPTION PAGE o o o o o o o 0662 o 0663 o 0664 o Pg 165 Pg 168 o 0665 o 0666 o Pg 116 Publication 1346 August 30, 2002 Part I Page 289 ATTACHMENT 1 ERROR REJECT CODE (ERC) CROSS REFERENCES ERC DESCRIPTION PAGE 0667 o Form 4797 – If Form 4797 is present and Gain/Loss (Form 8824 Sec 1231) (SEQ 456) or Form 8824 Ordinary Gain/Loss for Entire Yr (SEQ 974) is significant, then Form 8824 must be present. Self-Select PIN Program – The Primary Taxpayer is ineligible to participate in the Self-Select PIN program since the Primary Taxpayer is a duplicate on the IRS File. Self-Select PIN Program – The Secondary Taxpayer is ineligible to participate in the Self-Select PIN program since the Secondary Taxpayer is a duplicate on the IRS File. Authentication Record – When the PIN Type Code (SEQ 008) is equal to "S", then the following fields must be present; Primary Date of Birth (SEQ 010), Primary Prior Year Adjusted Gross Income (SEQ 020), Primary Taxpayer Signature (SEQ 035), Taxpayer Signature Date (SEQ 070), Jurat/Disclosure Code (SEQ 075), PIN Authorization Code (SEQ 080) and ERO EFIN/PIN (SEQ 090). When the Filing Status (SEQ 130) equals “2”, AND the Primary Date of Death (SEQ 020) is significant and the Secondary Date of Death (SEQ 040) on the Tax Return is “NOT” significant, bypass this check. Only the spouse fields are required. Authentication Record – When the PIN Type Code (SEQ 008) is equal to "S" and Filing Status (SEQ 130) is "2" (Married Filing Jointly), then the following fields must be present; Spouse Date of Birth (SEQ 040), Spouse Prior Year Adjusted Gross Income (SEQ 050) and Spouse Signature (SEQ 065). When the Secondary Date of Death (SEQ 040) on the Tax Return is significant and the Primary Date of Death (SEQ 020) is “NOT” significant, bypass this check. Only the primary fields are required. When the Primary Date of Death (SEQ 020) “AND” the Secondary Date of Death (SEQ 040) are significant on the Tax Return, bypass this check. Only the primary fields are required. Authentication Record – When the PIN Type Code (SEQ 008) is equal to “P” or “S”, then the ERO EFIN/PIN (SEQ 090) must be present. When the PIN Type Code (SEQ 008) is equal to “O”, then the ERO EFIN/PIN (SEQ 090) cannot be present. Authentication Record – For On-Line Returns only, when the PIN Type Code (SEQ 008) is blank (No PIN Used), then the Jurat/Disclosure Code (SEQ 075) must equal "B". | | | | | | | | | | | Pg 146 0668 o Pg 216 0669 o Pg 216 0670 o Pg 168 216 o 0671 o Pg 168 216 o o 0672 o Pg 168 216 o 0673 o Pg 168, 216 Publication 1346 August 30, 2002 Part I Page 290 ATTACHMENT 1 ERROR REJECT CODE (ERC) CROSS REFERENCES ERC DESCRIPTION PAGE 0674 o Authentication Record – When the PIN Type Code (SEQ 008) is equal to "P", "S" or "O", then Primary Taxpayer Signature (SEQ 1321) on the Tax Return must be five digits and cannot be all zeros. and The Primary Taxpayer Signature (SEQ 1321) on the Tax Return must match the Primary Taxpayer Signature (SEQ 035) on the Authentication Record. When the PIN Type Code (SEQ 008) is "Blank", then the Primary Taxpayer Signature (SEQ 035) cannot be present. When the Filing Status (SEQ 130) equals “2”, the Primary Date of Death (Seq 020) on the Tax Return is significant and the Secondary Date of Death (SEQ 040) is “NOT” significant, bypass this check. Only the spouse fields are required. Authentication Record – When the PIN Type Code (SEQ 008) is equal to "P", "S" or "O" and the Filing Status (SEQ 130) is “2” (Married Filing Jointly), then Spouse Signature (SEQ 1324) on the Tax Return must be five digits and cannot be all zeros. And The Spouse Signature (SEQ 1324) on the Tax Return must match the Spouse Signature (SEQ 065) on the Authentication Record. When the PIN Type Code (SEQ 008) is "Blank" and when the Filing Status (SEQ 130) is "2" (Married Filing Jointly), then the Primary Taxpayer Signature (SEQ 035) and Spouse Signature (SEQ 065) cannot be present. When the Secondary Date of Death (SEQ 040) on the Tax Return is significant but the Primary Date of Death (SEQ 020) is “NOT” significant, bypass this check. Only the primary fields are required. When the Primary Date of Death (SEQ 020) “AND” the Secondary Date of Death (SEQ 040) are significant on the Tax Return, bypass this check. Only the primary fields are required. | | | | | | | | | | | Pg 169, 217 o o 0675 o Pg 159, 217 o o Publication 1346 August 30, 2002 Part I Page 291 ATTACHMENT 1 ERROR REJECT CODE (ERC) CROSS REFERENCES ERC 0676 o DESCRIPTION Authentication Record – When the PIN Type Code (SEQ 008) is equal to “P”, “S”, or “O” and the Filing Status (SEQ 130) is “2” (Married Filing Jointly), then the Primary Taxpayer Signature (SEQ 035) and Spouse Signature (SEQ 065) both must be present. When the PIN Type Code (SEQ 008) is equal to “P”, “S” or “O” and the Filing Status is other than “2” (Married Filing Jointly), then the Spouse Signature (SEQ 065) cannot be present. When the Secondary Date of Death (SEQ 040) on the Tax Return is significant but the Primary Date of Death (SEQ 020) is “NOT” significant, bypass this check. Only the primary fields are required. When the Primary Date of Death (SEQ 020) “AND” the Secondary Date of Death (SEQ 040) are significant on the Tax Return, bypass this check. Only the primary fields are required. When the Filing Status (SEQ 130) equals “2”, the Primary Date of Death (SEQ 020) on the Tax Return is significant and the Secondary Date of Death (SEQ 040) is “NOT” significant, bypass this check. Only the spouse fields are required. Self-Select PIN Program – The Primary Taxpayer is ineligible to participate in the Self-Select PIN program, if they are under the age of sixteen and has never filed a tax return. Self-Select PIN Program – The Secondary Taxpayer is ineligible to participate in the Self-Select PIN program, if they are under the age of sixteen and did not file a tax return in the previous year. Authentication Record – When the PIN TYPE Code (SEQ 008) is equal to “S” or “O”, the Primary Prior Year Adjusted Gross Income (SEQ 020) must match the Primary Prior Year Adjusted Gross Income on the IRS Master File. When the Filing Status (SEQ 130) equals “2”, the Primary Date of Death (Seq 020) on the Tax Return is significant and the Secondary Date of Death (SEQ 040) is “NOT” significant, bypass this check. Only the spouse fields are required. Authentication Record – When the PIN TYPE Code (SEQ 008) is equal to “S” or “O” and the Filing Status (SEQ 130) is “2” (Married Filing Jointly), the Spouse Prior Year Adjusted Gross Income (SEQ 050) must match the Spouse Prior Year Adjusted Gross Income on the IRS Master File. When the Filing Status (SEQ 130) on the Tax Return equals “2”, and the Secondary Date of Death (SEQ 040) is significant, but the Primary Date of Death (SEQ 020) is “NOT” significant, bypass this check. Only the primary fields are required. | | | | | | | | Pg 170, 218 | | | | | | | | | | | Pg 218 | | Pg 218 | | Pg 170, 218 PAGE Pg 169, 217 o o o o 0677 o 0678 o 0679 o o 0680 o o Publication 1346 August 30, 2002 Part I Page 292 ATTACHMENT 1 ERROR REJECT CODE (ERC) CROSS REFERENCES ERC 0681 o DESCRIPTION Authentication Record – When the PIN Type Code (SEQ 008) is equal to "O", then the following fields must be present; Primary Date of Birth (SEQ 010), Primary Prior Year Adjusted Gross Income (SEQ 020), Primary Taxpayer Signature (SEQ 035), Taxpayer Signature Date (SEQ 070), Jurat/Disclosure Code (SEQ 075) and PIN Authorization Code (SEQ 080). When the Filing Status (SEQ 130) equals “2”, AND the Primary Date of Death (SEQ 020) is significant and the Secondary Date of Death (SEQ 040) on the Tax Return is “NOT” significant, bypass this check. Only the spouse fields are required. Authentication Record – When the PIN Type Code (SEQ 008) is equal to "O" and Filing Status (SEQ 130) is "2" (Married Filing Jointly), then the following fields must be present; Spouse Date of Birth (SEQ 040), Spouse Prior Year Adjusted Gross Income (SEQ 050) and Spouse Signature (SEQ 065). When the Secondary Date of Death (SEQ 040) on the Tax Return is significant and the Primary Date of Death (SEQ 020) is “NOT” significant, bypass this check. Only the primary fields are required. When the Primary Date of Death (SEQ 020) “AND” the Secondary Date of Death (SEQ 040) are significant on the Tax Return, bypass this check. Only the primary fields are required. Authentication Record – When the PIN TYPE Code (SEQ 008) is equal to “P” or “S”, the first six numeric of the ERO EFIN/PIN (SEQ 090) must equal the Electronic Filer ID Number (EFIN) in the Declaration Control Number (DCN)(11 digits total). Authentication Record – When the PIN TYPE Code (SEQ 008) is equal to “P”, “S” or “O”, then the Paper Document Indicator 1 (SEQ 150) or Paper Document Indicator 3 (SEQ 170) or Paper Document Indicator 4 (SEQ 180) or Paper Documents Indicator 5 (SEQ 185) or Paper Document Indicator 6 (SEQ 188) or Paper Documents Indicator 7 (SEQ 189) of Summary Record cannot be present. Summary Record - Number of Preparer Note Records (SEQ 110) must equal the number of preparer notes computed by the IRS. Summary Record - Number of Election Explanation Records (SEQ 120) must equal the number of election explanations computed by the IRS. Summary Record - Number of Regulatory Explanation Records (SEQ 130) must equal the number of regulatory explanations computed by the IRS. Summary Record - Count of Authentication Record (SEQ 140) must equal the count of authentication record computed by the IRS. Authentication Record – The year of Taxpayer Signature Date (SEQ 070) must equal current processing year. | | | | | | | Pg 170, 219 | | | | Pg 170, 218 PAGE Pg 170, 218 o 0682 o o o 0683 o 0684 o Pg 170, 219 -| 0685 o 0686 o Pg 175 Pg 175 0687 o Pg 175 0688 o 0689 o Pg 175 Pg 171, 219 Publication 1346 August 30, 2002 Part I Page 293 ATTACHMENT 1 ERROR REJECT CODE (ERC) CROSS REFERENCES ERC 0690 o DESCRIPTION Form Payment (Balance Due ) – If Refund (SEQ 1270) of the Tax Form is greater than zero, then a Tax Type Code of Form 1040, Form 1040A or Form 1040EZ or Form 1040T cannot be present. Form Payment (Balance Due) – Amount of Tax Payment (SEQ 060) cannot be greater than Amount Owed (SEQ 1290) of the Tax Form. Form Payment – Amount of Tax Payment (SEQ 060) must be greater than zero. Form Payment – When there are two occurrences of Form Payments, one of the occurrences must have a Tax Type Code (SEQ 070) of “1040S”. Authentication Record – When the PIN Type Code (SEQ 008) is equal to "S", then the Jurat/Disclosure Code (SEQ 075) must equal "C". Authentication Record – When the PIN Type Code (SEQ 008) is equal to "P", then the Jurat/Disclosure Code (SEQ 075) must equal "D". Authentication Record – When the PIN Type Code (SEQ 008) is equal to "O", then the Jurat/Disclosure Code (SEQ 075) must equal "A". Authentication Record – When the PIN Type Code (SEQ 008) is equal to "P", then the following fields must be present; Primary Taxpayer Signature (SEQ 035), Taxpayer Signature Date (SEQ 070), Jurat/Disclosure Code (SEQ 075), PIN Authorization Code (SEQ 080) and ERO EFIN/PIN (SEQ 090). When the Filing Status (SEQ 130) equals “2”, the Primary Date of Death (Seq 020) on the Tax Return is significant and the Secondary Date of Death (SEQ 040) is “NOT” significant, bypass this check. Only the spouse fields are required. Authentication Record – When the PIN Type Code (SEQ 008) is equal to "P" and Filing Status (SEQ 130) is "2" (Married Filing Jointly), then the Spouse Signature (SEQ 065) must be present. When the Secondary Date of Death (SEQ 040) on the Tax Return is significant and the Primary Date of Death (SEQ 020) is “NOT” significant, bypass this check. Only the primary fields are required. When the Primary Date of Death (SEQ 020) “AND” the Secondary Date of Death (SEQ 040) are significant on the Tax Return, bypass this check. Only the primary fields are required. Authentication Record – When the PIN Type Code (SEQ 008) is equal to "P", then the following fields must NOT be present; Primary Prior Year Adjusted Gross Income (SEQ 020) and Spouse Prior Year Adjusted Gross Income (SEQ 050). | | | | | | | Pg 171, 219 | | | | Pg 171, 219 PAGE Pg 167 0691 o 0692 o 0693 o Pg 167 Pg 167 Pg 167 0694 o Pg 171, 219 0695 o Pg 171 219 0696 o Pg 171 219 0697 o Pg 171, 219 o 0698 o o o 0699 o Publication 1346 August 30, 2002 Part I Page 294 ATTACHMENT 1 ERROR REJECT CODE (ERC) CROSS REFERENCES ERC 0700 o DESCRIPTION Form 6781 – When Mixed Straddle Account Election Box (SEQ 040) equals “X”, Statement Required by Regulations (SEQ 050) must equal “STMbnn”. Form 6781 – When Form 1099-B Adjustments (SEQ 200) is significant, Form 1099-B Adjustment Schedule (SEQ 190) must contain “STMbnn”. Form 2120 - Person Supported First Name (SEQ 020) and Person Support Last (SEQ 030) must be significant. Form 2120 - Eligible First Name (SEQ 040), Eligible Last Name (SEQ 045), SSN (SEQ 050), Street Address (SEQ 060), City (SEQ 070), State Abbr (SEQ 080), and Zip Code (SEQ 090) must be significant, else reject the return. Reserved Reserved Form 2120 - The Calendar Year (SEQ 010) must equal the Current Tax Year, else reject the return. | | | | | PAGE Pg 150 0701 o Pg 150 0702 o 0703 o Pg 134 Pg 134 0704 o 0705 o 0706 o 0707 o -| -| | Pg 134 Pg 134 Pg 134 Pg 134 Form 2120 – The Person Supported First Name (SEQ 020) must equal | one of the following Dependent First (SEQs 170, 180, 190, 200, -| 210). Last Name of Person Supported (SEQ 050) must equal one of the following: Dependent Last Name (SEQs 171, 181, 191, 201, 211) -| | Pg 134 0708 o Form 2120 - SSN of Eligible Person (SEQ 050, 110, and 230) must be within the valid ranges of SSNs. It must be all numeric characters and cannot equal all zeroes or all nines. Refer to Attachment 8 for valid ranges of Social security Numbers. Form 2120 - SSN of T/P Not Claiming Dependent (SEQ 170, 050, 110, and 230) cannot equal Primary SSN (SEQ 010) of Form 1040/1040A and Filing Status (SEQ 130) equals "1", "3", "4", or "5" Form 2120 - SSN of T/P Not Claiming Dependent (SEQ 170) cannot equal Primary SSN (010) or Secondary SSN (SEQ 030) of Form 1040/1040A with Filing Status (SEQ 130) equals "2". Reserved o | | o 0709 o Publication 1346 August 30, 2002 Part I Page 295 ATTACHMENT 1 ERROR REJECT CODE (ERC) CROSS REFERENCES ERC 0710 o DESCRIPTION Form 9465 – When Direct Debit information is present, Routing Transit Number (SEQ 330)(RTN) must contain nine numeric characters. The first two positions must be 01 through 12, or 21 through 32; the RTN must be present on the Financial Organization Master File (FOMF); and the banking institution must process Electronic Funds Transfer (EFT). See Section 6 for optional Routing Transmit Number validation. Bank Account Number (SEQ 340) must be alphanumeric (i.e., only alpha characters, numeric characters, and hyphens), must be left-justified with trailing blanks if less than 17 positions, and cannot equal all zeros. If Routing Transit Number (SEQ 330) or Bank Account Number (SEQ 340) is significant, then Checking Account Indicator (SEQ 350) or Savings Account Indicator (SEQ 360) must equal “X”. Both cannot equal “X”. Form 8082 - Only one of the Following fields can equal "X": Pass-Through Entity (Partnership) (SEQ 050) or Pass-Through Entity (Electing large Partnership) (SEQ 055) or Pass-Through Entity (S Corporation) (SEQ 060) or Pass-Through Entity (Estate) (SEQ 065) or Pass-Through Entity (Trust)(SEQ 070) or Pass-Through Entity (REMIC)(SEQ 075). Form 8082 - Identifying Number of Pass-Through Entity (SEQ 080) and Name of Pass-Through Entity (SEQ 090) must be significant. Form 8082 - The Identifying Number (SEQ 010) must be significant and equal to Primary SSN (SEQ 010) or Secondary SSN (SEQ 030) of Form 1040. Form 8697 - Employer Identification Number of Entity (SEQ 150) and Name of Entity (SEQ 140) on Form 8697 must be present. Form 8697 – Only one of the following fields can be significant; REG-Net Amount of Interest You Owe (SEQ 460) and SMI-Net Amount of Interest You Owe (SEQ 830). Form 8697 - Identifying Number (SEQ 080) must equal either Primary SSN (SEQ 010) or Secondary SSN (SEQ 030) of Form 1040. Pg 150 PAGE Pg 166 o o 0711 o 0712 o 0713 o Pg 150 Pg 151 0714 o 0715 o Pg 156 Pg 156 0716 o Pg 156 Publication 1346 August 30, 2002 Part I Page 296 ATTACHMENT 1 ERROR REJECT CODE (ERC) CROSS REFERENCES ERC 0717 o DESCRIPTION Form 1040 – When F8697 or F8866 Literal (SEQ 1129) is equal to "FORM 8697" or “FORM8866”, then Form 8697 or F8866 must be present. Form 1040 – When F8697 Amount (SEQ 1131) is significant, then REG-Net Amount of Interest You Owe (SEQ 460) or SMI-Net Amount of Interest You Owe (SEQ 830) of Form 8697 must be significant. Form 1040 – When F8866 Amount (SEQ 1131) is significant, then Net Amount of Interest You Owe (SEQ 460) of Form 8866 must be significant. When REG-Net Amount of Interest You Owe (SEQ 460) or SMI-Net Amount of Interest You Owe (SEQ 830) of Form 8697 is significant, then F8697 Amount (SEQ 1131) must be significant. When Net amount of Interest You Owe (SEQ 460) of Form 8866 is significant, then F8866 Amount (SEQ 1131) of Form 1040 must be significant. PAGE Pg 117 o o o o 0718-0719 Reserved 0720 o Form 3800 – When any two or more of the following forms are present, Form 3800 must be present: Form 3468, Form 5884, Form 6478, Form 6765, Form 8586, Form 8820, Form 8826, Form 8830, Form 8835, Form 8845, Form 8846, Form 8847 or Form 8861. Form 1040 – When Other Form Literal (SEQ 1010) equals “8834”, Form 8834 must be present. When Other Form Literal (SEQ 1010) equals “8844”, Form 8844 must be present. -| 0722 o Form 1040 – When Other Credits (SEQ 1015) is significant, at least one of the following forms must be present: Form 3468, Form 3800, Form 5884, Form 6478, Form 6765, Form 8586, Form 8801, Form 8820, Form 8826, Form 8830, Form 8834, Form 8835, Form 8844, Form 8845, Form 8846, Form 8847, or Form 8861. Form 3468 – If Certified Historic Structures (SEQ 050) or Calculated Expenditures Certified Historic Struct. SEQ 060) of Form 3468 is present, Qualified Rehabilitation NPS Number must be significant (SEQ 0070). Form 3468 – If Certified Historic Structures (SEQ 050) or “Calculated Expenditures Certified Historic Struct. (SEQ 060) of Form 3468 is present, Date of NPS Approval (SEQ 071) must be significant. (Certified Historic Structures) Form 3468 – If Current Year Investment Credit (SEQ 160) and Net Income Tax (SEQ 320) both contain an entry greater than zero, then Form 6251 must be present. Pg 117 -| -| Pg 139 | | | | | | | Pg 139 Pg 139 0721 o Pg 117 0723 o o 0724 o Publication 1346 August 30, 2002 Part I Page 297 ATTACHMENT 1 ERROR REJECT CODE (ERC) CROSS REFERENCES ERC 0725 o 0726 o 0727 o 0728 o 0729 o 0730 o 0731 o 0732 o 0733 o 0734 o 0735 o 0736 o 0737 o 0738 o DESCRIPTION Form 3800 – If Current Year Investment Credit (SEQ 020) is significant, then Form 3468 must be present. Form 3800 – If Current Year Work Opportunity Credit (SEQ 030) is significant, then Form 5884 must be present. Form 3800 – If Current Year Welfare to Work Credit (SEQ 040) is significant, then Form 8861 must be present. Form 3800 – If Current Year Credit for Alcohol Used As Fuel (SEQ 050) is significant, then Form 6478 must be present. Form 3800 – If Current Year Credit for Increasing Research (SEQ 060) is significant, then Form 6765 must be present. Form 3800 – If Current Year Low-Income Housing Credit (SEQ 070) is significant, then Form 8586 must be present. Form 3800 – If Current Year Enhanced Oil Recovery Credit (SEQ 080) is significant, then Form 8830 must be present. Form 3800 – If Current Year Disabled Access Credit (SEQ 090) is significant, then Form 8826 must be present. Form 3800 – If Current Year Renewable Electricity Production (SEQ 100) is significant, then Form 8835 must be present. Form 3800 – If Current Year Indian Employment Credit (SEQ 110) is significant, then Form 8845 must be present. Form 3800 – If Current Year Credit for Employer Social Security (SEQ 120) is significant, then Form 8846 must be present. Form 3800 – If Current Year Orphan Drug Credit (SEQ 130) is significant, then Form 8820 must be present. Form 3800 – If Current Year Credit for Contributions (SEQ 140) is significant, then Form 8847 must be present. Form 3800 – If Current Year Trans-Alaska Pipeline Credit (SEQ 150) is significant, then Current Yr Trans-Alaska Pipeline Attach Statement (SEQ 145) must equal “STMbnn”. Form 3800 – If Passive Activity Credits (SEQ 180) is significant, then Passive Activity Credits (SEQ 180) must not be greater than Current Year General Business Credit (SEQ 170). Form 3800 – If Subtract Line 3 from Line 2 (SEQ 190) is significant, then Subtract Line 3 from Line 2 (SEQ 190) must not be less than zero. Form 3800 – If Passive Activity Credits Allowed (SEQ 200) is significant, then Form 8582-CR must be present. Form 3800 – If Tentative General Business Credit (SEQ 230) and Net Income Tax (SEQ 390) both contain an entry greater than zero, then Form 6251 must be present. PAGE Pg 139 Pg 139 Pg 139 Pg 139 Pg 139 Pg 139 Pg 139 Pg 139 Pg 139 Pg 139 Pg 139 Pg 140 Pg 140 Pg 140 0739 o Pg 140 0740 o Pg 140 0741 o 0742 o Pg 140 Pg 140 Publication 1346 August 30, 2002 Part I Page 298 ATTACHMENT 1 ERROR REJECT CODE (ERC) CROSS REFERENCES ERC 0743 o DESCRIPTION Form 3800 – The following fields must be positive: SEQs 020, 030, 050, 060, 070, 080, 090, 100, 110, 120, 130, 140, 150, 160, 180, 200, and 210. Form 5884 – If Total Current Year Work Opportunity Credit (SEQ 0110) and Net Income Tax (SEQ 270) both contain an entry greater than zero, then Form 6251 must be present. Form 6478 – Qualified Ethanol Fuel Production (SEQ 020) cannot be greater than 15000000 (fifteen million). Form 6478 - If Total Current Year Credit for Alcohol Used as Fuel (SEQ 230) and Net Income Tax (SEQ 390) both contain an entry greater than zero, then Form 6251 must be present. Form 6765 – Fixed-base Percentage (SEQ 100) cannot be greater than 16% (016000). Form 6765 – If Subtract Line 2 from Line 1 – Sect. A (SEQ 040), Subtract Line 11 from Line 8 (SEQ 130), Subtract line 18 from Line 17 (SEQ 220), Subtract Line 27 from Line 25 (SEQ 310), Subtract Line 29 from Line 25 (SEQ 330) Subtract Line 30 from Line 28 (SEQ 340), Subtract Line 32 from Line 25 (360), and Subtract Line 33 from line 30 (SEQ 370) cannot be less than zero. Form 6765 - If Subtract Line 43 from Line 42 (SEQ 530) and Net Income Tax (SEQ 690) both contain an entry greater than zero, then Form 6251 must be present. Form 8820 - If Total Current Year Orphan Drug Credit (SEQ 050) and Net Income Tax (SEQ 210) both contain an entry greater than zero, then Form 6251 must be present. Form 8826 – Subtract Line 2 from Line 1 (SEQ 030) cannot be less than zero. Form 8826 – Total Current Year Disabled Access Credit (SEQ 070) cannot be greater than 5000. Form 8826 - If Total Current Year Disabled Access Credit (SEQ 070) and Net Income Tax (SEQ 230) both contain an entry greater than zero, then Form 6251 must be present. Form 8830 - If Total Current Year Credit (SEQ 050) and Net Income Tax (SEQ 210) both contain an entry greater than zero, then Form 6251 must be present. Form 8834 - If Tentative Qualified Electric Vehicle Credit (SEQ 230) and Net Regular Tax (SEQ 360) both contain an entry greater than zero, then Form 6251 must be present. Form 8835 - If Total Current Year Credit (SEQ 200) and Net Income Tax (SEQ 360) both contain an entry greater than zero, then Form 6251 must be present. Form 8844 - If Tentative EZE Credit (SEQ 120) and Net Income Tax (SEQ 280) both contain an entry greater than zero, then Form 6251 must be present. PAGE Pg 140 0744 o Pg 149 0745 o 0746 o Pg 150 Pg 150 0747 o 0748 o Pg 150 Pg 150 0749 o Pg 150 0750 o Pg 158 0751 o 0752 o 0753 o Pg 158 Pg 158 Pg 158 0754 o Pg 158 0755 o Pg 158 0756 o Pg 159 0757 o Pg 160 Publication 1346 August 30, 2002 Part I Page 299 ATTACHMENT 1 ERROR REJECT CODE (ERC) CROSS REFERENCES ERC 0758 o DESCRIPTION Form 8845 - If Total Current Year Credit (SEQ 070) and Net Income Tax (SEQ 230) both contain an entry greater than zero, then Form 6251 must be present. Form 8846 - If Total Current Year Credit (SEQ 080) and Net Income Tax (SEQ 240) both contain an entry greater than zero, then Form 6251 must be present. Form 8847 - If Total Current Year CDC Credit (SEQ 050) and Net Income Tax (SEQ 210) both contain an entry greater than zero, then Form 6251 must be present. Form 8859 – Divide Line 3 by $20,000 (SEQ 140) cannot be greater than a decimal of 1.0000. Form 8861 - If Total Current Year Welfare-to-Work Credit (SEQ 080) and Net Income Tax (SEQ 240) both contain an entry greater than zero, then Form 6251 must be present. PAGE Pg 160 0759 o Pg 160 0760 o Pg 160 0761 o 0762 o Pg 161 Pg 161 0763-0766 Reserved 0767 o Tax Form - When Third Party Designee "Yes" Box (SEQ 1303) equals to "X", Third Party Designee Name (SEQ 1307) and Third Party Designee PIN (SEQ 1313) must be present. If the literal “PREPARER” is in Third Party Designee Name (SEQ 1307), then Third Party Designee PIN (SEQ 1313) is not required. Form 8621 – If Deemed Dividend Election (SEQ 0250) equals “X”, then Attach Statement For Post 1986 Earnings & Profits (SEQ 0255) must contain "STMbnn". Form 8621 – If Total Amount Of Cash & Fair Market Value Of Other (SEQ 0360) is greater than Add Lines 1c and 2c (SEQ 0350), then Attach Statement (SEQ 0365) must contain "STMbnn". Tax Form – Third Party Designee “Yes” Box (SEQ 1303) and Third Party Designee “No” Box (SEQ 1305) cannot both equal “X”. Form 8621- Identifying Number (SEQ 020) must be significant. Form 8621 – When Total Distributions From PFIC During Current Tax Year (SEQ 500) or Total Distributions, Reduced (SEQ 510) or Enter Gain (LOSS) of A Sec. 1291 Fund (SEQ 550) is significant then Attach statement for each Distribution and Disposition (SEQ 555) must contain “STMbnn”. Form 8621 – If Elect to Treat PFIC as QEF (SEQ 230) equals “X” then PRO RATA Share of the Ordinary Earnings of the QEF (SEQ 290), Portion of Line 1a (SEQ 300), Subtract Line 1b from Line 1a (SEQ 310), PRO RATA Share of Total NET Capital Gain of QEF (SEQ 320), Portion of Line 2a (SEQ 330) and Subtract Line 2b from Line 2a (SEQ 340) must be significant. Form 8621 – When Elect to Recognize Gain on Sale of Interest in PFIC (SEQ 240) equals “X”, then Enter Gain (Loss) of Stock of A Sec. 1291 Fund (SEQ 550) must be significant. Pg 155 Pg 106 o 0768 o 0769 o Pg 155 0770 o 0771 o 0772 o Pg 106 Pg 155 Pg 155 0773 o Pg 155 0774 o Pg 155 Publication 1346 August 30, 2002 Part I Page 300 ATTACHMENT 1 ERROR REJECT CODE (ERC) CROSS REFERENCES ERC 0775 o DESCRIPTION Form 8621 – When Elect to Treat POST 1986 Earnings & Profits as an Excess Distribution (SEQ 250) equals “X”, then Subtract Line 10d from Line 10a (SEQ 540) must be significant. Form 8621 – When Elect to Extend Time of PYMT (SEQ 260) equal “X”, then Add Lines 1c and 2c (SEQ 350), Total amount of Cash & Fair Market Value of Other Property Distributed (SEQ 360), Enter Portion of Line 3a (SEQ 370), Add Lines 3b and 3c (SEQ 0380), Subtract Line 3d From Line 3a (SEQ 390), Total Taxable Income For the Tax Year (SEQ 400), Total Tax Without Regard to Amount on Line 3e (SEQ 410) and Subtract Line 4b From Line 4a (SEQ 420) must be significant. Form 8621 – If Election To Recognize Gain On Deemed Sale Of Pfic (SEQ 0270) equals “X”, then Enter Gain (Loss) Of Stock Of A Sec. 1291 Fund (SEQ 0550) must be significant. Form 1040 – When F8611 Literal (SEQ 1114) equals “LIHCR” and F8611 Amount (SEQ 1116) is significant, then Form 8611 must be present. Form 1040 – If F8693 Approved Indicator (SEQ 1118) is significant, then F8693 Approved Date (SEQ 1119) must be significant. If F8693 Approved Date (SEQ 1119) is significant, then F8693 Approved Indicator (SEQ 1118) must be significant Form 8609 – Percentage Aggregate Basis Financed (SEQ 250) cannot be blank. Form 8609 – If Form 8609 is present, then Paper Document Indicator 7 (SEQ 189) for Form 8609 must equal 1. Form 982 – When Discharge of Indebtedness in a Title 11 Case (SEQ 020) equals blank, Discharge of Indebtedness to the Extent Insolvent (SEQ 030) equals blank, Discharge of Qualified Real Prop Bus Indebtedness (SEQ 050) equals blank and Discharge of Qualified Farm Indebtedness (SEQ 040) is equal to “X”, then Amt Excluded From Inc: To Reduce Basis (SEQ 150) must be blank. Form 982 – When Amt Excluded From Inc: Under Section 108(b)(5) (SEQ 100) is significant, then Attach Description of Transactions (SEQ 085) must equal “STMbnn”. Form 982 – When Discharge of Qualified Real Prop Bus Indebtedness (SEQ 050) is significant, then Amt Excluded From Inc: Discharge of Qual Real Prop (SEQ 090) must be significant. Form 2439 – All of these fields must be significant: Company or Trust Name Control (SEQ 050), Company or Trust Name (SEQ 060), and Company or Trust Identification Number (SEQ 120). Form 2439 – Shareholder SSN (SEQ 130) must equal Primary SSN (SEQ 010) or Secondary SSN (SEQ 030) of Form 1040. PAGE Pg 156 0776 o Pg 156 0777 o Pg 156 0778 o Pg 117 0779 o Pg 117 0780 o 0781 o 0782 o -| Pg 154 Pg 154 Pg 130 0783 o Pg 130 0784 o Pg 130 0785 o Pg 135 0786 o Pg 135 0787-0789 Reserved Publication 1346 August 30, 2002 Part I Page 301 ATTACHMENT 1 ERROR REJECT CODE (ERC) CROSS REFERENCES ERC 0790 0791 o o DESCRIPTION Form 1040 – If Form 2439 Block (SEQ 1202) equal “X”, then Form 2439 must be present and vice versa. Form 1040 – If Other Payments (SEQ 1210) is significant, then at least one of the following must equal “X”: Form 2439 Block (SEQ 1202), Form 4136 Block (SEQ 1205). Reserved Reserved Reserved Reserved TRANS Record B (TRANB) must be present. TRANS Record A (TRANA) - Processing Site (SEQ 040) must equal a valid Electronic Filing site: "A" = Cincinnati, "B" = Ogden, "C" = Andover, "D" = Memphis, "E" = Austin. Reserved TRANS Record A (TRANA) - Transmission Sequence for Julian Day (SEQ 080) matches a previously accepted transmission (Duplicate Transmission). Unrecognizable Transmission - If there are any unrecognizable or inconsistent control data, the transmission will be rejected. TRANS Record A (TRANA) - Transmitter EFIN (SEQ 110) must be present. Invalid Sequence of Records in Transmission - The data records of the transmission must be in the following sequence: TRANA, TRANB, Return Records (1-500 for dial-up or 1-10,000 for dedicated/leased line or high speed protocol), and RECAP. The format and content of the TRANA, TRANB, and RECAP Records must be exactly as defined in Part II Record Layouts. 0826-0829 0830 o Reserved RECAP Record - Total EFT (SEQ 020) does not equal programcomputed count. Total EFT Count is a count of Direct Deposit Requests and is incremented for each return that contains a non-blank character in any one of the Direct Deposit data fields (SEQ 1272, 1274, 1276, 1278) of the Tax Form. If an extraneous character is present within those fields, it will be counted as an EFT. RECAP Record - Total Return Count (SEQ 030) does not equal program-computed count. Total Return Count is a count of returns transmitted and is incremented each time the Primary SSN within a Record ID changes. Pg 88 Pg 87 Pg 87 Pg 87 PAGE Pg 117 Pg 117 0792-0794 0795 0796 o o 0797-0804 0805 0806 o o 0807-0821 0822 o 0823 o Pg 87 0824 0825 o o Pg 87 Pg 87 o 0831 o Pg 88 Publication 1346 August 30, 2002 Part I Page 302 ATTACHMENT 1 ERROR REJECT CODE (ERC) CROSS REFERENCES ERC 0832 o DESCRIPTION RECAP Record – Total State Only Return Count (SEQ 0130) does not equal program computed count. Total State only Return Count is a count of State Only Returns transmitted and is incremented each time the Primary SSN within a Record ID changes. | | | | | PAGE Pg 88, 180 0833-0839 Reserved 0840 o RECAP Record - The following fields must equal those in the Trans Record A (TRANA): IDENTIFICATION TRANA RECAP Electronic Trnsmtr Identification Number (ETIN) SEQ 060 SEQ 040 Julian Day of Transmission SEQ 070 SEQ 050 Transmission Sequence Number for SEQ 080 SEQ 060 Julian Day Pg 88 0841-0899 Reserved 0900 o Primary SSN (SEQ 010) of the Tax Form cannot duplicate Primary SSN or Secondary SSN of any previously accepted electronic return for the current tax year. Reserved Declaration Control Number (DCN) (SEQ 008) of the Tax Return Record Identification Page 1 cannot duplicate a DCN on a previously accepted electronic return for the current processing year. Secondary SSN (SEQ 030) of the Tax Form cannot duplicate the Secondary SSN of any previously accepted return for the current tax year. The Secondary SSN cannot have been filed previously as a Primary SSN for the current tax year. Primary SSN (SEQ 010) of the Tax Form cannot duplicate a Primary SSN within the same “drain” of returns. Declaration Control Number (DCN) (SEQ 008) of the Tax Return cannot duplicate a DCN within the same “drain” of returns. Secondary SSN (SEQ 030) of the Tax Return cannot duplicate a Secondary SSN within the same “drain” of returns. Reserved A maximum of 96 Error Reject Codes can be provided in the acknowledgment file. If more than 96 reject conditions are identified, the 96th Error Reject Code will be replaced with "999". Form 1310 – When the Filing Status Code (SEQ 0130) of the Tax Form is NOT equal to "Married Filing Joint" and the Refund (SEQ 1270) of the Tax Form is significant, then Form 1310 must be present and the Decedent's SSN (SEQ 0040) must equal the Primary SSN (SEQ 0010) of the Tax Form. | | | | | Pg 93 Pg 93 Pg 93 0901 0902 o o 0903 o Pg 93 0904 0905 0906 o o o Pg 93 Pg 93 Pg 93 0907-0998 0999 o 1000 o Pg 132 Publication 1346 August 30, 2002 Part I Page 303 ATTACHMENT 1 ERROR REJECT CODE (ERC) CROSS REFERENCES ERC 1001 o DESCRIPTION Form 1310 – When the Filing Status Code (SEQ 0130) of the Tax Form is equal to "Married Filing Joint", the Decedent's SSN (SEQ 0040) must equal either the Primary SSN (SEQ 0010) or the Secondary SSN (SEQ 0030) of the Tax Form. Form 1310 – The Tax Year Decedent Due Refund (SEQ 0010) must equal the current tax year. Form 1310 – The year of the Date of Death (SEQ 0030) must equal either the current tax year or the current processing year. Form 1310 – The Date of Death (SEQ 0030) must match data from the IRS Master File and either the Primary Date of Death (SEQ 0020) or the Secondary Date of Death (SEQ 0040). Form 1310 – When Person Other Than A or B Claiming Decedent Refund (SEQ 0190) equals "X", then all of the following fields must also equal "X": Did Decedent Leave a Will "YES" Box (SEQ 0210) or Did Decedent Leave a Will "NO" Box (SEQ 0220), Court Appointed Personal Rep "NO" Box (SEQ 0240), Personal Rep will be Appointed "NO" Box (SEQ 0260) and Refund Paid out According to State Laws "YES" Box (SEQ 0270). Form 1310 - When Person Other Than A or B Claiming Decedent Refund (SEQ 0190) and Refund Paid Out According to State Laws "YES" Box (SEQ 0270) are equal to "X", then at least one of the following fields on the Tax Form must be significant: Primary Date of Death (SEQ 0020) or Secondary Date of Death (0040). Form 1310 – Person Claiming Refund Signature (SEQ 0290) and Signature Date (SEQ 0300) must be significant. Form 1310 – Valid Proof of Death is in my Possession (SEQ 0200) must equal "X". Form 1310 – Street Address (SEQ 0100) is alphanumeric and cannot have leading or consecutive embedded spaces. The leftmost position must contain an alpha or numeric character. The only special characters permitted are space, hyphen (-), and slash (/). See Section 7.03 for Street Address format. Street Address (SEQ 0100) is a required field. Form 1310 – Zip Code (SEQ 0150) must be within the valid ranges of zip codes listed for the corresponding State Abbreviation (SEQ 0140). The zip code cannot end in "00", with the exception of 20500 (the White House zip code). Refer to Attachment 3. Form 1310 – State Abbreviation (SEQ 0140) must be significant and consistent with the standard state abbreviations issued by the Postal Service. Refer to Attachment 3 for State Abbreviations. State Abbreviation (SEQ 0140) is a required field. | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | Pg 133 PAGE Pg 132 1002 o 1003 o Pg 132 Pg 132 1004 o Pg 132 1005 o Pg 132 1006 o Pg 132 1007 o 1008 o 1009 o Pg 132 Pg 132 Pg 132 o 1010 o 1011 o Pg 133 Publication 1346 August 30, 2002 Part I Page 304 ATTACHMENT 1 ERROR REJECT CODE (ERC) CROSS REFERENCES ERC 1012 o DESCRIPTION Form 1310 – City (SEQ 0130) must be left-justified and must contain a minimum of three alpha characters. This field cannot contain consecutive embedded spaces and must contain only alphabetic characters and spaces. Do not abbreviate the city name. City (SEQ 0130) is a required field. 1013 o Form 1310 – If Address Ind (SEQ 0160) equals "1" (APO/FPO Address), then City (SEQ 0160) must equal "APO" or "FPO", and State Abbreviation (SEQ 0140) must equal "AA", "AE", or "AP" with the appropriate Zip Code (SEQ 0150). If State Abbreviation (SEQ 0140) equals "AA", "AE", or "AP", then Address Ind (SEQ 0160) must equal "1". Refer to Attachment 4. Tax Form – When Filing Status Code (SEQ 0130) is equal to "2" and the Primary Date of Death (SEQ 0020) and the Secondary Date of Death (SEQ 0040) and Refund (SEQ 1270) are significant, then Form 1310 must be present and Name Line 2 must match the Name of Person Claiming Refund (SEQ 0060) on Form 1310. Tax Form - When Filing Status Code (SEQ 0130) is equal to "2" and either the Primary Date of Death (SEQ 0020) or the Secondary Date of Death (SEQ 0040) are significant, then either the Surviving Spouse Yes (SEQ 1325) or the Surviving Spouse No (SEQ 1326). Tax Form - When Filing Status Code (SEQ 0130) is NOT equal to "2" and the Primary Date of Death (SEQ 0020) and the Refund (SEQ 1270) are significant, then Form 1310 must be present and Person other than A or B Claiming Decedent Refund (SEQ 0190) must be significant. Form 1310 – The SSN of Person Claiming Refund must be significant and cannot equal Primary SSN (SEQ 0010) or Secondary SSN (SEQ 0030) of Form 1040. When two Form 1310 are present, the SSN of Person Claiming Refund (SEQ 0070) of the first Form 1310 must equal the SSN of Person Claiming Refund (SEQ 0070) of the second Form 1310. Form 1310 – When only one Form 1310 is present, Decedent's SSN (SEQ 0040) must equal Primary SSN (SEQ 0010) or Secondary SSN (SEQ 0030) of Form 1040. When two Forms 1310 are present, Decedent's SSN (SEQ 0040) of the first Form 1310 must equal Primary SSN (SEQ 0010) of Form 1040 and Decedent's SSN (SEQ 0040) of the second Form 1310 must equal Secondary SSN (SEQ 0030) of Form 1040. Reserved Form 970 – If Valued At Cost "No" Box (SEQ 0080) is equal to "X", then If No, Explanation (SEQ 0090) must equal "STMbnn". | | Pg 129 | | | | | | | | | | | | | | | | | | | | | | | | | | Pg 133 PAGE Pg 133 1014 o Pg 106 1015 o Pg 106 1016 o Pg 106 1017 o | Pg 133 | | | | | | Pg 133 | | | | | | o 1018 o o 1019 o 1020 o Publication 1346 August 30, 2002 Part I Page 305 ATTACHMENT 1 ERROR REJECT CODE (ERC) CROSS REFERENCES ERC 1021 o DESCRIPTION Form 970 – If Inventory Taken at Actual Cost "No" Box (SEQ 0110) is equal to "X", then Actual Cost "No" Explanation (SEQ 0120) must equal "STMbnn". Form 970 – If Adjustment Included in Income Over 3 Years "N" Box (SEQ 0160) is equal to "X", then Adjustment "No" Explanation (SEQ 0170) must equal "STMbnn". Form 970 – If Goods Treated as Acquired "N" Box (SEQ 0200) is equal to "X", then Goods Treated as Acquired "N" Explanation (SEQ 0210) must equal "STMbnn". Form 970 – If Other Cost Method Box (SEQ 0290) is equal to "X", then Other Cost Method Explanation (SEQ 0300) must equal "STMbnn". Form 970 – If any of the following fields equal "X": Line Type or Class of Goods Box (SEQ 0350), Pooling Method Box (SEQ 0360), Natural Business Unit Box (SEQ 0370), Multiple Pools Box (SEQ 0380), Raw Material Content Box (SEQ 0390) and Simplified Dollar-value Method Box (SEQ 0400), then Statements describing Contents of Pool (SEQ 0340) must equal "STMbnn". Form 970 – If Other Pooling Method Box (SEQ 0410) is equal to "X", then Other Pooling Method Explanation (SEQ 0420) must equal "STMbnn". Form 970 – If any of the following fields equal "X": Double Extension Box (SEQ 0440), New Vehicle Alternative LIFO (SEQ 0450), Index Box (SEQ 0460), Link-chain Box (SEQ 0470) and Used Vehicle Alternative LIFO (SEQ 0480), then Description of LIFO Computation Method (SEQ 0430) must equal "STMbnn". Form 970 – If Other Method Box (SEQ 0490) is equal to "X", then Other Cost Computing Method Explanation (SEQ 0500) must equal "STMbnn". | | | | | | | | | | | | | | | | | | | | | | | | | | | | | PAGE Pg 129 1022 o Pg 129 1023 o Pg 129 1024 o Pg 129 1025 o Pg 129 1026 o Pg 129 1027 o Pg 129 1028 o Pg 129 1029 o | Form 970 – If Commissioner's Permission to Change "Yes" Box (SEQ 0530) is equal to "X", then Copy of Grant Letter Retained | | by Filer (SEQ 0550) must equal "Y". Form 970 – If Used LIFO Method Before "Yes" Box (SEQ 0560) is equal to "X", then Used LIFO Before Explanation (SEQ 0570) must equal "STMbnn". Form 970 – When only one Form 970 is present, the SSN (SEQ 0020) must equal the Primary SSN (SEQ 0010) or the Secondary SSN (SEQ 0030) of Form 1040. When two Forms 970 are present, the SSN (SEQ 0020) of the first Form 970 must equal the Primary SSN (SEQ 0010) of Form 1040 and the SSN (SEQ 0020) of the second Form 970 must equal the Secondary SSN (SEQ 0030) of Form 1040. | | | | | | | | | | Pg 129 1030 o Pg 129 1031 o Pg 129 1032-1040 Reserved Publication 1346 August 30, 2002 Part I Page 306 ATTACHMENT 1 ERROR REJECT CODE (ERC) CROSS REFERENCES ERC 1041 o 1042 o 1043 o DESCRIPTION Form W-2GU – When Advance EIC Payment (SEQ 0200) is significant, taxpayers cannot file Form 1040EZ. Form W-2GU – Employer City (SEQ 0070) must contain at least three characters. Form W-2GU – Employer Identification Number (SEQ 0040) must be numeric, then first two digits of Employer Identification Number (SEQ 0040) must equal a valid District Office Code, Employer Name Control (SEQ 0045) must be significant, and W-2GU Indicator (SEQ 0300) must equal "N" or "S". Refer to Attachment 7 for District Office Codes. See Section 7.05 for Business Name Control format. Note: The value "N" (Non-Standard) indicates that the Form W-2GU was altered, handwritten, or typed, or that a cumulative earnings statement or a substitute Form W-2GU was used. The value "S" (Standard) identifies a Form W-2GU that is a computer-produced print, an IRS form, or an IRS-approved facsimile. 1044 o Form W-2GU - The following fields Name (SEQ 0050), Employer Address (SEQ 0090), Employee Address (SEQ 0110), Employee State (SEQ 0113), and Wages (SEQ 0120). must be significant: Employer (SEQ 0060), Employee Name 0100), Employee City (SEQ Employee Zip Code (SEQ 0115), PAGE | Pg 127 | | Pg 127 | | Pg 127 | | | | | | | | | | | | | | Pg 127 | | | | | | | | | | Pg 128 | | | Pg 175 | | Pg 128 | | | | Exception: The check for Wages (SEQ 0120) is bypassed when Combat Pay has been excluded from Wages. Exception: When a period (.) is present in the Employee State (SEQ 0113), the checks for Employee City (SEQ 0110) and Employee Zip Code (SEQ 0115) are bypassed. 1045 o Form W-2GU – Employee SSN (SEQ 0080) must equal either the Primary SSN (SEQ 0010) or Secondary SSN (SEQ 0030) of the Tax Form. Summary Record – Number of Forms W-2GU Records (SEQ 0063) must equal the number of Forms W-2GU computed by the IRS. Form W-2GU – If the total of Wages (SEQ 0120) from Form(s) W-2GU is greater than $4,999 and the Adjusted Gross Income (SEQ 0750) of Tax Form is greater than $49,999, then Form 1040 must be used, Form 5074 must be attached and the return must be processed at the Andover Service Center. 1046 o 1047 o Publication 1346 August 30, 2002 Part I Page 307 ATTACHMENT 1 ERROR REJECT CODE (ERC) CROSS REFERENCES ERC 1048 o DESCRIPTION Tax Form – If the State Abbreviation (SEQ 0087) is equal to "GU" and Wages, Salaries, and Tips (SEQ 0375) equals the total amount(s) of Wages (SEQ 0120) from Form(s) W-2GU and Wages, Salaries, and Tips (SEQ 0375) equals Total Income (SEQ 0600) from Form 1040/A or Adjusted Gross Income (SEQ 0750) from Form 1040EZ and Total Payments (SEQ 1250) equals the total amount(s) of Guam Withholding (SEQ 0130) from Form(s) W-2GU, then this return must be filed with the Department of Revenue and Taxation, Government of Guam. Form 8594 – When SEQ 300 is present, then SEQ 315 must equal "STMbnn". PAGE | Pg 106 | | | | | | | | | | | | | | Pg 154 | | | Pg 172 | | | | | 1050 o 1051-1059 Reserved 1060 o STCGL/LTCGL – Schedule D Page 1 or Form 8865 Page 1 must be the next record after the Capital Gain/Loss Records. The Subpart Type (SEQ 0001) and Subpart Occurrence Number (SEQ 0005) must match the Record ID (SEQ 0000) and Schedule/Form Occurrence Number (SEQ 0005) from the parent (Schedule D or Form 8865) that immediately follows the Capital Gain Records. 1061 o STCGL/LTCGL – The Transaction Occurrence Number (SEQ 0010) must | Pg 172 be significant and in ascending, consecutive numerical sequence | beginning with "0000001". | STCGL/LTCGL – any STCGL Reference number "STCGL" occurring within a tax return must have a corresponding STCGL Record. | Pg 172 | 1062 o Any LTCGL Reference number "LTCGL" occurring within a tax return | must have a corresponding LTCGL Record. | If ST Property Desc 1 of Schedule D (SEQ 0020) is equal to "STCGL" then SEQ 0030 – 0285 must be blank. If LT Property Desc 1 of Schedule D (SEQ 0880) is equal to "LTCGL" then SEQ 0890 – 1155 must be blank. If S-T Description of Property of Form 8865 (SEQ 2480) is equal to "STCGL" then SEQ 2490 – 2710 must be blank. IF L-T Description of Property of Form 8865 (SEQ 2760) is equal to "LTCGL" then SEQ 2770 – 3030 must be blank. 1063 o Summary Record – Number of STCGL Records (SEQ 133) must equal the number of STCGL Records computed by the IRS. Summary Record – Number of LTCGL Records (SEQ 135) must equal the number of LTCGL Records computed by the IRS. | | | | | | | | | Pg 175 | | Pg 175 | 1064 o Publication 1346 August 30, 2002 Part I Page 308 ATTACHMENT 2 ACCEPTABLE ABBREVIATIONS Word Air Force Base And Apartment Avenue Boulevard Building Care of, or In Care of Circle Court Drive East Fort General Delivery Heights Highway Island Junction Lane Lodge North Abbreviation AFB & APT AVE BLVD BLDG % CIR CT DR E FT GEN DEL HTS HWY IS JCT LN LDG N Word Abbreviation NE NW 1/4 * 1/2 * PKY PL PO BOX RD RT RR Northeast, N.E. Northwest, N.W. One-fourth, or One-quarter One-half Parkway Place Post Office Box, or P.O. Box Road Route, Rte. R.D., Rural Delivery, RFD, R.F.D., R.R., or Rural Route South Southeast, S.E. Southwest, S.W. Square Street Terrace West S SE SW SQ ST TER W * (For all fractions, enter a space before and after the number, e.g., 1012 1/2 ST) For a complete listing of acceptable address abbreviations, see Document 7475, Catalogue # 7046E, State Abbreviations, Major City Codes and Address Abbreviations. Publication 1346 August 30, 2002 Part I Page 309 INTENTIONAL BLANK PAGE Publication 1346 August 30, 2002 Part I Page 310 ATTACHMENT 3 STANDARD POSTAL SERVICE STATE ABBREVIATIONS AND ZIP CODES State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Abbr. AL AK AZ AR CA CO CT DE DC FL Zip Code 350nn-369nn 995nn-999nn 850nn-865nn 716nn-729nn, 75502 900nn-908nn, 910nn-961nn 800nn-816nn 060nn-069nn 197nn-199nn 200nn-205nn 320nn-339nn, 341nn,342nn, 344nn,346nn, 347nn,349nn 300nn-319nn, 399nn 967nn,968nn 832nn-838nn 600nn-629nn 460nn-479nn 500nn-528nn 660nn-679nn 400nn-427nn, 45275 700nn-714nn, 71749 03801, 039nn-049nn 20331, 206nn-219nn 010nn-027nn, 055nn 480nn-499nn 550nn-567nn 386nn-397nn State Abbr. Missouri MO Montana MT Nebraska NE Nevada NV New Hampshire NH New Jersey NJ New Mexico NM New York NY Zip Code 630nn-658nn 590nn-599nn 680nn-693nn 889nn-898nn 030nn-038nn 070nn-089nn 870nn-884nn 004nn,005nn, 06390, 100nn-149nn 270nn-289nn 580nn-588nn 430nn-459nn 730nn-732nn, 734nn-749nn 970nn-979nn 150nn-196nn 028nn,029nn 290nn-299nn 570nn-577nn 370nn-385nn 733nn,73949, 750nn-799nn 840nn-847nn 050nn-054nn, 056nn-059nn 20041,201nn, 20301,20370, 220nn-246nn 980nn-986nn, 988nn-994nn 247nn-268nn 49936, 530nn-549nn 820nn-831nn North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia NC ND OH OK OR PA RI SC SD TN TX UT VT VA Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS Washington West Virginia Wisconsin Wyoming WA WV WI WY Publication 1346 August 30, 2002 Part I Page 311 ATTACHMENT 3 (continued) STANDARD POSTAL SERVICE STATE ABBREVIATIONS AND ZIP CODES U.S. Possession American Samoa Guam Commonwealth of the Northern Mariana Islands Puerto Rico U.S. Virgin Islands Abbr. AS GU MP Zip Code 967nn 9691n, 9692n 9695n PR VI 006nn, 007nn, 009nn 008nn Publication 1346 August 30, 2002 Part I Page 312 ATTACHMENT 4 APO/FPO CITY/STATE/ZIP CODES FOR MILITARY OVERSEAS ADDRESSES City APO or FPO APO or FPO APO or FPO State AA AE AP Zip Code 340nn 090nn-098nn 962nn-966nn Publication 1346 August 30, 2002 Part I Page 313 INTENTIONAL BLANK PAGE Publication 1346 August 30, 2002 Part I Page 314 ATTACHMENT 5 Community Property State Abbreviations Community Property States Community Property State Abbreviations AZ CA ID LA NM NV TX WA WI Arizona California Idaho Louisiana New Mexico Nevada Texas Washington Wisconsin Publication 1346 August 30, 2002 Part I Page 315 INTENTIONAL BLANK PAGE Publication 1346 August 30, 2002 Part I Page 316 ATTACHMENT 6 CLARIFICATION OF NON-PAID AND PAID PREPARER FIELDS AND FORM 8453 1. Non-Paid Preparer Field for IRS-Sponsored Programs The Non-Paid Preparer field on the tax form (Form 1040, Form 1040A, Form 1040EZ) should only contain an entry when the related paper tax return was prepared or reviewed through an IRS tax assistance program. These include VITA, Tax Counseling for the Elderly, Self-Help, and Outreach Programs, as well as the taxpayer assistance "walk-in" program in the district offices. When a return is prepared or reviewed in one of these programs, a literal value identifying the specific program or special aspect of the program is either stamped and/or written in the Paid Preparer Information section of the tax form. If one of the following literal values appears in the Paid Preparer Information section of the paper return, enter that literal value in SEQ 1330 of the tax form record: "IRS-PREPARED" "IRS-REVIEWED" "TCE" "VITA" “ONLINE-PARTNR” (see below for description) In all other cases, enter blanks for fixed format or omit the field for variable format. ONLINE-PARTNR - The record layouts for Forms 1040/1040A/1040EZ (SEQ 1338) has been updated to record information in the field description to include “ONLINE-PARTNR” as a new literal. This literal will be utilized to identify the returns that are transmitted as a result of a partnering effort conducted by the IRS. As a result of this partnering effort an Online Software Company may develop a partnership with another entity, i.e. a large employer, community organization, government entity, financial institution, educational institution, etc. If the Online Software Company provides their software to be utilized by the entities’ employees, constituents, customers, students, etc. this literal should be included in ALL of the returns that will be transmitted. This literal should ONLY be used to identify the returns that are transmitted as a result of the IRS partnering effort. NOTE: The Online Software Company MUST inform their users that this field MUST be input in order for the IRS to correctly capture the data. | | | | | | | | | | | | | | | | Publication 1346 August 30, 2002 Part I Page 317 ATTACHMENT 6 (continued) CLARIFICATION OF NON-PAID AND PAID PREPARER FIELDS AND FORM 8453 2. Self-Prepared Returns If the taxpayer prepared the return or if the return was prepared by another person who was not paid to prepare the return, such as a friend or a relative, the Non-Paid Preparer field should be left blank. 3. Paid Preparer If the return was prepared by a paid preparer, then fields 1340 through 1410 of the tax form record must be completed, with the following exceptions: a. Self-Employed If the paid preparer is self-employed, then SEQ 1350 (Preparer Self-Employment Indicator) should equal "X", and either SEQ 1360 (Preparer SSN/Prepaper TIN) or SEQ 1380 (Preparer Firm EIN) should be present. b. Employee of Preparer Firm If the paid preparer is not self-employed, then SEQ 1350 (Preparer Self-Employment Indicator) should be blank and both SEQ 1360 (Preparer SSN/Preparer TIN) and SEQ 1380 (Preparer Firm EIN) should be present. 4. Electronic Return Originators (ERO's) a. Collectors Who Do Not Change Data Some Electronic Return Originators who are not the paid preparer are erroneously entering their identifying information in the Paid Preparer fields of the tax form. The fact that a taxpayer is paying a fee to have the return filed electronically does not mean that the ERO is the paid preparer of the return. b. Collectors Who Change Data However, if the ERO changes the taxpayer's entries or computation on the return in a substantive manner (see Publication 1345), then the ERO is considered the paid preparer of the return and must enter his/her identifying information in the Paid Preparer fields of the tax form. This also applies when the return was originally prepared by a paid preparer and the ERO makes substantive changes to the original return information. Publication 1346 August 30, 2002 Part I Page 318 ATTACHMENT 6 (continued) CLARIFICATION OF NON-PAID AND PAID PREPARER FIELDS AND FORM 8453 Do not confuse the Paid and Non-Paid Preparer information requirements for the tax form (Form 1040, Form 1040A, Form 1040EZ) with the Form 8453 Electronic Return Originator requirements. The Electronic Return Originator must sign the Form 8453 and provide the applicable information as follows: (1) Paid Self-Employed If the ERO is the paid preparer and is self-employed, he/she must check the box "Check if self-employed", and enter his/her SSN/PTIN or EIN, as appropriate, as well as the Firm Name and Address data. (2) Employee of Firm If the ERO is the paid preparer and is an employee of a return preparation firm, he/she must enter his/her SSN/PTIN, as well as the Firm EIN, Firm Name and Address data. (3) Collector If the ERO did not prepare the return but collected it for electronic filing (transmission) purposes only, sign the Form 8453 in the ERO box, and enter the Firm EIN, Firm Name and Firm Address data. There is no requirement to provide his/her SSN/PTIN in this case. Publication 1346 August 30, 2002 Part I Page 319 INTENTIONAL BLANK PAGE Publication 1346 August 30, 2002 Part I Page 320 ATTACHMENT 7 {PRIVATE } EIN'S PREFIXES The first two digits of a valid Employer Identification Number (EIN) must equal one of the EIN prefixes listed below: EINs Prefixes 01, 02, 03, 04, 05, 06; 11; 13, 14, 15, 16; 21, 22, 23, 24, 25; 31; 33, 34, 35, 36, 37, 38, 39; 41, 42, 43, 44, 45, 46, 47, 48; 51, 52, 53, 54, 55, 56, 57, 58, 59; 61, 62, 63, 64, 65, 66, 67, 68; 71, 72, 73, 74, 75, 76, 77; 81, 82, 83, 84, 85, 86, 87, 88; 91, 92, 93, 94, 95, 96, 97, 98, 99; 40; 50; 60, 69; 70; 80; 90. 20, 26, 27; 30, 32; New Overflow EIN Prefixes 10, 12; Publication 1346 August 30, 2002 Part I Page 321 ATTACHMENT 7 DISTRICT OFFICE CODES FOR EIN'S AND EFIN'S DISTRICT OFFICE CODES FOR EFIN'S The first two digits of a valid Electronic Filer Identification Number (EFIN) must equal one of the 73 District Office (DO) Codes listed below: 01, 02, 08; 10, 11; 13, 14; 16, 17, 21, 22, 25; 29; 31, 32, 41, 42, 51, 52, 61, 62, 68; 71, 72, 81, 82, 91, 92, 98 99. 73, 83, 93, 74, 84, 94, 75, 85, 95 76, 86, 77; 87, 88; 33, 43, 53, 63, 34, 44, 54, 64, 35, 45, 55, 65; 36, 46, 56, 37, 47, 57, 38, 48, 58, 39; 49; 59; 18; 23; 03, 04, 05, 06; Publication 1346 August 30, 2002 Part I Page 322 ATTACHMENT 8 SOCIAL SECURITY/TAXPAYER IDENTIFICATION NUMBERS Social Security/Taxpayer Identification Numbers are broken down as follows: 1 2 3 Area 4 5 Group 6 7 8 9 Serial Valid Ranges for Social Security Number (SSN): 001-01-0001 through 690-99-9999, 700-01-0001 through 728-99-9999, 750-01-0001 through 763-99-9999. 764-01-0001 through 899-99-9999. When the SSN "Group" contains zeros, the SSN is a test SSN and the return will be rejected. When the SSN "Serial" contains all zeros, the return will be rejected. Valid Range for Individual Taxpayer Identification Number (ITIN): 900-70-0000 through 999-80-9999 The valid range for the ITIN "Area" is 900 through 999. The valid range for the ITIN "Group" is 70 through 80. The valid range for the ITIN "Serial" is 0000 through 9999. An ITIN is a nine-digit number assigned by the Internal Revenue Service to taxpayers who are not eligible to obtain an SSN. It is used for tax purposes only. Valid Range for Adoption Taxpayer Identification Number (ATIN): 900-93-0000 through 999-93-9999 The valid range for the ATIN "Area" is 900 through 999. The valid ATIN "Group" is 93. The valid range for the ATIN "Serial" is 0000 through 9999. An ATIN is a temporary nine-digit number issued by the Internal Revenue Service for an adoptive child. It is provided to individuals who are in the process of legally adopting a U.S. citizen or resident child and who are not eligible to obtain an SSN for that child in time to file their tax return. Publication 1346 August 30, 2002 Part I Page 323 INTENTIONAL BLANK PAGE Publication 1346 August 30, 2002 Part I Page 324 ATTACHMENT 9 POST OF DUTY (POD) CODES FOR FORMS 2555/2555-EZ and Foreign Employer Compensation Record (FEC Record) If the country is not listed, use Post of Duty Code "85" - Other Countries POD Code 84 84 15 84 08 84 85 85 49 25 54 85 49 84 85 68 13 15 85 44 25 85 75 49 85 85 11 45 29 44 84 54 84 85 53 45 85 49 84 Name of Country Afars & Issas Afghanistan Albania Algeria Andorra Angola Anguilla Antarctica Antigua & Barbuda Arab Republic of Egypt Argentina Armenia Aruba Ascension Island Ashmore & Cartier Islands Australia Austria Azerbaijan Azores Bahamas Bahrain Islands Baker Islands Bangladesh Barbados Bassas da India Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Botswana Bouvet Island Brazil British Honduras British Indian Ocean Territory British Virgin Islands Brunei POD Code 15 84 75 84 85 84 84 33 32 33 37 37 32 37 35 37 34 33 84 43 43 84 75 84 02 54 65 38 85 84 85 44 45 15 84 84 Name of Country Bulgaria Burkina Burma Burundi Byelarus Cambodia Cameroon Canada - Alberta Canada - British Columbia Canada - Manitoba Canada - New Brunswick Canada - Newfoundland Canada - Northwest Territory Canada - Nova Scotia Canada - Ontario Canada - Prince Edward Island Canada - Quebec Canada - Saskatchewan Canton & Enderbury Islands Cape Verde Cayman Islands Central African Republic Ceylon Chad Channel Islands Chile China (Taiwan) China, People's Republic Christmas Island (Indian Ocean) Christmas Island (Pacific Ocean) Clipperton Island Cocos (Keeling) Islands Colombia Commonwealth of Independent States (USSR) Comoro Islands Congo | Publication 1346 August 30, 2002 Part I Page 325 ATTACHMENT 9 (continued) POST OF DUTY (POD) CODES FOR FORMS 2555/2555-EZ and Foreign Employer Compensation Record (FEC Record) POD Code 84 85 45 84 19 15 84 03 84 49 44 45 25 45 84 02 01 84 85 84 85 84 84 85 84 03 65 08 07 84 84 85 84 84 84 15 13 84 09 84 Name of Country Cook Islands Coral Sea Islands Territory Costa Rica Cuba Cyprus Czech Republic Dahomey Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Ellice Islands England England - London Equatorial Guinea Estonia Ethiopia Europa Island Falkland Islands Faroe Islands Federated States of Micronesia Fiji Finland Formosa France France - Paris French Guinea French Polynesia French Southern & Antarctic Lands Gabon Gambia Gaza Strip Georgia Germany Ghana Gibraltar Gilbert Island POD Code 85 02 01 19 84 84 49 45 02 84 84 49 44 84 14 45 73 85 15 84 75 74 84 84 84 02 02 19 19 18 84 84 44 84 60 59 02 84 84 85 Name of Country Glorioso Islands Great Britain Great Britain - London Greece Greenland Grenada Guadeloupe Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Heard Island & McDonald Island Holland Honduras Hong Kong Howland Island Hungary Iceland India Indonesia Iran Iraq Iraq - Saudi Arabia Neutral Zone Ireland Isle of Man Israel Italy Italy - Rome Ivory Coast Iwo Jima (Japan) Jamaica Jan Mayen Japan Japan - Tokyo Jersey Johnston Atoll Jordan Juan de Nova Island | Publication 1346 August 30, 2002 Part I Page 326 ATTACHMENT 9 (continued) POST OF DUTY (POD) CODES FOR FORMS 2555/2555-EZ and Foreign Employer Compensation Record (FEC Record) POD Code 84 15 29 85 84 85 61 25 15 84 15 84 84 09 84 08 15 08 85 84 84 74 84 84 19 85 85 84 84 85 42 41 85 85 85 08 84 49 84 Name of Country Kampuchea Kazakhstan Kenya Kingman Reef Kiribati Korea, Democratic People's Rep. of Korea, Republic of Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Lichtenstein Lithuania Luxembourg Macau Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Mexico City Micronesia, Federal States of Midway Islands Moldova Monaco Mongolia Montserrat Morocco POD Code 29 25 75 85 70 85 75 14 49 84 70 70 45 85 29 84 84 02 03 60 25 85 75 85 85 48 70 54 84 54 63 84 15 09 74 25 84 15 15 84 19 Name of Country Mozambique Muscat Myanmar Namibia Nauru Navassa Island Nepal Netherlands Netherlands Antilles New Caledonia New Hebrides (Ranuatn) New Zealand Nicaragua Niger Nigeria Niue (New Zealand) Norfolk Island Northern Ireland Norway Okinawa (Japan) Oman Other Countries Pakistan Palau Palmyra Atoll Panama Papua-New Guinea Paraguay Persia Peru Philippines Pitcairn Islands Poland Portugal Portuguese Timor Qatar Reunion Island Romania Russia Rwanda San Marino | Publication 1346 August 30, 2002 Part I Page 327 ATTACHMENT 9 (continued) POST OF DUTY (POD) CODES FOR FORMS 2555/2555-EZ and Foreign Employer Compensation Record (FEC Record) POD Code 84 24 02 84 84 84 74 15 84 84 28 85 85 84 15 09 85 75 49 49 49 49 49 37 49 84 84 84 84 03 10 84 65 15 84 75 49 Name of Country Sao Tome and Principe Saudi Arabia Scotland Senegal Seychelles Sierra Leone Singapore Slovakia (Slovic Republic) Solomon Islands Somalia South Africa South-West Africa Southern Rhodesia Southern Yemen Soviet Union Spain Spratly Islands Sri Lanka St. Christmas-Nevis St. Christopher St. Helena St. Kitts & Nevis St. Lucia Island St. Pierre & Miquelon St. Vincent and the Grenadines Sudan Suriname Svalbard Swaziland Sweden Switzerland Syria Taiwan Tajikistin Tanzania, United Republic of Thailand Tobago POD Code 84 84 84 49 85 85 84 19 15 43 84 15 84 15 85 25 02 01 84 54 85 70 18 49 84 85 02 84 85 44 85 84 84 24 15 29 84 29 Name of Country Togo Tokelau Islands Tonga Trinidad & Tobago Tromelin Island Trust Territory of the Pacific Islands Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Ubekistin Uganda Ukraine Union of Soviet Socialist Republics United Arab Emirates United Kingdom United Kingdom - London Upper Volta Uruguay Uzbekistan Vanuatu Vatican City Venezuela Vietnam Wake Island Wales Wallis & Futuna West Bank West Indies Western Sahara Western Samoa Yemen (Aden) Yemen (Sanaa) Yugoslavia Zaire Zambia Zimbabwe | Note: For the the for electronic filing only, enter numeric value “00” (not shown in POD Code Table) for the Post of Duty Code, Field No. 0130, of Foreign Employer Compensation Record (FEC Record) when services foreign employer were performed in the U.S. | | | | Publication 1346 August 30, 2002 Part I Page 328 ATTACHMENT 10 MAXIMUM NUMBER OF SCHEDULES AND FORMS Schedule or Form Form 1040 Form 1040A Form 1040EZ Schedule A Schedule B Schedule 1 Schedule C Schedule C-EZ Schedule D Schedule E Schedule EIC Schedule F Schedule H Schedule J Schedule R Schedule 3 Schedule SE Form W-2 Form W-2G Form W-2GU Form 970 Form 982 Form 1099-G Form 1099-R Form 1116 Form 1310 Form 2106 Form 2106-EZ Form 2210 Form 2210F Form 2120 Form 2441 Schedule 2 Form 2439 Form 2555 Form 2555EZ Form 3468 Form 3800 Form 3903 Form 4136 Form 4137 Form 4255 Form 4562 Publication 1346 Maximum Number 1 1 1 1 1 1 8 1 1 15 1 2 1 1 1 1 1 50 30 10 2 2 10 10 20 2 1 1 1 1 4 1 1 4 1 1 1 1 2 1 1 1 30 Schedule or Form Maximum Number per taxpayer* ** per taxpayer* per taxpayer* | | | | per taxpayer* per taxpayer Form 4563 2 Form 4684 1 Form 4797 1 Form 4835 4 Form 4952 1 Form 4970 1 Form 4972 1 per taxpayer* Form 5074 1 Form 5329 1 per taxpayer* Form 5471 1 Schedule J (Form 5471) 1 Schedule M (Form 5471) 5 Schedule N (Form 5471) 1 Schedule O (Form 5471) 5 Form 5713 1 Schedule A (Form 5713) 5 Schedule B (Form 5713) 5 Schedule C (Form 5713) 1 Form 5884 1 Form 6198 10 Form 6251 1 Form 6252 3 Form 6478 1 Form 6765 1 Form 6781 1 Form 8082 4 Form 8271 2 Form 8275 1 Form 8275-R 1 Form 8283 2 per taxpayer* per taxpayer* per taxpayer* August 30, 2002 Part I Page 329 ATTACHMENT 10 MAXIMUM NUMBER OF SCHEDULES AND FORMS Schedule or Form Maximum Number Schedule or Form Form Form Form Form Form | Form 8853 Form 8859 Form 8861 Form 8862 Form 8863 Form 8865 Schedule K-1 (Form 8865) Schedule O (Form 8865) Schedule P (Form 8865) Form 8866 Form 8880 Form 9465 Form Payment ST 0001 ST 0002 1 1 1 1 1 5 5 5 5 5 2 1 2 1 9 8839 8844 8845 8846 8847 Maximum Number 1 1 1 1 1 Form 8379 1 Form 8396 1 Form 8582 1 Form 8582-CR 1 Form 8586 1 Form 8594 1 Form 8606 1 per taxpayer* Form 8609 10 Schedule A (Form 8609) 10 Form 8611 5 Form 8615 1 Form 8621 5 Form 8689 1 Form 8697 4 Form 8801 1 Form 8812 1 Form 8814 10 Form 8815 1 Form 8820 1 Form 8824 5 Form 8826 1 Form 8828 1 Form 8829 8 *** Form 8830 1 Form 8834 5 Form 8835 1 | * ** *** Maximum of two per return on a Joint Return (one for each taxpayer) Maximum of 45 (3 Rental Properties on each Schedule E) One Form 8829 for each Schedule C Publication 1346 August 30, 2002 Part I Page 330 INTENTIONAL BLANK PAGE Publication 1346 August 30, 2002 Part I Page 331 INTENTIONAL BLANK PAGE Publication 1346 August 30, 2002 Part I Page 332 INTERNAL REVENUE SERVICE PART II ELECTRONIC RETURN RECORD LAYOUTS for INDIVIDUAL INCOME TAX RETURNS TAX YEAR 2002 ELECTRONIC FILING SECTION (ELF) and ELECTRONIC FILING SYSTEMS OFFICE August 30, 2002 HIGHLIGHTS TO THIS REVISION OF RECORD LAYOUTS I NEW FORMS For Tax Year 2002: a. b. Forms W2-C, W2-GU, 970, 1099-G, 1310, 8594, 8880 Records: Foreign Employer Compensation (FEC) Record Long-Term Capital Gains/Loss Transaction (LTCGL) Short-Term Capital Gains/Loss Transaction (STCGL) have been incorporated into the Electronic Filing System. II NON-UPDATED 2002 FORM CHANGES As this revision goes to publication, all known updates have been made. Pending legislative changes may require late change pages. August 30, 2002 -i- TABLE OF CONTENTS Page GENERAL INSTRUCTIONS SECTION 1 TRANS RECORD Trans Record "A" Trans Record "B" SECTION 2 TAX RETURN Tax Return Record Identification Form 1040, Form 1040, Page 1 Page 2 7 11 20 27 35 41 3 5 1 Form 1040A, Page 1 Form 1040A, Page 2 Form 1040EZ SECTION 3 (1040) (1040A) SCHEDULES Schedule Record Identification Schedule A Schedule B Schedule 1 Schedule C, Page 1 Schedule C, Page 2 Schedule C-EZ Schedule D, Page 1 Schedule D, Page 2 Schedule E, Page 1 Schedule E, Page 2 Schedule EIC Schedule F, Page 1 Schedule F, Page 2 Schedule H, Page 1 Schedule H, Page 2 Schedule J Schedule R, Page 1 Schedule R, Page 2 August 30, 2002 -ii- 47 49 53 57 61 65 69 71 76 79 84 91 93 98 101 103 107 109 111 TABLE OF CONTENTS SECTION 3 (1040A) SCHEDULES (continued) Schedule 3, Page 1 Schedule 3, Page 2 Schedule SE Schedule SE (Short Form) Conversion Guide SECTION 4 FORMS Form Record Identification Form W-2 Form W-2C Form W-2G Form W-2GU FEC Record Form 970 Form 982 Form 1099-G Form 1099-R Form 1116, Page 1 Form 1116, Page 2 Form 1310 Form 2106, Page 1 Form 2106, Page 2 Form 2106EZ Form 2120 Form 2210, Page 1 Form 2210, Page 2 Form 2210, Page 3 Form 2210F Form 2439 Form 2441, Form 2441, (1040A) Schedule 2, Schedule 2, Form 2555, Page 1 Page 2 Page 1 Page 2 Page 1 August 30, 2002 -iii121 123 129 135 139 143 147 153 157 161 165 172 175 179 181 185 187 191 193 197 205 207 211 214 217 220 223 Page 113 115 117 119 TABLE OF CONTENTS SECTION 4 FORMS (continued) Page 2 Page 3 Page 229 233 235 238 241 245 249 Page 1 Page 2 251 255 259 261 Page 1 Page 2 Page 1 Page 2 Page 1 Page 2 265 270 279 283 286 291 295 303 307 309 313 317 Page 1 Page 2 Page 1 Page 2 Page 3 Page 4 325 328 331 339 350 357 361 365 373 381 390 Form 2555, Form 2555, Form 2555EZ, Page 1 Form 2555EZ, Page 2 Form 3468 Form 3800 Form 3903 Form 4136, Form 4136, Form 4137 Form 4255 Form 4562, Form 4562, Form 4563 Form 4684, Form 4684, Form 4797, Form 4797, Form 4835 Form 4952 Form 4970 Form 4972 Form 5074 Form 5329, Form 5329, Form 5471, Form 5471, Form 5471, Form 5471, (5471) (5471) (5471) (5471) (5471) Schedule J Schedule M Schedule N Schedule O, Page 1 Schedule O, Page 2 August 30, 2002 -iv- TABLE OF CONTENTS SECTION 4 FORMS (continued) Page 1 Page 2 Page 3 Page 4 Page 399 403 411 418 431 435 441 443 447 Form 5713, Form 5713, Form 5713, Form 5713, (5713) (5713) (5713) Schedule A Schedule B Schedule C Form 5884 Form 6198 Form 6251, Form 6251, Form 6252 Form 6478 Form 6765, Form 6765, Form 6781 Form 8082, Form 8082, Form 8271 Form 8275, Form 8275, Page 1 Page 2 451 454 457 461 Page 1 Page 2 Page 1 Page 2 Page 1 Page 2 465 469 471 477 481 483 487 490 493 496 499 502 507 510 515 519 521 529 531 534 537 541 Form 8275-R, Page 1 Form 8275-R, Page 2 Form 8283, Form 8283, Form 8379, Form 8379, Form 8396 Form 8582, Form 8582, Form 8582, Page 1 Page 2 Page 3 Page 1 Page 2 Page 1 Page 2 Form 8582-CR, Page 1 Form 8582-CR, Page 2 Form 8586 Form 8594, Page 1 August 30, 2002 -v- TABLE OF CONTENTS SECTION 4 FORMS (continued) Form 8594, Form 8606, Form 8606, Form 8609 (8609) Schedule A Form 8611 Form 8615 Form 8621, Form 8621, Form 8689 Form 8697, Form 8697, Form 8801, Form 8801, Form 8812 Form 8814 Form 8815 Form 8820 Form 8824, Form 8824, Form 8826 Form 8828 Form 8829 Form 8830 Form 8834 Form 8835 Form 8839, Form 8839, Form 8844 Form 8845 Form 8846 Form 8847 Form 8853, Form 8853, Page 1 Page 2 August 30, 2002 -viPage 1 Page 2 Page 1 Page 2 Page 1 Page 2 Page 1 Page 2 Page 1 Page 2 Page 2 Page 1 Page 2 Page 544 547 549 551 557 559 563 567 571 577 583 587 591 594 597 599 603 607 611 615 617 621 625 629 633 637 641 645 649 653 657 661 665 668 TABLE OF CONTENTS SECTION 4 FORMS (continued) Form 8859 Form 8861 Form 8862, Form 8862, Form 8863 Form 8865, Form 8865, Form 8865, Form 8865, Form 8865, Form 8865, Form 8865, (8865) (8865) (8865) (8865) Page 1 Page 2 Page 3 Page 4 Page 5 Page 6 Page 7 Page 1 Page 2 Page 671 673 677 681 687 693 700 710 715 720 728 732 739 745 749 767 775 779 781 785 Schedule K-1, Page 1 Schedule K-1, Page 2 Schedule O Schedule P Form 8866 Form 8880 Form 9465 Form Payment SECTION 5 AUTHENTICATION Authentication Record 787 SECTION 6 STATEMENTS Statement Record LTCGL Record STCGL Record 791 793 795 SECTION 7 PREPARER NOTE, ELECTION EXPLANATION, and REGULATORY EXPLANATION Preparer Note Election Explanation Regulatory Explanation August 30, 2002 -vii797 799 801 TABLE OF CONTENTS SECTION 8 STATE RECORDS State Record Unformatted Record SECTION 9 SUMMARY Summary Record SECTION 10 RECAP Recap Record 815 811 803 809 August 30, 2002 -viii- 1040 Return Record Layouts for Tax Year 2002 General Instructions An asterisk (*) precedes any field which may contain a statement reference (STMbnn) indicating either the first entry of a line or table of related items to be continued on a statement record. When present, a plus-sign (+) precedes the items related to the first entry field. An at-sign (@) precedes any field which must contain a statement reference when significant. In some cases, the related statement fields require more than the maximum 80 positions allowed, such as Schedule E, Page 2, Part/S-Corp Name A (SEQ 1170). An asterisk followed by a plus sign (*+) indicates the first field of a separate statement record which continues the required related fields from the previous statement record. ----------------------------------------------------------------| This is the issuance of the 2002 Electronic | | Return Record Layouts. Changes for the AUGUST 2002 | | revision are indicated by a vertical line (|) in the | | right margin. Deletions are indicated by the delete | | symbol (--|) in the right margin. | | Changes made after AUGUST 30, 2002 are indicated | | by two vertical lines (||) in the right margin. Deletions | | are indicated by the delete symbol (--||) in the right | | margin. | ----------------------------------------------------------------- Publication 1346 August 30, 2002 Part II Page 1 Section 1 1040 Return Record Layouts for Tax Year 2001 General Instructions (Cont'd) Field Description Abbreviations The following are abbreviations found in the Field Descriptions and their meanings to help describe the type of field: A - Alpha AN - Alphanumeric DT - Date YYYYMMDD - length = YYYYMM - length = YYYY - length = N - Numeric R - Ratio/Percentage (Exceptions in File 8 6 4 Specifications, Part I, Section 5) Repeated Field Description Values Literal values described in recurring fields will only be specified in the first occurrence. All subsequent occurrences will read as: 'See 1st Occ.' Publication 1346 August 30, 2002 Part II Page 2 Section 1 SECTION 1 TRANS RECORD The first two records on each file must be the TRANS records which will contain the following (for this purpose, Transmitter is the firm transmitting directly to the IRS): TRANS Record "A" TRANA Field Identification No. ----- ----- -------------Byte Count Start of Record Sentinel 0000 0010 Record ID Employer Identification Number of Transmitter EIN Transmitter Name Type Transmitter Form Ref. ---Transmission Information Record - A Length -----4 4 6 9 Field Description ----------------"0120" Value "****" Value "TRANAb" N (Must match same field on "TRANB" record) AN Value = "Preparer's Agent" or "Preparer" "A" "B" "C" "D" "E" = = = = = Cincinnati, Ogden, Andover, Memphis, Austin 0020 0030 35 16 0040 Processing Site 1 0050 0060 Transmission Date Electronic Transmitter Identification Number (ETIN) Julian Day Transmission Sequence for Julian Day in (0070) Acknowledgment Transmission Format 8 7 YYYYMMDD N (ETIN plus Transmitter's Use Code) N N 0070 0080 3 2 0090 1 "A" = ASCII Publication 1346 August 30, 2002 Part II Page 3 Section 1 TRANS Record "A" TRANA (Cont'd) Transmission Information Record - A Form Ref. ---Length -----1 Field Description ----------------"F" = Fixed "V" = Variable length option N Blank Blank Blank IRS Use Only "P" = Production "T" = Test Blank " " = Regular ELF "D" = ETD "O" = Online Filing IRS Use Only Field Identification No. ----- -------------0100 Record Type 0110 0120 0130 0140 0150 0160 0170 Transmitter EFIN Filler Reserved Reserved Reserved Production-Test Code Transmission Type Code Reserved 6 5 1 1 6 1 1 0180 1 Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 4 Section 1 TRANS Record "B" TRANB Field Identification No. ----- -------------Byte Count Start of Record Sentinel 0000 0010 Record ID EIN of Transmitter Transmission Information Record - B Form Ref. ---Length -----4 4 6 9 Field Description ----------------"0120" Value "****" "TRANBb" N (Must match same field on "TRANA" record) AN AN N 0020 0030 0040 Transmitter's Address Transmitter's City, State, Zip Code Transmitter's Area Code & Telephone Number Filler 35 35 10 0050 16 blank Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 5 Section 1 INTENTIONAL BLANK PAGE Publication 1346 August 30, 2002 Part II Page 6 Section 1 SECTION 2 TAX RETURN Tax Return Record Identification, Page 1 - Forms 1040, 1040A and 1040EZ Each tax return must start with a byte count, start of record sentinel, and Tax Return Record Identification (Fields 0000 thru 0006). Page 1 of the Tax Return Record must also contain Fields 0007 and 0008. The following fields describe the composition of the Record ID. Note: Do not enclose the record ID fields (the first 42 characters) in brackets. Field# Identification Byte Count, Page 1 Start of Record Sentinel 0000 0001 Record ID Return Type Length 4 4 6 6 Description (see form) for fixed; "nnnn" for variable Value "****" Value "RETbbb" Value "1040bb", "1040Ab" or "1040Zb" Value "PG01b" or “PG02b” N (Primary Social Security) Number Blank Value "200212", YYYYMM Blank | 0002 0003 0004 0005 0006 Page Number Taxpayer Identification Number Filler Tax Period Filler (42 characters) 5 9 1 6 1 (Begin data fields for Page 1 of the Return record layout.) Publication 1346 August 30, 2002 Part II Page 7 Section 2 Tax Return Record Identification, Page 1 - Forms 1040, 1040A and 1040EZ (Cont'd) (Begin bracketing Field Numbers for Page 1 of the Tax Return when using variable format.) Field# 0007 Identification Return Sequence Number a. b. c. d. e. Length 16 5 2 3 2 4 14 2 6 3 2 1 Description N (composed of) N N N N (00-99) N (0000-9999) N (assigned by the ERO) N N N (000-999) N (00-99) N ("3") ETIN of Transmitter Transmitter Use Field Julian Day of Transmission Transmission Sequence Number Sequence Number of each Return | | 0008 Declaration Control Number a. b. c. d. e. Always "00" EFIN of Originator Batch Number Serial Number Year Digit | Publication 1346 August 30, 2002 Part II Page 8 Section 2 Tax Return Record Identification, Page 2 - Forms 1040, and 1040A Field# Identification Byte Count, Page 1 Start of Record Sentinel 0000 0001 0002 0003 0004 0005 0006 Record ID Return Type Page Number Taxpayer Identification Number Filler Tax Period Filler Length 4 4 6 6 5 9 1 6 1 Description (see form) for fixed; "nnnn" for variable Value "****" Value "RETbbb" Value "1040bb" or "1040Ab" Value “PG02b” N (Primary Social Security Number Blank Value "200212", YYYYMM Blank | --------------------------------42 characters--------------------------------Begin Page 2 data fields. format Begin bracketing Field Numbers when using variable Publication 1346 August 30, 2002 Part II Page 9 Section 2 Proposed Record ID Fields for All Record Types Except Tax Return Field# Identification Byte Count, Page 1 Start of Record Sentinel 0000 Record ID Type Length 4 4 6 Description (see record) for fixed; "nnnn" for variable Value "****" Value "FRMbbb", “SCHaaa”, “STMbnn”, “NTSbbb”, “ELCbbb”,or“REGbbb”, “STbbbb”, “a” = AN or blank AN = aaaaaa “1040bb”,“1040Ab”, “2106bb” “2106EZ”, “W-2bbb”, “W-2Gbb”, “1099Rb”, “8582CR” “0001bb”, “PMTbbb” AN “PGnnb” (nn = 01-99) Primary SSN Blank 0000001 - 0000099 Number limited to the maximum number of forms allowed 0001 Form Number 6 0002 0003 0004 0005 Page Number Taxpayer Identification Number Filler Form/Schedule Occurrence Number 5 9 1 7 -------------------------------42 characters--------------------------------Begin Data Fields (starting with Field # 0010). Publication 1346 August 30, 2002 Part II Page 10 Section 2 FORM 1040 PAGE 1 Field Identification No. ----- -------------Byte Count U.S. Individual Income Tax Return Form Ref. ---Length -----4 Field Description ----------------"1355" for Fixed; "nnnn" for variable format Value "****" "RETbbb" "1040bb" "PG01b" N (Primary SSN) | Start of Record Sentinel 0000 0001 0002 0003 Record ID Type Page Number Taxpayer Identification Number Filler Tax Period Filler Return Sequence Number Declaration Control Number Primary SSN Primary Date of Death Secondary SSN Secondary Date of Death Primary Name Control 4 6 6 5 9 0004 0005 0006 0007 0008 0010 0020 0030 0040 0050 1 6 1 16 14 9 8 9 8 4 blank Value "200212", YYYYMM | blank N N N (Your Social Security Number) YYYYMMDD or blank | N or blank YYYYMMDD or blank | First 4 significant characters of taxpayer's last name, no leading or embedded spaces; allowable characters are alpha, hyphen or space (see special instructions) Part II Page 11 Section 2 Publication 1346 August 30, 2002 FORM 1040 PAGE 1 Field Identification No. ----- -------------0055 Spouse's Name Control U.S. Individual Income Tax Return Form Ref. ---Length -----4 Field Description ----------------First 4 significant characters of spouse's last name, no leading or embedded spaces; allowable characters are alpha, hyphen or space (see special instructions) AN Taxpayer's name allowable special characters are: space, less-than (<), hyphen (-) and ampersand (&) AN, Allowable special characters are space, slash, and hyphen AN, Allowable special characters are space, slash, and hyphen A, Allowable special character is space AN, in care of Addressee, or address continuation. Allowable special characters are space, ampersand, slash, hyphen and percent (%) AN, Allowable special characters are space, slash, hyphen and Literal "NONE" A, Allowable special character is space A (Standard Postal State | Abbreviations) or "SO" (State-Only return data attached) N (left-justified) Part II Page 12 Section 2 0060 Name Line 1 35 0062 Foreign Street Address Foreign City, State or Province, Postal Code Foreign Country Name Line 2 35 0064 35 0066 0070 22 35 0080 Street Address 35 0083 0087 City State Abbreviation 22 2 0095 Zip Code August 30, 2002 12 Publication 1346 FORM 1040 PAGE 1 Field Identification No. ----- -------------0097 Address Ind U.S. Individual Income Tax Return Form Ref. ---Length -----1 Field Description ----------------1 = APO/FPO Address, 2 = Stateside Military Address, 3 = Foreign Address, or blank "DESERTbSTORM", "HAITI", "FORMERbYUGOSLAVIA", "UNbOPERATION", "JOINTbGUARD", "JOINTbFORGE", "NORTHERNbWATCH", "OPERATIONbALLIEDbFORCE" "NORTHERNbFORGE", "ENDURINGbFREEDOM or blank "X" or blank "X" or blank "X" or blank "X" or blank Value 1, 2, 3, 4 or 5 (Applicable block, lines 1-5) "STMbnn" or blank AN (must be present if filing status = 3, otherwise blank) A or blank N N (YYYY) "X" or blank "X" or blank Values 0, 1 or 2 Part II Page 13 Section 2 0100 Special Processing Literal 22 0110 0115 0120 0125 0130 PECF Primary Yes PECF Primary No PECF Spouse Yes PECF Spouse No Filing Status 1-5 1 1 1 1 1 @0135 0140 Overseas Extension Explanation Spouse's Name 3 6 25 0150 0153 0155 0160 0163 0167 Qualifying Name for H of Household SSN for Qual Name Year Spouse Died Exempt Self Exempt Spouse Total Box 6a and 6b 4 4 5 6a 6b 25 9 4 1 1 1 Publication 1346 August 30, 2002 FORM 1040 PAGE 1 Field Identification No. ----- -------------*0170 +0171 +0172 Dependent First Name 1 Dependent Last Name 1 Dependent Name Control - 1 U.S. Individual Income Tax Return Form Ref. ---6c(1) 6c(1) Length -----10 15 4 Field Description ----------------AN (first name, blank) or "STMbnn" AN (last name) or blank. First 4 significant characters of dependent's last name, no leading or embedded spaces; allowable characters are alpha, hyphen or space (see special instructions) N or blank Values: "CHILD", "FOSTERCHILD", "GRANDCHILD", "GRANDPARENT", "PARENT", "BROTHER", "SISTER", "AUNT", "UNCLE", "NEPHEW", "NIECE", "NONE", "SON", "DAUGHTER", "OTHER" "X" or blank AN (first name, blank) 'See 1st Occ.' 'See 1st Occ.' 'See 1st Occ.' 'See 1st Occ.' 'See 1st Occ.' 'See 2nd Occ.' Part II Page 14 Section 2 +0175 +0177 Dependent's SSN - 1 Relationship - 1 6c(2) 6c(3) 9 11 +0178 0180 0181 0182 0185 0187 0188 0190 Eligibility for Child Tax Credit - 1 Dependent First Name 2 Dependent Last Name 2 Dependent Name control 2 Dependent's SSN - 2 Relationship - 2 Eligibility for Child Tax Credit - 2 Dependent First Name 3 6c(4) 6c(1) 6c(1) 1 10 15 4 6c(2) 6c(3) 6c(4) 6c(1) August 30, 2002 9 11 1 10 Publication 1346 FORM 1040 PAGE 1 Field Identification No. ----- -------------0191 0192 0195 0197 0198 0200 0201 0202 0205 0207 0208 0210 0211 0212 0215 0217 0218 Dependent Last Name 3 Dependent Name Control - 3 Dependent's SSN - 3 Relationship - 3 Eligibility for Child Tax Credit - 3 Dependent First Name 4 Dependent Last Name 4 Dependent Name Control 4 Dependent's SSN - 4 Relationship - 4 Eligibility for Child Tax Credit - 4 Dependent First Name 5 Dependent Last Name 5 Dependent Name Control 5 Dependent's SSN - 5 Relationship - 5 Eligibility for Child Tax Credit - 5 U.S. Individual Income Tax Return Form Ref. ---6c(1) Length -----15 4 6c(2) 6c(3) 6c(4) 6c(1) 6c(1) 9 11 1 10 15 4 6c(2) 6c(3) 6c(4) 6c(1) 6c(1) 9 11 1 10 15 4 6c(2) 6c(3) 6c(4) 9 11 1 Field Description ----------------'See 1st Occ.' 'See 1st Occ.' 'See 1st Occ.' 'See 1st Occ.' 'See 1st Occ.' 'See 2nd Occ.' 'See 1st Occ.' 'See 1st Occ.' 'See 1st Occ.' 'See 1st Occ.' 'See 1st Occ.' 'See 2nd Occ.' 'See 1st Occ.' 'See 1st Occ.' 'See 1st Occ.' 'See 1st Occ.' 'See 1st Occ.' --| --| --| --| --| --| Part II Page 15 Section 2 Publication 1346 August 30, 2002 FORM 1040 PAGE 1 Field Identification No. ----- -------------0240 0247 0350 0360 0362 0364 0366 0368 0369 0370 0371 0372 0373 @0374 0375 0376 0377 0378 Number of Children Who Lived with You Number of Children Not living With You Number of Other Dependents Listed Total Exemptions Prisoner Earned Income Literal Prisoner Earned Income Amount Household Help Literal Household Help Amt Adoption Literal Fringe Benefit Literal Dependent Care Benefits Literal Scholarship Literal Scholarship Amount Non-W2 Disability Payment Explanation Wages, Salaries,Tips Workfare Payments Literal Workfare Payments Amount Foreign Employer Compensation Literal U.S. Individual Income Tax Return Form Ref. ---6c 6c 6c 6d 7 7 7 7 7 7 7 7 7 7 7 7 7 7 Length -----2 2 2 2 3 12 3 12 2 2 3 3 12 6 12 2 12 3 Field Description ----------------Value Range 00-99 Value Range 00-99 Value Range 00-99 Value Range 00-99 "PRI" or blank N "HSH" or blank N "AB" or blank "FB" or blank "DCB" or blank "SCH" or blank N "STMbnn" or blank N "WP" or blank N "FEC" or blank | Publication 1346 August 30, 2002 Part II Page 16 Section 2 FORM 1040 PAGE 1 Field Identification No. ----- -------------0379 0380 0385 0394 0420 0430 0440 0447 0450 0460 0470 0475 0477 @0479 0480 0485 0487 0495 0510 Foreign Employer Compensation Total Taxable Interest Tax-Exempt Interest Total Ordinary Dividends State/Local Income Tax Refund Alimony Received Business Income/Loss Capital Distribution Box Capital Gain/Loss F4684 Literal Other Gain/Loss IRA Distributions Received IRA Distribution Literal IRA Distribution Explanation Taxable IRA Amount Pensions Annuities Received Pensions and Annuities Literal Taxable Pensions Amount Rent/Royalty/Part/ Estates/Trusts Inc U.S. Individual Income Tax Return Form Ref. ---7 8a 8b 9 10 11 12 13 13 14 14 15a 15b 15b 15b 16a 16b 16b 17 August 30, 2002 Length -----12 12 12 12 12 12 12 1 12 5 12 12 8 6 12 12 8 12 12 Field Description ----------------N or blank N N N N N N "X" or blank N "F4684" or blank N N | | "ROLLOVER" or blank "STMbnn" or blank N N "ROLLOVER" or blank N N Part II Page 17 Section 2 Publication 1346 FORM 1040 PAGE 1 Field Identification No. ----- -------------0520 0545 0551 0552 0553 0555 0557 *0560 +0570 *0574 Farm Income Repayment Literal Repayment Amount Unemployment Compensation Social Security Benefits SS Benefit Indicator Taxable Amount of Social Security Type of Other Income Amount of Other Income Housing/Foreign Earned Income Exclusion Literal Housing/Foreign Earned Income Exclusion Amount Total Other Income Total Income Educator Expenses IRA Deduction Student Loan Interest Deduction Tuition and Fees Deduction Archer MSA Deduction Current Year Moving Expenses U.S. Individual Income Tax Return Form Ref. ---18 19 19 19 20a 20a 20b 21 21 21 Length -----12 6 12 12 12 3 12 25 12 12 Field Description ----------------N "REPAID" or blank N N N "D", "LSE" or blank N AN, "MSA", "LTC", "MED&MSA" or "STMbnn" N Values "FORMb2555", "FORMb2555-EZ", "STMbnn" or blank N +0577 21 12 0590 0600 0623 0626 0628 0630 0632 0637 21 22 23 24 25 26 27 28 August 30, 2002 12 12 12 12 12 12 12 12 N N N N N N N N | | | | | | Part II Page 18 Section 2 Publication 1346 FORM 1040 PAGE 1 Field Identification No. ----- -------------0640 Self-Employed Deduction Schedule SE Self-Employed Health Insurance Ded Keogh/SEP/SIMPLE Deduction Early Withdrawal Penalty Recip Soc Sec No. Alimony Amount Total Alimony Paid Other Adjustments Literal U.S. Individual Income Tax Return Form Ref. ---29 Length -----12 Field Description ----------------N | 0645 0650 0680 *0693 +0695 0697 *0720 30 31 32 33b 33a 33a 34 12 12 12 9 12 12 11 N N N N or "STMbnn" N N | | | | | | Values are | "RFST", "SUB-PAYbTRA", "QPA", "JURYbPAY", "501(C)(18)", "PPR", "CLEAN-FUEL", "FBO", "FORMb2555", "STMbnn" or blank N N N N | | | | +0730 0735 0740 0750 Other Adjustment Amount Total Other Adjustments Total Adjustments Adjusted Gross Income 34 34 34 35 12 12 12 12 Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 19 Section 2 FORM 1040 PAGE 2 Field Identification No. ----- -------------Byte Count U.S. Individual Income Tax Return Form Ref. ---Length -----4 Field Description ----------------"1133" for Fixed; "nnnn" for variable format Value "****" "RETbbb" "1040bb" "PG02b" N (Primary SSN) | Start of Record Sentinel 0760 0761 0762 0763 Record ID Type Page Number Taxpayer Identification Number Filler Tax Period Filler AGI Repeated Self 65 or Over Box Self Blind Box Spouse 65 or Over Box Spouse Blind Box Total Boxes Checked Must Itemize Indicator Modified Standard Deduction Ind Itemize Election Ind Total Itemized or Standard Deduction AGI Less Deduction Exemption Amount 36 37a 37a 37a 37a 37a 37b 38 38 38 39 40 August 30, 2002 4 6 6 5 9 0764 0765 0766 0770 0772 0774 0776 0778 0783 0786 0787 0788 0789 0800 0810 1 6 1 12 1 1 1 1 1 1 8 2 12 12 12 blank Value "200212", YYYYMM | blank N "X" or blank "X" or blank "X" or blank "X" or blank | | | | | 1, 2, 3, 4 or blank | "X" or blank | "SECTb933" or blank | "IE" or blank N N N | | | | Part II Page 20 Section 2 Publication 1346 FORM 1040 PAGE 2 Field Identification No. ----- -------------0820 0853 0857 0880 0890 0900 0915 0918 0920 Taxable Income Form 8814 Block Form 8814 Amount Form 4972 Block Education Credit Recapture Literal Education Credit Recapture Amount Tax Alternative Minimum Tax Total Tax Before Credits & Other Taxes Foreign Tax Credit Credit for Child & Dependent Care Credit for Elderly or Disabled Education Credits (Form 8863) Credit for Qualified Retirement Savings Child Tax Credit Adoption Credit Form 8396 Block From 8859 Block Credits from F8396 & F8859 U.S. Individual Income Tax Return Form Ref. ---41 42a 42a 42b 42 42 42 43 44 Length -----12 1 12 1 3 12 12 12 12 Field Description ----------------N "X" or blank N "X" or blank "ECR" or blank N N N N | | | | | | | | | 0922 0925 0930 0935 0937 45 46 47 48 49 12 12 12 12 12 N N N N N | | | | | 0940 0960 0985 0990 0995 50 51 52a 52b 52 August 30, 2002 12 12 1 1 12 N N "X" or blank "X" or blank N --| | | | | | Part II Page 21 Section 2 Publication 1346 FORM 1040 PAGE 2 Field Identification No. ----- -------------1000 Form 3800 Block U.S. Individual Income Tax Return Form Ref. ---53a Length -----1 Field Description ----------------"X" or blank | --| --| | | 1005 1006 1010 Form 8801 Block Other Form Block Other Form Literal 53b 53c 53c 1 1 12 "X" or blank "X" or blank "8586", "3468", "5884", | "6478", "6765", "8820", "8826", "8830", "8834", "8835", "8844", "8845", "8846", "8847", "8859", "8861" or "TRANSbALASKA" N "FNS" or blank | | 1015 1017 Other Credits Nonconventional Source Fuel Credit Literal Nonconventional Source Fuel Credit Amount Total Credits Nonconventional Source Fuel Credit Tax Less Credits Exempt SE Tax Indicator Self Employment Tax Railroad Retire Indicator Social Security & Medicare tax on Tips Retirement Tax Plan Literal Tax on Retirement Plans 53 54 12 3 1018 54 12 N | 1020 @1025 1030 1035 54 54 55 12 6 12 13 N | "STMbnn" or blank | N | "F4029", "F4361", "EXEMPT-NOTARY", or blank N "RRTA" or blank N "NO" or blank N | | | | | Part II Page 22 Section 2 1040 1070 1080 1095 1100 56 57 57 58 58 August 30, 2002 12 4 12 2 12 Publication 1346 FORM 1040 PAGE 2 Field Identification No. ----- -------------1105 1107 *1110 Advanced EIC Payments Household Employment Taxes Other Tax Literal U.S. Individual Income Tax Return Form Ref. ---59 60 61 Length -----12 12 8 Field Description ----------------N N | | "EPP", "S72P", "UT", | "S453A", "STMbnn", "ADT", "72(M)(5)", "MSA", "MED&MSA" or blank N "LIHCR" or blank N "X" or blank DT "ICR" or blank N "FMSR" or blank N "QEVCR" or blank N "FORMb8697" or "FORMb8866" N "IECR" or blank N N N | | | | | | | | | | | | | | | | | Part II Page 23 Section 2 +1112 1114 1116 1118 1119 1121 1122 1123 1124 1126 1128 1129 1131 1132 1134 1136 1138 Other Tax Amount F8611 Literal F8611 Amount Form 8693 Approved Indicator Form 8693 Approved Date F4255 Literal F4255 Amount F8828 Literal F8828 Amount F8834 Literal F8834 Amount F8697 Literal or F8866 Literal F8697 Amount or F8866 Amount F8845 Literal F8845 Amount Total Other Tax Total Tax 61 61 61 61 61 61 61 61 61 61 61 61 61 61 61 61 61 August 30, 2002 12 5 12 1 8 3 12 4 12 5 12 9 12 4 12 12 12 Publication 1346 FORM 1040 PAGE 2 Field Identification No. ----- -------------1140 1160 1161 1162 1170 @1173 Other 1099 Withholding Literal Withholding Divorced Spouse SSN Divorced Literal ES Payments Estimated Payment Name Change EIC Literal Earned Income Credit EIC Eligibility Excess SS & Tier 1 RRTA Tax Additional Child Tax Credit (Form 8812) F4868 Amount Form 2439 Block Form 4136 Block Other Payments Form 8689 Literal Form 8689 Amount Total Payments Overpaid Refund Routing Transit Number U.S. Individual Income Tax Return Form Ref. ---62 62 63 63 63 63 Length -----9 12 9 3 12 6 Field Description ----------------"FORMb1099" or blank | N N or blank "DIV" or blank N | | | | "STMbnn" or blank | --| | | 1178 1180 1183 1184 1186 64 64 64 65 66 3 12 6 12 12 NO ENTRY N "CLERGY" or "NO" or | blank N N | | 1190 1202 1205 1210 1245 1246 1250 1260 1270 1272 67 68a 68b 68 68 68 69 70 71a 71b August 30, 2002 12 1 1 12 9 12 12 12 12 9 N "X" or blank "X" or blank N | | | | "FORMb8689" or blank | N N N N N or blank | | | | | Publication 1346 Part II Page 24 Section 2 FORM 1040 PAGE 2 Field Identification No. ----- -------------1274 1276 1278 1280 1290 1295 1300 1303 1305 1307 1309 Checking Account Indicator Savings Account Indicator Depositor Account Number Applied to ES Tax Amount Owed ES Penalty Indicator ES Penalty Amount Third Party Designee "Yes" Box Third Party Designee "No" Box Third Party Designee Name Third Party Designee Telephone Number Third Party Designee PIN Remittance Primary Taxpayer Signature Occupation Spouse Signature Surviving Spouse Yes Surviving Spouse No Spouse Occupation U.S. Individual Income Tax Return Form Ref. ---71c 71c 71d 72 73 74 74 Length -----1 1 17 12 12 1 12 1 1 35 10 Field Description ----------------"X" or blank "X" or blank | | AN (includes hyphens or | blank) N N NO ENTRY N "X" or blank "X" or blank AN or "PREPARER" N | | | | 1313 1315 1321 1323 1324 1325 1326 1327 5 12 5 25 5 1 1 25 August 30, 2002 AN or blank No Entry N (PIN Use Only) AN N (PIN Use Only) "X" or blank "X" or blank AN Part II Page 25 Section 2 | | Publication 1346 FORM 1040 PAGE 2 Field Identification No. ----- -------------1328 1329 Taxpayer Daytime Telephone Number Taxpayer Optional Foreign Telephone Number Non-Paid Preparer U.S. Individual Income Tax Return Form Ref. ---Length -----10 20 Field Description ----------------N N, Allowable special characters are hyphen and space Values "TCE", "VITA", | "IRS-PREPARED", "IRS-REVIEWED", "ONLINE-PARTNR", (left justified) or blanks AN AN ("X" if self-employed, otherwise blank) N or PNNNNNNNN AN N AN A N N "Y" or "N" NO ENTRY 1338 13 1340 1350 Name of Paid Preparer Preparer SelfEmployment Indicator Preparer SSN/ Preparer TIN Preparer Firm Name Preparer Firm EIN Firm City Firm State Firm Zip Firm Telephone Number RAL Indicator Refund Indicator 35 1 1360 1370 1380 1390 1400 1410 1420 1465 1470 9 35 9 20 2 9 10 1 1 Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 26 Section 2 FORM 1040A PAGE 1 Field Identification No. ----- -------------Byte Count U.S. Individual Income Tax Return Form Ref. ---Length -----4 Field Description ----------------"1058" for Fixed; "nnnn" for variable format Value "****" "RETbbb" "1040Ab" "PG01b" N (Primary SSN) | Start of Record Sentinel 0000 0001 0002 0003 Record ID Type Page Number Taxpayer Identification Number Filler Tax Period Filler Return Sequence Number Declaration Control Number Primary SSN Primary Date of Death Secondary SSN Secondary Date of Death Primary Name Control 4 6 6 5 9 0004 0005 0006 0007 0008 0010 0020 0030 0040 0050 1 6 1 16 14 9 8 9 8 4 blank Value "200212", YYYYMM | blank N N N (Your Social Security Number) YYYYMMDD or blank | N or blank YYYYMMDD or blank | First 4 significant characters of taxpayer's last name, no leading or embedded spaces; allowable characters are alpha, hyphen or space (see special instructions) Part II Page 27 Section 2 Publication 1346 August 30, 2002 FORM 1040A PAGE 1 Field Identification No. ----- -------------0055 Spouse's Name Control U.S. Individual Income Tax Return Form Ref. ---Length -----4 Field Description ----------------First 4 significant characters of spouse's last name, no leading or embedded spaces; allowable characters are alpha, hyphen or space (see special instructions) AN Taxpayer's name allowable special characters are: space, less-than (<), hyphen (-) and ampersand (&). AN, Allowable special characters are space, slash, and hyphen AN, Allowable special characters are space, slash, and hyphen A, Allowable special character is space AN, in care of addressee or address continuation. Allowable special characters are space, ampersand, slash, hyphen and percent. AN, Allowable special characters are space, slash, hyphen and Literal "NONE" A, Allowable special character is space. A (Standard Postal State Abbreviations) N (left-justified) 0060 Name Line 1 35 0062 Foreign Street Address Foreign City, State or Province, Postal Code Foreign Country Name Line 2 35 0064 35 0066 0070 22 35 0080 Street Address 35 0083 0087 0095 City State Abbreviation Zip Code 22 2 12 Publication 1346 August 30, 2002 Part II Page 28 Section 2 FORM 1040A PAGE 1 Field Identification No. ----- -------------0097 Address Ind U.S. Individual Income Tax Return Form Ref. ---Length -----1 Field Description ----------------1 = APO/FPO Address, 2 = Stateside Military Address, 3 = Foreign Address, or blank "DESERTbSTORM", "HAITI", "FORMERbYUGOSLAVIA", "UNbOPERATION", "JOINTbGUARD", "JOINTbFORGE", "NORTHERNbWATCH", "OPERATIONbALLIEDbFORCE" "NORTHERNbFORGE", "ENDURINGbFREEDOM, or blank "X" or blank "X" or blank "X" or blank "X" or blank Value 1, 2, 3, 4 or 5 (Applicable block, lines 1-5) "STMbnn" or blank AN (must be present if filing status = 3, otherwise blank) A or blank N N (YYYY) "X" or blank "X" or blank Values 0, 1 or 2 Part II Page 29 Section 2 0100 Special Processing Literal 22 0110 0115 0120 0125 0130 PECF Primary Yes PECF Primary No PECF Spouse Yes PECF Spouse No Filing Status 1-5 1 1 1 1 1 @0135 0140 Overseas Extension Explanation Spouse's Name 3 6 25 0150 0153 0155 0160 0163 0167 Qualifying Name for H of Household SSN for Qual Name Year Spouse Died Exempt Self Exempt Spouse Total Box 6a and 6b 4 4 5 6a 6b 25 9 4 1 1 1 Publication 1346 August 30, 2002 FORM 1040A PAGE 1 Field Identification No. ----- -------------*0170 +0171 +0172 Dependent First Name 1 Dependent Last Name - 1 Dependent Name Control - 1 U.S. Individual Income Tax Return Form Ref. ---6c(1) 6c(1) Length -----10 15 4 Field Description ----------------AN (first name, blank) or "STMbnn" AN (last name) or blank First 4 significant characters of dependent's last name, no leading or embedded spaces; allowable characters are alpha, hyphen or space (see special instructions) N or blank Values: "CHILD", "FOSTERCHILD", "GRANDCHILD", "GRANDPARENT", "PARENT", "BROTHER", "SISTER", "AUNT", "UNCLE", "NEPHEW", "NIECE", "NONE","SON", "DAUGHTER", "OTHER" "X" or blank AN (first name, blank) 'See 1st Occ.' 'See 1st Occ.' 'See 1st Occ.' 'See 1st Occ.' 'See 1st Occ.' 'See 2nd Occ.' Part II Page 30 Section 2 +0175 +0177 Dependent's SSN - 1 Relationship - 1 6c(2) 6c(3) 9 11 +0178 0180 0181 0182 0185 0187 0188 0190 Eligibility for Child Tax Credit - 1 Dependent First Name 2 Dependent Last Name 2 Dependent Name control - 2 Dependent's SSN - 2 Relationship - 2 Eligibility for Child Tax Credit - 2 Dependent First Name 3 6c(4) 6c(1) 6c(1) 1 10 15 4 6c(2) 6c(3) 6c(4) 6c(1) August 30, 2002 9 11 1 10 Publication 1346 FORM 1040A PAGE 1 Field Identification No. ----- -------------0191 0192 0195 0197 0198 0200 0201 0202 0205 0207 0208 0210 0211 0212 0215 0217 0218 Dependent Last Name 3 Dependent Name Control - 3 Dependent's SSN - 3 Relationship - 3 Eligibility for Child Tax Credit - 3 Dependent First Name 4 Dependent Last Name 4 Dependent Name Control - 4 Dependent's SSN - 4 Relationship - 4 Eligibility for Child Tax Credit - 4 Dependent First Name 5 Dependent Last Name 5 Dependent Name Control - 5 Dependent's SSN - 5 Relationship - 5 Eligibility for Child Tax Credit - 5 U.S. Individual Income Tax Return Form Ref. ---6c(1) Length -----15 4 6c(2) 6c(3) 6c(4) 6c(1) 6c(1) 9 11 1 10 15 4 6c(2) 6c(3) 6c(4) 6c(1) 6c(1) 9 11 1 10 15 4 6c(2) 6c(3) 6c(4) 9 11 1 Field Description ----------------'See 1st Occ.' 'See 1st Occ.' 'See 1st Occ.' 'See 1st Occ.' 'See 1st Occ.' 'See 2nd Occ.' 'See 1st Occ.' 'See 1st Occ.' 'See 1st Occ.' 'See 1st Occ.' 'See 1st Occ.' 'See 2nd Occ.' 'See 1st Occ.' 'See 1st Occ.' 'See 1st Occ.' 'See 1st Occ.' 'See 1st Occ.' --| --| --| --| --| --| Part II Page 31 Section 2 Publication 1346 August 30, 2002 FORM 1040A PAGE 1 Field Identification No. ----- -------------0240 0247 0350 0360 0362 0364 0366 0368 0369 0370 0371 0372 0373 0375 0376 0377 0378 0379 0380 Number of Children Who Lived with You Number of Children Not living With You Number of Other Dependents Listed Total Exemptions Prisoner Earned Income Literal Prisoner Earned Income Amount Household Help Literal Household Help Amt Adoption Literal Fringe Benefit Literal Dependent Care Benefits Literal Scholarship Literal Scholarship Amount Wages, Salaries,Tips Workfare Payments Literal Workfare Payments Amount Foreign Employer Compensation Literal Foreign Employer Compensation Total Taxable Interest U.S. Individual Income Tax Return Form Ref. ---Length -----2 2 2 6d 7 7 7 7 7 2 3 12 3 12 2 2 3 3 12 7 7 7 7 7 8a August 30, 2002 12 2 12 3 12 12 Field Description ----------------Value Range 00-99 Value Range 00-99 Value Range 00-99 Value Range 00-99 "PRI" or blank N "HSH" or blank N "AB" or blank "FB" or blank "DCB" or blank "SCH" or blank N N "WP" or blank N "FEC" or blank N or blank N Part II Page 32 Section 2 | | Publication 1346 FORM 1040A PAGE 1 Field Identification No. ----- -------------0385 0394 0450 0475 0477 @0479 0480 0485 0487 0495 0545 0551 0552 0553 0555 0557 0600 0623 0626 Tax-Exempt Interest Total Ordinary Dividends Capital Gain/Loss IRA Distributions Received IRA Distribution Literal IRA Distribution Explanation Taxable IRA Amount Pensions Annuities Received Pensions and Annuities Literal Taxable Pensions Amount Repayment Literal Repayment Amount Unemployment Compensation Social Security Benefits SS Benefit Indicator Taxable Amount of Social Security Total Income Education Expenses IRA Deduction U.S. Individual Income Tax Return Form Ref. ---8b 9 10 11a 11b 11b 11b 12a 12b 12b Length -----12 12 12 12 8 6 12 12 8 12 6 12 13 14a 14a 14b 15 16 17 August 30, 2002 12 12 3 12 12 12 12 Field Description ----------------N N N N | "ROLLOVER" or blank "STMbnn" or blank N N "ROLLOVER" or blank N "REPAID" or blank N N N "D", "LSE" or blank N N N N | | Part II Page 33 Section 2 Publication 1346 FORM 1040A PAGE 1 Field Identification No. ----- -------------0628 0630 0740 0750 Student Loan Interest Deduction Tuition and Fees Deduction Total Adjustments Adjusted Gross Income U.S. Individual Income Tax Return Form Ref. ---18 19 20 21 Length -----12 12 12 12 Field Description ----------------N N N N | | | | Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 34 Section 2 FORM 1040A PAGE 2 Field Identification No. ----- -------------Byte Count U.S. Individual Income Tax Return Form Ref. ---Length -----4 Field Description ----------------"0808" for Fixed; "nnnn" for variable format Value "****" "RETbbb" "1040Ab" "PG02b" N (Primary SSN) | Start of Record Sentinel 0760 0761 0762 0763 Record ID Type Page Number Taxpayer Identification Number Filler Tax Period Filler AGI Repeated Self 65 or Over Box Self Blind Box Spouse 65 or Over Box Spouse Blind Box Total Boxes Checked Must Itemize Indicator Identification Modified Standard Deduction Ind Total Itemized or Standard Deduction AGI Less Deduction Exemption Amount 22 23a 23a 23a 23a 23a 23b 23 4 6 6 5 9 0764 0765 0766 0770 0772 0774 0776 0778 0783 0786 0787 1 6 1 12 1 1 1 1 1 1 8 blank Value "200212", YYYYMM | blank N "X" or blank "X" or blank "X" or blank "X" or blank | | | | | 1, 2, 3, 4 or blank | "X" or blank | "SECTb933" or blank | 0789 0800 0810 24 25 26 August 30, 2002 12 12 12 N N N | | | Part II Page 35 Section 2 Publication 1346 FORM 1040A PAGE 2 Field Identification No. ----- -------------0820 0840 0850 0854 0857 0860 0925 0930 0950 Taxable Income Education Credit Recapture Literal Education Credit Recapture Amount Alternative Minimum Tax Literal Alternative Minimum Tax Amount Tax Credit for Child & Dependent Care Credit for Elderly or Disabled Education Credits (Form 8863) Credit for Qualified Retirement Savings Child Tax Credit Adoption Credit Total Credits Tax Less Credits Advanced EIC Payments Total Tax Other 1099 Withholding Literal Withholding Divorced Spouse SSN U.S. Individual Income Tax Return Form Ref. ---27 28 28 28 28 28 29 30 31 Length -----12 3 12 3 12 12 12 12 12 Field Description ----------------N "ECR" or blank N "AMT" or blank N N N N N | | | | | | | | | --| | 0953 32 12 N 0955 0960 1020 1030 1105 1138 1140 1160 1161 33 34 35 36 37 38 39 39 12 12 12 12 12 12 9 12 9 N N N N N N | | | | | | "FORMb1099" or blank | N N or blank Part II Page 36 Section 2 | Publication 1346 August 30, 2002 FORM 1040A PAGE 2 Field Identification No. ----- -------------1162 1170 @1173 Divorced Literal ES Payments Estimated Payment Name Change EIC Literal Earned Income Credit EIC Eligibility Additional Child Tax Credit (Form 8812) F4868 Literal F4868 Amount Excess SST Literal Excess SS Tax Total Payments Overpaid Refund Routing Transit Number Checking Account Indicator Savings Account Indicator Depositor Account Number Applied to ES Tax Amount Owed ES Penalty Indicator U.S. Individual Income Tax Return Form Ref. ---Length -----3 40 12 6 Field Description ----------------"DIV" or blank N "STMbnn" or blank --| | | | | | 1178 1180 1183 1186 41 41 41 42 3 12 6 12 NO ENTRY N "NO" or blank N 1187 1190 1199 1200 1250 1260 1270 1272 1274 1276 1278 1280 1290 1295 43 43 43 43 43 44 45a 45b 45c 45c 45d 46 47 48 9 12 10 12 12 12 12 9 1 1 17 12 12 1 "FORMb4868" or blank | N | "EXCESSbSST" or blank | N N N N N or blank "X" or blank "X" or blank | | | | | | | AN (includes hyphens or | blank) N N NO ENTRY | | | Part II Page 37 Section 2 Publication 1346 August 30, 2002 FORM 1040A PAGE 2 Field Identification No. ----- -------------1300 1303 1305 1307 1309 ES Penalty Amount Third Party Designee "Yes" Box Third Party Designee "No" Box Third Party Designee Name Third Party Designee Telephone Number Third Party Designee PIN Remittance Primary Taxpayer Signature Occupation Spouse Signature Surviving Spouse Yes Surviving Spouse No Spouse Occupation Taxpayer Daytime Telephone Number Optional Foreign Telephone Number Non-Paid Preparer U.S. Individual Income Tax Return Form Ref. ---48 Length -----12 1 1 35 10 Field Description ----------------N "X" or blank "X" or blank AN or "PREPARER" N | 1313 1315 1321 1323 1324 1325 1326 1327 1328 1329 5 12 5 25 5 1 1 25 10 20 AN or blank No Entry N (PIN Use Only) AN N (PIN Use Only) "X" or blank "X" or blank AN N N, allowable special characters are hyphen and space Values "TCE", "VITA", | "IRS-PREPARED", "IRS-REVIEWED", "ONLINE-PARTNR", (left justified) or blanks AN Part II Page 38 Section 2 | | 1338 13 1340 Name of Paid Preparer August 30, 2002 35 Publication 1346 FORM 1040A PAGE 2 Field Identification No. ----- -------------1350 1360 1370 1380 1390 1400 1410 1420 1465 1470 Preparer SelfEmployment Indicator Preparer SSN/ Preparer TIN Preparer Firm Name Preparer Firm EIN Firm City Firm State Firm Zip Firm Telephone Number RAL Indicator Refund Indicator U.S. Individual Income Tax Return Form Ref. ---Length -----1 9 35 9 20 2 9 10 1 1 Field Description ----------------"X" or blank N or PNNNNNNNN AN N AN A N N "Y" or "N" NO ENTRY Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 39 Section 2 INTENTIONAL BLANK PAGE Publication 1346 August 30, 2002 Part II Page 40 Section 2 FORM 1040EZ Field Identification No. ----- -------------Byte Count U.S. Individual Income Tax Return Form Ref. ---Length -----4 Field Description ----------------"0982" for Fixed; "nnnn" for variable format Value "****" "RETbbb" "1040Zb" "PG01b" N (Primary SSN) | Start of Record Sentinel 0000 0001 0002 0003 Record ID Type Page Number Taxpayer Identification Number Filler Tax Period Filler Return Sequence Number Declaration Control Number Primary SSN Primary Date of Death Secondary SSN Secondary Date of Death Primary Name Control 4 6 6 5 9 0004 0005 0006 0007 0008 0010 0020 0030 0040 0050 1 6 1 16 14 9 8 9 8 4 blank Value "200212", YYYYMM | blank N N N (Your Social Security Number) YYYYMMDD or blank | N or blank YYYYMMDD or blank | First 4 significant characters of taxpayer's last name, no leading or embedded spaces; allowable characters are alpha, hyphen or space (see special instructions) Publication 1346 August 30, 2002 Part II Page 41 Section 2 FORM 1040EZ Field Identification No. ----- -------------0055 Spouse's Name Control U.S. Individual Income Tax Return Form Ref. ---Length -----4 Field Description ----------------First 4 significant characters of spouse's last name, no leading or embedded spaces; allowable characters are alpha, hyphen or space (see special instructions) AN Taxpayer's name allowable special characters are: space, less-than (<), hyphen (-) and ampersand (&). AN, Allowable special characters are space, slash, and hyphen AN, Allowable special characters are space, slash, and hyphen A, Allowable special character is space AN, in care of addressee, or address continuation. Allowable special characters are space, ampersand, slash, hyphen and percent. AN, Allowable special characters are space, slash, hyphen and Literal "NONE" A, Allowable special character is space. A (Standard Postal State Abbreviations) N (left-justified) 0060 Name Line 1 35 0062 Foreign Street Address Foreign City, State or Province, Postal Code Foreign Country Name Line 2 35 0064 35 0066 0070 22 35 0080 Street Address 35 0083 0087 0095 City State Abbreviation Zip Code 22 2 12 Publication 1346 August 30, 2002 Part II Page 42 Section 2 FORM 1040EZ Field Identification No. ----- -------------0097 Address Ind U.S. Individual Income Tax Return Form Ref. ---Length -----1 Field Description ----------------1 = APO/FPO Address, 2 = Stateside Military Address, 3 = Foreign Address, or blank "DESERTbSTORM", "HAITI", "FORMERbYUGOSLAVIA", "UNbOPERATION", "JOINTbGUARD", "JOINTbFORGE", "NORTHERNbWATCH", "OPERATIONbALLIEDbFORCE" "NORTHERN FORGE", "ENDURINGbFREEDOM" or blank "X" or blank "X" or blank "X" or blank "X" or blank "STMbnn" or blank "PRI" or blank N "HSH" or blank N "SCH" or blank N N "WP" or blank N Part II Page 43 Section 2 0100 Special Processing Literal 22 0110 0115 0120 0125 @0135 0362 0364 0366 0368 0372 0373 0375 0376 0377 PECF Primary Yes PECF Primary No PECF Spouse Yes PECF Spouse No Overseas Extension Explanation Prisoner Earned Income Literal Prisoner Earned Income Amount Household Help Literal Household Help Amt Scholarship Literal Scholarship Amount Wages, Salaries,Tips Workfare Payments Literal Workfare Payments Amount 1 1 1 August 30, 2002 1 1 1 1 1 1 1 1 6 3 12 3 12 3 12 12 2 12 Publication 1346 FORM 1040EZ Field Identification No. ----- -------------0378 0379 0380 0382 0385 0545 0551 0552 0750 0784 0785 0815 Foreign Employer Compensation Literal Foreign Employer Compensation Total Taxable Interest Tax Exempt Literal Tax Exempt Interest Repayment Literal Repayment Amount Unemployment Compensation Adjusted Gross Income Dependent Yes-Ind Dependent No-Ind Combined Standard Deduction and Personal Exemption Taxable Income Other 1099 Withholding Literal Withholding EIC Literal Earned Income Credit EIC Eligibility F4868 Literal F4868 Amount Total Payments U.S. Individual Income Tax Return Form Ref. ---1 1 2 2 2 3 3 3 4 5 5 5 Length -----3 12 12 3 12 6 12 12 12 1 1 12 Field Description ----------------"FEC" or blank N or blank N "TEI" or blank N "REPAID" or blank N N N (AGI) "X" or blank "X" or blank N | | 0820 1140 1160 1178 1180 1183 1187 1190 1250 6 7 7 8 8 8 9 9 9 August 30, 2002 12 9 12 3 12 6 9 12 12 N --| "FORMb1099" or blank | N NO ENTRY N "NO" or blank | --| | | | "FORMb4868" or blank | N N | | Part II Page 44 Section 2 Publication 1346 FORM 1040EZ Field Identification No. ----- -------------1256 1270 1272 1274 1276 1278 1290 1303 1305 1307 1309 Total Tax Refund Routing Transit Number Checking Account Indicator Savings Account Indicator Depositor Account Number Amount Owed Third Party Designee "Yes" Box Third Party Designee "No" Box Third Party Designee Name Third Party Designee Telephone Number Third Party Designee PIN Remittance Primary Taxpayer Signature Occupation Spouse Signature Surviving Spouse Yes Surviving Spouse No Spouse Occupation U.S. Individual Income Tax Return Form Ref. ---10 11a 11b 11c 11c 11d 12 Length -----12 12 9 1 1 17 12 1 1 35 10 Field Description ----------------N N N or blank "X" or blank "X" or blank | | | | | AN (includes hyphens or | blank) N "X" or blank "X" or blank AN or "PREPARER" N | 1313 1315 1321 1323 1324 1325 1326 1327 5 12 5 25 5 1 1 25 August 30, 2002 AN No Entry N (PIN Use Only) AN N (PIN Use Only) "X" or blank "X" or blank AN Part II Page 45 Section 2 | | Publication 1346 FORM 1040EZ Field Identification No. ----- -------------1328 1338 Taxpayer Daytime Telephone Number Non-Paid Preparer U.S. Individual Income Tax Return Form Ref. ---Length -----10 13 Field Description ----------------N Values "TCE", "VITA", | "IRS-PREPARED", "IRS-REVIEWED", "ONLINE-PARTNR", (left justified) or blanks AN AN ("X" if self-employed, otherwise blank) N or PNNNNNNNN AN N AN A N N "Y" or "N" NO ENTRY 1340 1350 1360 1370 1380 1390 1400 1410 1420 1465 1470 Name of Paid Preparer Preparer SelfEmployment Indicator Preparer SSN/ Preparer TIN Preparer Firm Name Preparer Firm EIN Firm City Firm State Firm Zip Firm Telephone Number RAL Indicator Refund Indicator 35 1 9 35 9 20 2 9 10 1 1 Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 46 Section 2 SECTION 3 SCHEDULES Schedule Record Identification Each page of a schedule will have a new Schedule Record with the Page Number incremented and must start with a Byte Count, Start of Record Sentinel and Record Identification. The following fields describe the composition of the Record ID. Field# Identification Byte Count Start of Record Sentinel 0000 0001 0002 0003 0004 0005 Record ID Schedule Type Page Number Taxpayer Identification Number Filler Schedule Occurrence Number Length 4 4 6 6 5 9 1 7 Description (see schedule) for fixed; "nnnn" for variable Value "****" Value "SCHbbb" Value "1040bb", "1040Ab" or "8847bb" Value "Pgnnb", nn = 0l to 02 N (Primary Social Security) Number Blank Number limited to the maximum number of schedules allowed (Begin data fields of the Schedule record layout.) Publication 1346 August 30, 2002 Part II Page 47 Section 3 INTENTIONAL BLANK PAGE Publication 1346 August 30, 2002 Part II Page 48 Section 3 SCHEDULE A Field Identification No. ----- -------------Byte Count Itemized Deductions Form Ref. ---Length -----4 Field Description ----------------"0664" for Fixed; "nnnn" for variable format Value "****" "SCHbbA" "1040bb" "PG01b" N (Primary SSN) Start of Record Sentinel 0000 0001 0002 0003 Record ID Schedule Type Page Number Taxpayer Identification Number Filler Schedule Occurrence Number Medical/Dental/ Expenses AGI Amount Medical Allowance Total Medical/Dental State & Local Taxes Real Estate Taxes Personal Property Taxes Other Taxes Type Other Taxes Amount Total Other Taxes Amount Total Taxes Form 1098 Explanation 1 2 3 4 5 6 7 8 8 8 9 10 4 6 6 5 9 0004 0005 0015 0065 0070 0080 0090 0100 0110 *0130 +0135 0140 0150 @0159 1 7 12 12 12 12 12 12 12 28 12 12 12 6 blank N 0000001 N N N N N N N AN or "STMbnn" N N N "STMbnn" or blank Publication 1346 August 30, 2002 Part II Page 49 Section 3 SCHEDULE A Field Identification No. ----- -------------0160 Mortgage Interest to Financial Institutions Form 1098 Name/ Address Recipient Name Recipient Address Recipient TIN Total Indiv Mortgage Interest Amount Deductible Points Investment Interest Total Interest Total Cash/Check Contribution Non-Cash/Check Contribution Carryover Prior Yr Total Contributions Casualty/Theft Loss Unreimbursed Emp Bus Expn Desc Unreimbursed Employee Business Expense Amount Tot Unreimbursed Employee Business Expense Amount Tax Preparation Fees Other Expenses Type (1) Itemized Deductions Form Ref. ---10 Length -----12 Field Description ----------------N @0165 *0170 +0180 +0190 0195 11 11 11 11 11 6 20 40 9 12 "STMbnn" or blank AN or "STMbnn" AN N N 0203 0207 0290 0350 0360 0370 0380 0390 *0400 +0405 12 13 14 15 16 17 18 19 20 20 12 12 12 12 12 12 12 12 25 12 N N N N N N N N AN or "STMbnn" N 0410 20 12 N 0415 *0420 21 22 12 30 N AN or "STMbnn" Part II Page 50 Section 3 Publication 1346 August 30, 2002 SCHEDULE A Field Identification No. ----- -------------+0430 0432 0434 0435 0445 0450 0455 0465 *0475 +0485 0495 0520 Other Expenses Amount(1) Other Expenses Type(2) Other Expenses Amount (2) Total Other Expenses Gross Miscellaneous Deductions Form 1040 AGI Repeated Miscellaneous Allowance Net Miscellaneous Deductions Other Expense Type Other Expense Amount Total Other Expenses Total Deductions Itemized Deductions Form Ref. ---22 22 22 22 23 24 25 26 27 27 27 28 Length -----12 30 12 12 12 12 12 12 31 12 12 12 Field Description ----------------N AN N N N N N N AN or "STMbnn" N N N Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 51 Section 3 INTENTIONAL BLANK PAGE Publication 1346 August 30, 2002 Part II Page 52 Section 3 SCHEDULE B Field Identification No. ----- -------------Byte Count Interest and Ordinary Dividends Form Ref. ---Length -----4 Field Description ----------------"1460" for Fixed; "nnnn" for variable format Value "****" "SCHbbB" "1040bb" "PG01b" N (Primary SSN) Start of Record Sentinel 0000 0001 0002 0003 Record ID Schedule Type Page Number Taxpayer Identification Number Filler Schedule Occurrence Number Seller Financed Mortgage Name Seller Financed Address Seller Financed TIN Seller Financed Mortgage Amount Total Seller Financed Mortgage Amount Interest Payer 1 Interest Amount 1 Interest Payer 2 Interest Amount 2 Interest Payer 3 Interest Amount 3 Interest Payer 4 1 1 1 1 1 4 6 6 5 9 0004 0005 *0010 +0011 +0012 +0015 0025 1 7 25 34 9 12 12 blank N 0000001 AN or "STMbnn" AN N N N *0030 +0040 0050 0060 0070 0080 0090 1 1 1 1 1 1 1 August 30, 2002 50 12 50 12 50 12 50 AN or "STMbnn" N AN N AN N AN Part II Page 53 Section 3 Publication 1346 SCHEDULE B Field Identification No. ----- -------------0100 0110 0120 0130 0140 0160 0220 0230 Interest Amount 4 Interest Payer 5 Interest Amount 5 Interest Payer 6 Interest Amount 6 Interest Subtotal Literal Interest Subtotal Nominee Literal Interest and Ordinary Dividends Form Ref. ---1 1 1 1 1 1 1 1 Length -----12 50 12 50 12 17 12 20 Field Description ----------------N AN N AN N "INTERESTbSUBTOTAL" or blank N "NOMINEEbDISTRIBUTION" or blank N "ACCRUEDbINTEREST" or blank N "TAX-EXEMPTbINTEREST" or blank N "OIDbADJUSTMENT" or blank N "ABPbADJUSTMENT" or blank N N N N Part II Page 54 Section 3 0240 0250 0260 0270 0280 0281 0282 0283 0284 0288 0289 0290 Nominee Amount Accrued Interest Literal Accrued Interest Amount Tax-Exempt Literal Tax Exempt Amount OID Adjustment Literal OID Amount ABP Adjustment Literal ABP Amount Taxable Interest Subtotal Excludable Savings Bond Interest Taxable Interest 1 1 1 1 1 1 1 1 1 2 3 4 August 30, 2002 12 16 12 19 12 14 12 14 12 12 12 12 Publication 1346 SCHEDULE B Field Identification No. ----- -------------*0300 +0310 0320 0330 0340 0350 0360 0370 0380 0390 0400 0410 0420 0430 0440 0450 0460 0470 0480 0490 0495 0499 0510 Dividend Payer 1 Dividend Amount 1 Dividend Payer 2 Dividend Amount 2 Dividend Payer 3 Dividend Amount 3 Dividend Payer 4 Dividend Amount 4 Dividend Payer 5 Dividend Amount 5 Dividend Payer 6 Dividend Amount 6 Dividend Payer 7 Dividend Amount 7 Dividend Payer 8 Dividend Amount 8 Dividend Payer 9 Dividend Amount 9 Dividend Payer 10 Dividend Amount 10 Dividend Subtotal Lit. Ordinary Dividend Subtotal Nominee Literal Interest and Ordinary Dividends Form Ref. ---5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 Length -----50 12 50 12 50 12 50 12 50 12 50 12 50 12 50 12 50 12 50 12 17 12 20 Field Description ----------------AN or "STMbnn" N AN N AN N AN N AN N AN N AN N AN N AN N AN N "DIVIDENDbSUBTOTAL" N "NOMINEEbDISTRIBUTION" or blank Part II Page 55 Section 3 Publication 1346 August 30, 2002 SCHEDULE B Field Identification No. ----- -------------0520 0525 0587 0590 0595 0600 0608 0610 0615 Nominee Amount Total Ordinary Dividends Acct. Form Literal Foreign Account Question - Yes Foreign Account Question - No Foreign Country Trust Form Literal Foreign Trust Question - Yes Foreign Trust Question - No Interest and Ordinary Dividends Form Ref. ---5 6 7a 7a 7a 7b 8 8 8 Length -----12 12 9 1 1 30 9 1 1 Field Description ----------------N N "FORMb8814" or blank "X" or blank "X" or blank AN "FORMb8814" or blank "X" or blank "X" or blank Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 56 Section 3 SCHEDULE 1 Field Identification No. ----- -------------Byte Count Interest and Ordinary... Form Ref. ---Length -----4 Field Description ----------------"1408" for Fixed; "nnnn" for variable format Value "****" "SCHbb1" "1040Ab" "PG01b" N (Primary SSN) Start of Record Sentinel 0000 0001 0002 0003 Record ID Schedule Type Page Number Taxpayer Identification Number Filler Schedule Occurrence Number Seller Financed Mortgage Name Seller Financed Address Seller Financed TIN Seller Financed Mortgage Amount Total Seller Financed Mortgage Amount Interest Payer 1 Interest Amount 1 Interest Payer 2 Interest Amount 2 Interest Payer 3 Interest Amount 3 Interest Payer 4 1 1 1 1 1 4 6 6 5 9 0004 0005 *0010 +0011 +0012 +0015 0025 1 7 25 34 9 12 12 blank N 0000001 AN or "STMbnn" AN N N N *0030 +0040 0050 0060 0070 0080 0090 1 1 1 1 1 1 1 August 30, 2002 50 12 50 12 50 12 50 AN or "STMbnn" N AN N AN N AN Part II Page 57 Section 3 Publication 1346 SCHEDULE 1 Field Identification No. ----- -------------0100 0110 0120 0130 0140 0160 0220 0230 0240 0250 0260 0270 0280 0281 0282 0283 0284 0288 0289 0290 *0300 Interest Amount 4 Interest Payer 5 Interest Amount 5 Interest Payer 6 Interest Amount 6 Interest Subtotal Literal Interest Subtotal Nominee Literal Nominee Amount Accrued Interest Literal Accrued Interest Amount Tax-Exempt literal Tax Exempt Amount OID Adjustment Literal OID Amount ABP Adjustment Literal ABP Amount Taxable Interest Subtotal Excludable Savings Bond Interest Taxable Interest Dividend Payer 1 Interest and Ordinary... Form Ref. ---1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 2 3 4 5 August 30, 2002 Length -----12 50 12 50 12 17 12 20 12 16 12 19 12 14 12 14 12 12 12 12 50 Field Description ----------------N AN N AN N "INTERESTbSUBTOTAL" or blank N "NOMINEEbDISTRIBUTION" or blank N "ACCRUEDbINTEREST" or blank N "TAX-EXEMPTbINTEREST" or blank N "OIDbADJUSTMENT" or blank N "ABPbADJUSTMENT" or blank N N N N AN or "STMbnn" Part II Page 58 Section 3 Publication 1346 SCHEDULE 1 Field Identification No. ----- -------------+0310 0320 0330 0340 0350 0360 0370 0380 0390 0400 0410 0420 0430 0440 0450 0460 0470 0480 0490 0495 0499 0510 0520 Dividend Amount 1 Dividend Payer 2 Dividend Amount 2 Dividend Payer 3 Dividend Amount 3 Dividend Payer 4 Dividend Amount 4 Dividend Payer 5 Dividend Amount 5 Dividend Payer 6 Dividend Amount 6 Dividend Payer 7 Dividend Amount 7 Dividend Payer 8 Dividend Amount 8 Dividend Payer 9 Dividend Amount 9 Dividend Payer 10 Dividend Amount 10 Dividend Subtotal Lit. Ordinary Dividend Subtotal Nominee Literal Nominee Amount Interest and Ordinary... Form Ref. ---5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 August 30, 2002 Length -----12 50 12 50 12 50 12 50 12 50 12 50 12 50 12 50 12 50 12 17 12 20 12 Field Description ----------------N AN N AN N AN N AN N AN N AN N AN N AN N AN N "DIVIDENDbSUBTOTAL" N "NOMINEEbDISTRIBUTION" or blank N Part II Page 59 Section 3 Publication 1346 SCHEDULE 1 Field Identification No. ----- -------------0525 Total Ordinary Dividends Interest and Ordinary... Form Ref. ---6 Length -----12 Field Description ----------------N Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 60 Section 3 SCHEDULE C PAGE 1 Field Identification No. ----- -------------Byte Count Profit or Loss From Business Form Ref. ---Length -----4 Field Description ----------------"0713" for Fixed; "nnnn" for variable format Value "****" "SCHbbC" "1040bb" "PG01b" N (Primary SSN) Start of Record Sentinel 0000 0001 0002 0003 Record ID Schedule Type Page Number Taxpayer Identification Number Filler Schedule Occurrence Number Name of Proprietor SSN of Proprietor Principal Business Business Code Business Name Employer ID Number Business Address Business City/State/ Zip Code Cash Acctg Method Accrual Acctg Meth Other Acctg Method Type of Other Meth Materially Participate in Current Tax Year - Y A B C D E E F(1) F(2) F(3) F(3) G 4 6 6 5 9 0004 0005 0010 0015 0020 0030 0040 0060 0061 0062 0063 0064 0066 *0068 0177 1 7 35 9 20 6 45 9 35 30 1 1 1 25 1 blank N 0000001 - 0000008 AN N AN N AN N AN AN "X" or blank "X" or blank "X" or blank AN or "STMbnn" "X" or blank Publication 1346 August 30, 2002 Part II Page 61 Section 3 SCHEDULE C PAGE 1 Field Identification No. ----- -------------0183 Materially Participate in Current Tax Year - N First Schedule C Filed for this Business Statutory Employee Earnings Ind Gross Receipts/Sales Returns/Allowances Gross Receipts Less Returns Allowances Cost of Goods Sold Gross Profit Other Income Gross Income Advertising Expense Bad Debts Car/Truck Expenses Commissions and Fees Depletion Depreciation/Sec 179 Deduction Employee Benefit Prog Insurance Form 1098 Explanation Mortgage Interest Profit or Loss From Business Form Ref. ---G Length -----1 Field Description ----------------"X" or blank 0195 H 1 "X" or blank 0198 0200 0210 0220 0230 0240 0260 0270 0280 0283 0293 0297 0303 0307 0317 0327 @0333 0337 1 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16a 16a August 30, 2002 1 12 12 12 12 12 12 12 12 12 12 12 12 12 12 12 6 12 "X" or blank N N N N N N N N N N N N N N N "STMbnn" or blank N Part II Page 62 Section 3 Publication 1346 SCHEDULE C PAGE 1 Field Identification No. ----- -------------@0340 0343 0353 0357 0363 0365 0367 0373 0377 0383 0387 0393 0397 0403 0407 0450 0605 0700 0702 0703 Form 1098 Name/ Address Other Interest Legal/Prof Services Office Expense Pension/Profit Sharing Rent on Machinery and Equipment Rent on Property Repairs and Maintenance Supplies Taxes and Licenses Travel Meals/Entertainment Meals/Entertainment Limit Allowable Meals/ Entertainment Limit Utilities Wages less Employment Credits Total Other Expenses Total Expenses Tentative Profit/ Loss Home Business Expense Profit or Loss From Business Form Ref. ---16b 16b 17 18 19 20a 20b 21 22 23 24a 24b 24c 24d 25 26 27 28 29 30 Length -----6 12 12 12 12 12 12 12 12 12 12 12 12 12 12 12 12 12 12 12 Field Description ----------------"STMbnn" or blank N N N N N N N N N N N N N N N N N N N Publication 1346 August 30, 2002 Part II Page 63 Section 3 SCHEDULE C PAGE 1 Field Identification No. ----- -------------0705 0710 0720 0730 Passive Activity Loss Indicator Net Profit (Loss) All is At Risk Some is Not At Risk Profit or Loss From Business Form Ref. ---31 31 32a 32b Length -----3 12 1 1 Field Description ----------------"PAL" or blank N "X" or blank "X" or blank Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 64 Section 3 SCHEDULE C PAGE 2 Field Identification No. ----- -------------Byte Count Profit or Loss From Business Form Ref. ---Length -----4 Field Description ----------------"0535" for Fixed; "nnnn" for variable format Value "****" "SCHbbC" "1040bb" "PG02b" N (Primary SSN) Start of Record Sentinel 0735 0736 0737 0738 Record ID Schedule Type Page Number Taxpayer Identification Number Filler Schedule Occurrence Number Clos Inv Cost Method Lower Cost/Market Other Clos Inv Method Other Meth Explanation Change Inventory Question - Yes Change Inventory Method Explanation Change Inventory Question - No Beginning Inventory Purchases Cost of Labor Materials/Supplies Other Costs 33a 33b 33c 33c 34 34 34 35 36 37 38 39 August 30, 2002 4 6 6 5 9 0739 0740 0741 0742 0744 @0746 0748 @0751 0753 0755 0758 0760 0770 0780 1 7 1 1 1 6 1 6 1 12 12 12 12 12 blank N 0000001 - 0000008 "X" or blank "X" or blank "X" or blank "STMbnn" or blank "X" or blank "STMbnn" or blank "X" or blank N N N N N Part II Page 65 Section 3 Publication 1346 SCHEDULE C PAGE 2 Field Identification No. ----- -------------0790 0800 0810 *0820 +0830 +0840 +0850 +0860 +0870 +0880 +0890 +0900 +0910 +0920 +0930 *0940 +0950 0960 0970 0980 0990 1000 Total Costs End of Year Inventory Cost of Goods Sold Vehicle Service Date Business Miles Commuting Miles Other Miles Another Vehicle Yes Another Vehicle No Vehicle Available Yes Vehicle Available No Evidence Yes Evidence No Written Yes Written No Other Expense Type 1 Other Expense Amount 1 Other Expense Type 2 Other Expense Amount 2 Other Expense Type 3 Other Expense Amount 3 Other Expense Type 4 Profit or Loss From Business Form Ref. ---40 41 42 43 44a 44b 44c 45 45 46 46 47a 47a 47b 47b Length -----12 12 12 8 6 6 6 1 1 1 1 1 1 1 1 25 12 25 12 25 12 25 Field Description ----------------N N N YYYYMMDD or "STMbnn", | or blank N N N "X" or blank "X" or blank "X" or blank "X" or blank "X" or blank "X" or blank "X" or blank "X" or blank AN or "STMbnn" N AN N AN N AN Part II Page 66 Section 3 Publication 1346 August 30, 2002 SCHEDULE C PAGE 2 Field Identification No. ----- -------------1010 1020 1030 1040 1050 1060 1070 1080 1090 1100 1110 1140 Other Expense Amount 4 Other Expense Type 5 Other Expense Amount 5 Other Expense Type 6 Other Expense Amount 6 Other Expense Type 7 Other Expense Amount 7 Other Expense Type 8 Other Expense Amount 8 Other Expense Type 9 Other Expense Amount 9 Total Other Expenses Profit or Loss From Business Form Ref. ---Length -----12 25 12 25 12 25 12 25 12 25 12 48 12 Field Description ----------------N AN N AN N AN N AN N AN N N | Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 67 Section 3 INTENTIONAL BLANK PAGE Publication 1346 August 30, 2002 Part II Page 68 Section 3 SCHEDULE C-EZ Field Identification No. ----- -------------Byte Count Net Profit from Business... Form Ref. ---Length -----4 Field Description ----------------"0303" for Fixed; "nnnn" for variable format Value "****" "SCHbCZ" "1040bb" "PG01b" N (Primary SSN) Start of Record Sentinel 0000 0001 0002 0003 Record ID Schedule Type Page Number Taxpayer Identification Number Filler Schedule Occurrence Number Name of Proprietor SSN of Proprietor Principal Business Business Code Business Name Employer ID Number Business Address Business City/State/ Zip Code Statutory Employee Earnings Ind Gross Receipts/Sales Total Expenses Net profit Vehicle Service Date A B C D E E 1 1 2 3 4 4 6 6 5 9 0004 0005 0010 0015 0020 0030 0040 0060 0061 0062 0198 0200 0700 0710 *0820 1 7 35 9 20 6 45 9 35 30 1 12 12 12 8 blank N 0000001 - 0000002 AN N AN N AN N AN AN "X" or blank N N N YYYYMMDD or "STMbnn", | or blank Part II Page 69 Section 3 Publication 1346 August 30, 2002 SCHEDULE C-EZ Field Identification No. ----- -------------+0830 +0840 +0850 +0860 +0870 +0880 +0890 +0900 +0910 +0920 +0930 Business Miles Commuting Miles Other Miles Another Vehicle Yes Another Vehicle No Vehicle Available Yes Vehicle Available No Evidence Yes Evidence No Written Yes Written No Net Profit from Business... Form Ref. ---5a 5b 5c 6 6 7 7 8a 8a 8b 8b Length -----6 6 6 1 1 1 1 1 1 1 1 Field Description ----------------N N N "X" or blank "X" or blank "X" or blank "X" or blank "X" or blank "X" or blank "X" or blank "X" or blank Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 70 Section 3 SCHEDULE D PAGE 1 Field Identification No. ----- -------------Byte Count Capital Gains and Losses Form Ref. ---Length -----4 Field Description ----------------"0900" for Fixed; "nnnn" for variable format Value "****" "SCHbbD" "1040bb" "PG01b" N (Primary SSN) Start of Record Sentinel 0000 0001 0002 0003 Record ID Schedule Type Page Number Taxpayer Identification Number Filler Schedule Occurrence Number ST Property Desc 1 ST Date Acquired 1 ST Date Sold 1 ST Sales Price 1 ST Cost/Other Basis 1 ST Gain or Loss for Entire Year 1 ST Property Desc 2 ST Date Acquired 2 ST Date Sold 2 ST Sales Price 2 ST Cost/Other Basis 2 ST Gain or Loss for Entire Year 2 ST Property Desc 3 1(a)1 1(b)1 1(c)1 1(d)1 1(e)1 1(f)1 1(a)2 1(b)2 1(c)2 1(d)2 1(e)2 1(f)2 1(a)3 August 30, 2002 4 6 6 5 9 0004 0005 *0020 +0030 +0040 +0050 +0060 +0075 0090 0100 0110 0120 0130 0145 0160 1 7 15 8 8 12 12 12 15 8 8 12 12 12 15 blank N 0000001 AN or "STCGL" or blank | YYYYMMDD, or "VARIOUS" | YYYYMMDD, or "BANKRUPT" | N, or "EXPIRED" N, or "EXPIRED" N AN 'See 1st Occ.' YYYYMMDD, or "BANKRUPT" | N, or "EXPIRED" N, or "EXPIRED" N AN Part II Page 71 Section 3 Publication 1346 SCHEDULE D PAGE 1 Field Identification No. ----- -------------0170 0180 0190 0200 0215 0230 0240 0250 0260 0270 0285 0639 0649 ST Date Acquired 3 ST Date Sold 3 ST Sales Price 3 ST Cost/Other Basis 3 ST Gain or Loss For Entire Year 3 ST Property Desc 4 ST Date Acquired 4 ST Date Sold 4 ST Sales Price 4 ST Cost/Other Basis 4 ST Gain or Loss For Entire Year 4 D-1 Total Short Term Sales D-1 Total Short Term Gain/Loss for Entire Year Total ST Sales Price Net ST Gain or Loss for Entire Year (Part/S-Corp/Fiduc) Net ST Gain or Loss for Ent Yr Short Loss Carryover Net Short Gain/Loss LT Property Desc 1 LT Date Acquired 1 Capital Gains and Losses Form Ref. ---1(b)3 1(c)3 1(d)3 1(e)3 1(f)3 1(a)4 1(b)4 1(c)4 1(d)4 1(e)4 1(f)4 2(d) 2(f) Length -----8 8 12 12 12 15 8 8 12 12 12 12 12 Field Description ----------------'See 1st Occ.' YYYYMMDD, or "BANKRUPT" | N, or "EXPIRED" N, or "EXPIRED" N AN 'See 1st Occ.' YYYYMMDD, or "BANKRUPT" | N, or "EXPIRED" N, or "EXPIRED" N NO ENTRY NO ENTRY 0710 0715 0725 3(d) 4(f) 5(f) 12 12 12 N N N 0860 0877 *0880 +0890 6(f) 7(f) 8(a)1 8(b)1 12 12 15 8 N N AN or "LTCGL" or blank | YYYYMMDD, or "INHERIT", | or "VARIOUS" Part II Page 72 Section 3 Publication 1346 August 30, 2002 SCHEDULE D PAGE 1 Field Identification No. ----- -------------+0900 +0910 +0920 +0935 +0946 0950 0960 0970 0980 0990 1005 1016 1020 1030 1040 1050 1060 1075 1086 1090 1100 LT Date Sold 1 LT Sales Price 1 LT Cost/Other Basis 1 LT Gain or Loss for Entire Year 1 28% Rate Gain or Loss 1 LT Property Desc 2 LT Date Acquired 2 LT Date Sold 2 LT Sales Price 2 LT Cost/Other Basis 2 LT Gain or Loss For Entire Year 2 28% Rate Gain or Loss 2 LT Property Desc 3 LT Date Acquired 3 LT Date Sold 3 LT Sales Price 3 LT Cost/Other Basis 3 LT Gain or Loss for Entire Year 3 28% Rate Gain or Loss 3 Lt Property Desc 4 LT Date Acquired 4 Capital Gains and Losses Form Ref. ---8(c)1 8(d)1 8(e)1 8(f)1 8(g)1 8(a)2 8(b)2 8(c)2 8(d)2 8(e)2 8(f)2 8(g)2 8(a)3 8(b)3 8(c)3 8(d)3 8(e)3 8(f)3 8(g)3 8(a)4 8(b)4 August 30, 2002 Length -----8 12 12 12 12 15 8 8 12 12 12 12 15 8 8 12 12 12 12 15 8 Field Description ----------------YYYYMMDD N, or "EXPIRED" N, or "EXPIRED" N N AN 'See 1st Occ.' YYYYMMDD N, or "EXPIRED" N, or "EXPIRED" N N AN 'See 1st Occ.' YYYYMMDD N, or "EXPIRED" N, or "EXPIRED" N N AN 'See 1st Occ.' Part II Page 73 Section 3 | | | Publication 1346 SCHEDULE D PAGE 1 Field Identification No. ----- -------------1110 1120 1130 1145 1155 1701 1703 1709 LT Date Sold 4 LT Sales Price 4 LT Cost/Other Basis 4 LT Gain or Loss for Entire Year 4 LT 28% Rate Gain or Loss 4 D-1 Total Long Term Sales D-1 Long Term Gain/ Loss for Entire Year D-1 Total Long Term 28% Rate Gain or Loss Total LT Sales Price Net LT Gain or Loss for Entire Year Net LT 28% Rate Gain or Loss Net LT Gain or Loss for Entire Year (Part/S-Corp) Net LT 28% Rate Gain or Loss (Part/ S-Corp) F8814 Literal F8814 Amount Capital Gain Distribution For Entire Year 28% Rate Gain Distributions Capital Gains and Losses Form Ref. ---8(c)4 8(d)4 8(e)4 8(f)4 8(g)4 9(d) 9(f) 9(g) Length -----8 12 12 12 12 12 12 12 Field Description ----------------YYYYMMDD N, or "EXPIRED" N, or "EXPIRED" N N NO ENTRY NO ENTRY NO ENTRY | 1715 1720 1726 1731 10(d) 11(f) 11(g) 12(f) 12 12 12 12 N N N N 1756 12(g) 12 N 1760 1770 1775 13 13 13(f) 9 12 12 "FORMb8814" or blank N N 1792 13(g) August 30, 2002 12 N Part II Page 74 Section 3 Publication 1346 SCHEDULE D PAGE 1 Field Identification No. ----- -------------1820 1825 1831 1835 Long Term Loss Carryover LT 28% Rate Loss Carryover Combined LT 28% Rate Gain or Loss Combined Net LT Gain/Loss for Entire Year Capital Gains and Losses Form Ref. ---14(f) 14(g) 15(g) 16(f) Length -----12 12 12 12 Field Description ----------------N N N N Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 75 Section 3 SCHEDULE D PAGE 2 Field Identification No. ----- -------------Byte Count Capital Gains and Losses Form Ref. ---Length -----4 Field Description ----------------"0331" for Fixed; "nnnn" for variable format Value "****" "SCHbbD" "1040bb" "PG02b" N (Primary SSN) Start of Record Sentinel 1840 1841 1842 1843 Record ID Schedule Type Page Number Taxpayer Identification Number Filler Schedule Occurrence Number Combined Net Gain/ Loss Allowable Loss Unrecaptured Section 1250 Gain Taxable Income Smaller of LT or Combined Gain or Loss Investment Capital Gain Subtract Line 22 from Line 21 Subtract Line 23 from Line 20 Tax on Amount on Line 24 Smaller of Taxable Income 17 18 19 20 21 4 6 6 5 9 1844 1845 1848 1849 1852 1856 1860 1 7 12 12 12 12 12 blank N 0000001 N N N N N 1870 1880 1885 1895 1950 22 23 24 25 26 August 30, 2002 12 12 12 12 12 N N N N N Part II Page 76 Section 3 Publication 1346 SCHEDULE D PAGE 2 Field Identification No. ----- -------------1995 2025 2028 Amount from Line 24 Subtract Line 27 from Line 26 Qualified 5-Year Gain From Line 7 of Worksheet Smaller of Line 28 or Line 29 Multiply Line 30 by 0.08 Subtract Line 30 from Line 28 Multiply Line 32 by 0.10 Smaller of Line 20 or Line 23 Amount From Line 28 Subtract Line 35 from Line 34 Multiply Line 36 by 0.20 Add Lines 25, 31, 33 and 37 Tax on Taxable Income Tax Capital Gains and Losses Form Ref. ---27 28 29 Length -----12 12 12 Field Description ----------------N N N 2150 2155 2170 2180 2184 2186 2199 2203 2211 2231 2236 30 31 32 33 34 35 36 37 38 39 40 12 12 12 12 12 12 12 12 12 12 12 N N N N N N N N N N N Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 77 Section 3 INTENTIONAL BLANK PAGE Publication 1346 August 30, 2002 Part II Page 78 Section 3 SCHEDULE E PAGE 1 Field Identification No. ----- -------------Byte Count Supplemental Income and Loss Form Ref. ---Length -----4 Field Description ----------------"1368" for Fixed; "nnnn" for variable format Value "****" "SCHbbE" "1040bb" "PG01b" N (Primary SSN) Start of Record Sentinel 0000 0001 0002 0003 Record ID Schedule Type Page Number Taxpayer Identification Number Filler Schedule Occurrence Number Property Kind Property Address Property Kind Property Address Property Kind Property Address Personal Use - Yes Personal Use - No Personal Use - Yes Personal Use - No Personal Use - Yes Personal Use - No Rents Received A Rents Received B Rents Received C A-1 A-1 B-1 B-1 C-1 C-1 A-2 A-2 B-2 B-2 C-2 C-2 A-3 B-3 C-3 August 30, 2002 4 6 6 5 9 0004 0005 0010 0020 0025 0030 0035 0040 0045 0050 0055 0060 0065 0070 0100 0110 0120 1 7 20 37 20 37 20 37 1 1 1 1 1 1 12 12 12 blank N 0000001 - 0000015 AN AN AN AN AN AN "X" or blank "X" or blank "X" or blank "X" or blank "X" or blank "X" or blank N N N Part II Page 79 Section 3 Publication 1346 SCHEDULE E PAGE 1 Field Identification No. ----- -------------0125 0130 0140 0150 0155 0170 0180 0190 0200 0210 0220 0230 0240 0250 0260 0270 0280 0290 0300 0310 0320 0330 0340 0342 0343 Total Rents Received Royalties Received A Royalties Received B Royalties Received C Total Royalties Rec'd Advertising A Advertising B Advertising C Auto-Travel A Auto-Travel B Auto-Travel C Cleaning-Maint A Cleaning-Maint B Cleaning-Maint C Commissions A Commissions B Commissions C Insurance A Insurance B Insurance C Legal-Pro Fees A Legal-Pro Fees B Legal-Pro Fees C Management Fees Management Fees Supplemental Income and Loss Form Ref. ---D-3 A-4 B-4 C-4 D-4 A-5 B-5 C-5 A-6 B-6 C-6 A-7 B-7 C-7 A-8 B-8 C-8 A-9 B-9 C-9 A-10 B-10 C-10 11a 11b August 30, 2002 Length -----12 12 12 12 12 12 12 12 12 12 12 12 12 12 12 12 12 12 12 12 12 12 12 12 12 Field Description ----------------N N N N N N N N N N N N N N N N N N N N N N N N N Part II Page 80 Section 3 Publication 1346 SCHEDULE E PAGE 1 Field Identification No. ----- -------------0344 @0345 0350 0360 0370 0380 @0385 0390 0400 0410 0420 0430 0440 0450 0460 0470 0480 0490 0500 0510 0520 0530 *0570 +0580 Management Fees Form 1098 Explanation Mortgage Interest A Mortgage Interest B Mortgage Interest C Total Mort Interest Form 1098 Name/ Address Other Interest A Other Interest B Other Interest C Repairs A Repairs B Repairs C Supplies A Supplies B Supplies C Taxes A Taxes B Taxes C Utilities A Utilities B Utilities C Other-Description 1 Other Amount A Supplemental Income and Loss Form Ref. ---11c 12 A-12 B-12 C-12 D-12 13 A-13 B-13 C-13 A-14 B-14 C-14 A-15 B-15 C-15 A-16 B-16 C-16 A-17 B-17 C-17 A-18-1 A-18-1 August 30, 2002 Length -----12 6 12 12 12 12 6 12 12 12 12 12 12 12 12 12 12 12 12 12 12 12 25 12 Field Description ----------------N "STMbnn" or blank N N N N "STMbnn" or blank N N N N N N N N N N N N N N N AN or "STMbnn" N Part II Page 81 Section 3 Publication 1346 SCHEDULE E PAGE 1 Field Identification No. ----- -------------+0590 +0600 0610 0620 0630 0640 0650 0660 0670 0680 0690 0700 0710 0720 0730 0740 0750 0760 0970 0980 0990 1000 1010 Other Amount B Other Amount C Other-Description 2 Other Amount A Other Amount B Other Amount C Other-Description 3 Other Amount A Other Amount B Other Amount C Other-Description 4 Other Amount A Other Amount B Other Amount C Other-Description 5 Other Amount A Other Amount B Other Amount C Tot Rental & Royalty Expenses A Tot Rental & Royalty Expenses B Tot Rental & Royalty Expenses C Rental & Royalty Deduction Deprec Expense A Supplemental Income and Loss Form Ref. ---B-18-1 C-18-1 A-18-2 A-18-2 B-18-2 C-18-2 A-18-3 A-18-3 B-18-3 C-18-3 A-18-4 A-18-4 B-18-4 C-18-4 A-18-5 A-18-5 B-18-5 C-18-5 A-19 B-19 C-19 D-19 A-20 August 30, 2002 Length -----12 12 25 12 12 12 25 12 12 12 25 12 12 12 25 12 12 12 12 12 12 12 12 Field Description ----------------N N AN N N N AN N N N AN N N N AN N N N N N N N N Part II Page 82 Section 3 Publication 1346 SCHEDULE E PAGE 1 Field Identification No. ----- -------------1020 1030 1040 1050 1060 1070 1080 1090 1100 1103 1105 1107 1110 1120 1130 Deprec Expense B Deprec Expense C Total Depreciation Total Expenses A Total Expenses B Total Expenses C Net Rental Income (Loss) A Net Rental Income (Loss) B Net Rental Income (Loss) C Deductible Rental Loss A Deductible Rental Loss B Deductible Rental Loss C Total Income Total Losses Non Passive Activity Literal (for EIC purposes) Non Passive Activity Amount Total Income or Loss Supplemental Income and Loss Form Ref. ---B-20 C-20 D-20 A-21 B-21 C-21 A-22 B-22 C-22 A-23 B-23 C-23 24 25 26 Length -----12 12 12 12 12 12 12 12 12 12 12 12 12 12 3 Field Description ----------------N N N N N N N N N N N N N N "NPA" or blank 1140 1150 26 26 12 12 N N Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 83 Section 3 SCHEDULE E PAGE 2 Field Identification No. ----- -------------Byte Count Supplemental Income and Loss Form Ref. ---Length -----4 Field Description ----------------"1222" for Fixed; "nnnn" for variable format Value "****" "SCHbbE" "1040bb" "PG02b" N (Primary SSN) Start of Record Sentinel 1160 1161 1162 1163 Record ID Schedule Type Page Number Taxpayer Identification Number Filler Schedule Occurrence Number Part/S-Corp Name A Part/S-Corp Ind Foreign Partner Part/S-Corp EIN All is At Risk Some is Not At Risk Part/S-Corp Passive F8582 Loss Part/S-Corp Passive Sch K-1 Income Part/S-Corp Nonpassive Sch K-1 Loss Part/S-Corp Nonpassive Sec 179 Deduction Part/S-Corp Nonpassive Sch K-1 Income 27A(a) 27A(b) 27A(c) 27A(d) 27A(e) 27A(f) 27A(g) 27A(h) 27A(i) 4 6 6 5 9 1164 1165 *1170 +1172 +1174 +1176 +1178 +1180 *+1186 +1188 +1192 1 7 47 1 1 9 1 1 12 12 12 blank N 0000001 - 0000015 AN or "STMbnn" "P" or "S" or blank "X" or blank N "X" or blank "X" or blank N or "STMbnn" N N +1194 27A(j) 12 N +1196 27A(k) 12 N Publication 1346 August 30, 2002 Part II Page 84 Section 3 SCHEDULE E PAGE 2 Field Identification No. ----- -------------1200 1210 1220 1230 1236 1238 1243 1247 1253 Part/S-Corp Name B Part/S-Corp Ind Foreign Partner Part/S-Corp EIN All is At Risk Some is Not At Risk Part/S-Corp Passive F8582 Loss Part/S-Corp Passive Sch K-1 Income Part/S-Corp Nonpassive Sch K-1 Loss Part/S-Corp Nonpassive Sec 179 Deduction Part/S-Corp Nonpassive Sch K-1 Income Part/S-Corp Name C Part/S-Corp Ind Foreign Partner Part/S-Corp EIN All is At Risk Some is Not At Risk Part/S-Corp Passive F8582 Loss Part/S-Corp Passive Sch K-1 Income Supplemental Income and Loss Form Ref. ---27B(a) 27B(b) 27B(c) 27B(d) 27B(e) 27B(f) 27B(g) 27B(h) 27B(i) Length -----47 1 1 9 1 1 12 12 12 Field Description 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----------------N 1315 27C(j) 12 N 1317 27C(k) 12 N 1320 1330 1340 1350 1356 1358 1363 1367 1373 27D(a) 27D(b) 27D(c) 27D(d) 27D(e) 27D(f) 27D(g) 27D(h) 27D(i) 47 1 1 9 1 1 12 12 12 AN "P" or "S" or blank "X" = Yes, " " = No N "X" or blank "X" or blank N N N 1375 27D(j) 12 N 1377 27D(k) 12 N 1380 1390 1400 1410 27E(a) 27E(b) 27E(c) 27E(d) August 30, 2002 47 1 1 9 AN "P" or "S" or blank "X" = Yes, " " = No N Part II Page 86 Section 3 Publication 1346 SCHEDULE E PAGE 2 Field Identification No. ----- -------------1416 1418 1423 1427 1433 All is At Risk Some is Not At Risk Part/S-Corp Passive F8582 Loss Part/S-Corp Passive Sch K-1 Income Part/S-Corp Nonpassive Sch K-1 Loss Part/S-Corp Nonpassive Sec 179 Deduction Part/S-Corp Nonpassive Sch K-1 Income Total Part/S-Corp Sch K-1 Passive Inc Total Part/S-Corp Sch K-1 Nonpass Inc Total Passive F8582 Loss Total Nonpassive Sch K-1 Loss Total Nonpassive Sec 179 Deduction Tot Part/S-Corp Income Tot Part/S-Corp Loss and Sec 179 Deduction Net Part/S-Corp Income or Loss Estate/Trust Name A Estate/Trust EIN Supplemental Income and Loss Form Ref. ---27E(e) 27E(f) 27E(g) 27E(h) 27E(i) Length -----1 1 12 12 12 Field Description ----------------"X" or blank "X" or blank N N N 1435 27E(j) 12 N 1437 27E(k) 12 N 1445 1455 1475 1485 1495 1750 1755 28a(h) 28a(k) 28b(g) 28b(i) 28b(j) 29 30 12 12 12 12 12 12 12 N N N N N N N 1765 *1790 +1800 31 32A(a) 32A(b) August 30, 2002 12 65 9 N AN or "STMbnn" N Part II Page 87 Section 3 Publication 1346 SCHEDULE E PAGE 2 Field Identification No. ----- -------------*+1807 +1813 +1817 +1825 1830 1840 1847 1853 1857 1865 1913 1917 1923 1927 1933 1937 1939 1943 Passive F8582 Loss Passive Sch K-1 Income Nonpassive Sch K-1 Loss Nonpassive Sch K-1 Inc Estate/Trust Name B Estate/Trust EIN Passive F8582 Loss Passive Sch K-1 Income Nonpassive Sch K-1 Loss Nonpassive Sch K-1 Inc Total Passive Sch K1 Income Total Nonpassive Sch K-1 Income Total Passive F8582 Loss Total Nonpassive Sch K-1 Loss Tot Estate/Trust Inc Tot Estate/Trust Loss Sch K-1 ES Payments Literal Sch K-1 ES Payments Amount Supplemental Income and Loss Form Ref. ---32A(c) 32A(d) 32A(e) 32A(f) 32B(a) 32B(b) 32B(c) 32B(d) 32B(e) 32B(f) 33a(d) 33a(f) 33b(c) 33b(e) 34 35 36 36 Length -----12 12 12 12 65 9 12 12 12 12 12 12 12 12 12 12 18 12 Field Description ----------------N or "STMbnn" N N N AN N N N N N N N N N N N "ESbPAYMENTbCLAIMED" or blank N Publication 1346 August 30, 2002 Part II Page 88 Section 3 SCHEDULE E PAGE 2 Field Identification No. ----- -------------1945 *1953 +1957 +1963 +1967 +1973 1977 1991 2010 2020 2030 Total Estate/Trust Net Income/Loss REMIC Name REMIC EIN Excess Inclusion Sch Q Taxable Income/Net Loss Sch Q Line 3 Income Total REMIC Income Net Farm Rental Income/Loss Total Supplemental Income (Loss) Farming/Fishing Share Net Rental Real Estate Income/Loss Supplemental Income and Loss Form Ref. ---36 37(a) 37(b) 37(c) 37(d) 37(e) 38 39 40 41 42 Length -----12 20 9 12 12 12 12 12 12 12 12 Field Description ----------------N AN or "STMbnn" N N N N N N N N N Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 89 Section 3 INTENTIONAL BLANK PAGE Publication 1346 August 30, 2002 Part II Page 90 Section 3 SCHEDULE EIC Field Identification No. ----- -------------Byte Count Earned Income Credit Form Ref. ---Length -----4 Field Description ----------------"0161" for Fixed; "nnnn" for variable format Value "****" "SCHEIC" "1040bb" "PG01b" N (Primary SSN) Start of Record Sentinel 0000 0001 0002 0003 Record ID Schedule Type Page Number Taxpayer Identification Number Filler Schedule Occurrence Number Qualifying Child Name Control - 1 4 6 6 5 9 0004 0005 0007 1 7 4 blank N 0000001 First 4 significant characters of child's last name, no leading or embedded spaces; allowable characters are alpha, hyphen or space (see special instructions) AN (first name) or blank AN (last name) or blank N N "X" or blank "X" or blank "X" or blank "X" or blank Part II Page 91 Section 3 0010 0011 0015 0020 0030 0035 0040 0045 Qualifying Child First Name - 1 Qualifying Child Last Name - 1 Qualifying SSN - 1 Year Of Birth - 1 Student "Yes" Box 1 Student "No" Box - 1 Disabled "Yes" Box 1 Disabled "No" Box 1 1 1 2 3 4(a) 4(a) 4(b) 4(b) August 30, 2002 10 15 9 4 1 1 1 1 Publication 1346 SCHEDULE EIC Field Identification No. ----- -------------0060 Relationship - 1 Earned Income Credit Form Ref. ---5 Length -----11 Field Description ----------------AN, "CHILD", "SON", "DAUGHTER", "GRANDCHILD", "FOSTERCHILD" N, Range 00-12 First 4 significant characters of child's last name, no leading or embedded spaces; allowable characters are alpha, hyphen or space (see special instructions) AN (first name) or blank AN (last name) or blank N N "X" or blank "X" or blank "X" or blank "X" or blank AN, "CHILD", "SON", "DAUGHTER", "GRANDCHILD", "FOSTERCHILD" N, Range 00-12 0070 0077 Number of Months - 1 Qualifying Child Name Control - 2 6 2 4 0080 0081 0085 0090 0100 0105 0110 0115 0130 Qualifying Child First Name - 2 Qualifying Child Last Name - 2 Qualifying SSN - 2 Year Of Birth - 2 Student "Yes" Box 2 Student "No" Box - 2 Disabled "Yes" Box 2 Disabled "No" Box 2 Relationship - 2 1 1 2 3 4(a) 4(a) 4(b) 4(b) 5 10 15 9 4 1 1 1 1 11 0140 Number of Months - 2 6 2 Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 92 Section 3 SCHEDULE F PAGE 1 Field Identification No. ----- -------------Byte Count Profit or Loss From Farming Form Ref. ---Length -----4 Field Description ----------------"0879" for Fixed; "nnnn" for variable format Value "****" "SCHbbF" "1040bb" "PG01b" N (Primary SSN) Start of Record Sentinel 0000 0001 0002 0003 Record ID Schedule Type Page Number Taxpayer Identification Number Filler Schedule Occurrence Number Name of Proprietor SSN of Proprietor Principal Product Agricultural Activity Code Accounting Method Cash Indicator Accounting Method Accrual Indicator Employer ID. Number Materially Participate Yes Indicator Materially Participate No Indicator Sales Amount of Livestock Purchased Cost or Other Basis A B C-1 C-2 D E 4 6 6 5 9 0004 0005 0010 0020 0030 0040 0050 0060 0070 0100 1 7 35 9 35 6 1 1 9 1 blank N 0000001 - 0000002 AN N AN N or blank "X" or blank "X" or blank N or blank "X" or blank 0110 E 1 "X" or blank 0140 0150 1 2 August 30, 2002 12 12 N N Part II Page 93 Section 3 Publication 1346 SCHEDULE F PAGE 1 Field Identification No. ----- -------------0160 0170 0180 0195 0205 0210 @0215 0230 0235 0240 0245 0250 @0251 0252 0255 0260 0270 0280 0295 0300 Purchased Profit Sales Amount for Products Raised Total Cooperative Distributions Taxable Amount Agricultural Program Payments Taxable Amount Commodity Credit Loans Explan Commodity Credit Loans Amount Commodity Credit Loans Forfeited Taxable Amount Crop Insurance Proceeds Amount Taxable Amount Election to Defer Explan Election to Defer Indicator Deferred Amount Custom Hire Income Amount From Tax Credits/Refunds Gross Income Amount Car and Truck Expense Chemicals Expense Profit or Loss From Farming Form Ref. ---3 4 5a 5b 6a 6b Length -----12 12 12 12 12 12 6 7a 7b 7c 8a 8b 12 12 12 12 12 6 8c 8d 9 10 11 12 13 August 30, 2002 1 12 12 12 12 12 12 Field Description ----------------N N N N N N "STMbnn" or blank N N N N N "STMbnn" or blank "X" or blank N N N N N N Part II Page 94 Section 3 | Publication 1346 SCHEDULE F PAGE 1 Field Identification No. ----- -------------0310 0315 0320 0330 0340 0350 0360 0370 0380 @0385 0390 @0395 0400 0410 0450 0460 0465 0470 0480 Conservation Expense Custom Hire Expense Sect 179 Expense Employee Benefit Programs Expense Feed Purchased Expense Fertilizer & Lime Expense Freight & Trucking Expense Gas, Fuel, Oil Expense Insurance Expense Form 1098 Explanation Mortgage Int Expense Form 1098 Name/ Address Other Interest Expense Labor Hired Expense Pension/Profit Sharing Expense Machinery/Equipment Rent or Lease Other/Land/Animals Rent or Lease Repairs/Maintenance Expense Seeds/Plants Purchased Expense Profit or Loss From Farming Form Ref. ---14 15 16 17 18 19 20 21 22 23a 23a 23b 23b 24 25 26a 26b 27 28 August 30, 2002 Length -----12 12 12 12 12 12 12 12 12 6 12 6 12 12 12 12 12 12 12 Field Description ----------------N N N N N N N N N "STMbnn" or blank N "STMbnn" or blank N N N N N N N Part II Page 95 Section 3 Publication 1346 SCHEDULE F PAGE 1 Field Identification No. ----- -------------0490 0510 0520 0530 0540 *0550 +0560 0570 0580 0590 0600 0610 0620 0630 0640 0642 0644 0650 Storage Warehousing Expense Supplies Purchased Expense Taxes Expense Utilities Veterinary Fees/ Medicine Expense Other Expenses Explanation 1 Other Expenses Amount 1 Other Expenses Explanation 2 Other Expenses Amount 2 Other Expenses Explanation 3 Other Expenses Amount 3 Other Expenses Explanation 4 Other Expenses Amount 4 Other Expenses Explanation 5 Other Expenses Amount 5 Other Expenses Explanation 6 Other Expenses Amount 6 Total Expenses Profit or Loss From Farming Form Ref. ---29 30 31 32 33 34a 34a 34b 34b 34c 34c 34d 34d 34e 34e 34f 34f 35 August 30, 2002 Length -----12 12 12 12 12 20 12 20 12 20 12 20 12 20 12 20 12 12 Field Description ----------------N N N N N AN or "STMbnn" N AN N AN N AN N AN N AN N N Part II Page 96 Section 3 Publication 1346 SCHEDULE F PAGE 1 Field Identification No. ----- -------------0675 0680 0690 0700 PAL Indicator Net Farm Profit or Loss All is At Risk Indicator Some is Not At Risk Indicator Profit or Loss From Farming Form Ref. ---36 36 37a 37b Length -----3 12 1 1 Field Description ----------------"PAL" or blank N "X" or blank "X" or blank Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 97 Section 3 SCHEDULE F PAGE 2 Field Identification No. ----- -------------Byte Count Profit or Loss From Farming Form Ref. ---Length -----4 Field Description ----------------"0265" for Fixed; "nnnn" for variable format Value "****" "SCHbbF" "1040bb" "PG02b" N (Primary SSN) Start of Record Sentinel 0710 0711 0712 0713 Record ID Schedule Type Page Number Taxpayer Identification Number Filler Schedule Occurrence Number Sales Amount of Livestock Total Cooperative Distributions Taxable Amount Agricultural Program Payments Taxable Amount Commodity Credit Loans Explain Commodity Credit Loans Amount Commodity Credit Loans Forfeited Taxable Amount Crop Insurance Proceeds Custom Hire Income 41a 41b 41c 42 43 August 30, 2002 38 39a 39b 40a 40b 4 6 6 5 9 0714 0715 0720 0730 0735 0760 0770 @0775 0780 0790 0800 0810 0820 1 7 12 12 12 12 12 6 12 12 12 12 12 blank N 0000001 - 0000002 N N N N N "STMbnn" or blank N N N N N Part II Page 98 Section 3 | Publication 1346 SCHEDULE F PAGE 2 Field Identification No. ----- -------------0830 0840 0850 0860 0870 0880 0890 0900 Other Income Credits/Refunds Total Income Amount Inventory At Beginning Year Cost of Products Purchased Beginning Inventory Plus Products Purchased Inventory At End of Year Cost of Farm Products Sold Gross Farm Income Profit or Loss From Farming Form Ref. ---44 45 46 47 48 49 50 51 Length -----12 12 12 12 12 12 12 12 Field Description ----------------N N N N N N N N Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 99 Section 3 INTENTIONAL BLANK PAGE Publication 1346 August 30, 2002 Part II Page 100 Section 3 SCHEDULE H PAGE 1 Field Identification No. ----- -------------Byte Count Household Employment Taxes Form Ref. ---Length -----4 Field Description ----------------"0216" for Fixed; "nnnn" for variable format Value "****" "SCHbbH" "1040bb" "PG01b" N (Primary SSN) Start of Record Sentinel 0000 0001 0002 0003 Record ID Schedule Type Page Number Taxpayer Identification Number Filler Schedule Occurrence Number Employer Name 4 6 6 5 9 0004 0005 0010 1 7 35 blank N 0000001 - 0000002 AN. Allowable special characters are: space, less than (<), hyphen (-) and ampersand (&) First 4 significant characters of employer's last name, no leading or embedded spaces; allowable characters are alpha, hyphen or space. N N 0015 Employer Name Control 4 0020 0030 Employer SSN Employer Identification Number Cash Wage Over $1300 Paid Yearly Yes Cash Wage Over $1300 Paid Yearly No Federal Income Tax Withheld - Yes A 9 9 0040 1 "X" or blank 0045 A 1 "X" or blank 0050 B August 30, 2002 1 "X" or blank Part II Page 101 Section 3 Publication 1346 SCHEDULE H PAGE 1 Field Identification No. ----- -------------0055 0060 Federal Income Tax Withheld - No Cash Wage Over $1000 Paid Qtrly No Cash Wage Over $1000 Paid Qtrly Yes Social Security Wages Social Security Tax Medicare Wages Medicare Tax Federal Income Tax Withheld Soc. Security, Medicare and Fed Income Tx Subtotal Disability Amount Advance EIC Payment Total Taxes Less Advance EIC Payments Cash Wages Over $1000 Paid Qtrly No Cash Wages Over $1000 Paid Qtrly Yes Household Employment Taxes Form Ref. ---B C Length -----1 1 Field Description ----------------"X" or blank "X" or blank 0065 C 1 "X" or blank 0070 0080 0090 0100 0110 0120 1 2 3 4 5 6 12 12 12 12 12 12 N N N N N N 0125 0130 0140 0150 6 7 8 9 12 12 12 1 N N N "X" or blank 0155 9 1 "X" or blank Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 102 Section 3 SCHEDULE H PAGE 2 Field Identification No. ----- -------------Byte Count Household Employment Taxes Form Ref. ---Length -----4 Field Description ----------------"0422" for Fixed; "nnnn" for variable format Value "****" "SCHbbH" "1040bb" "PG02b" N (Primary SSN) Start of Record Sentinel 0160 0161 0162 0163 Record ID Schedule Type Page Number Taxpayer Identification Number Filler Schedule Occurrence Number Unemplymnt Cntrbtns to Only One State Yes Unemplymnt Cntrbtns to Only One State No Total Unemplymnt Cntrbtns Pd By April Deadline Yes Total Unemplymnt Cntrbtns Pd By April Deadline No Taxable Wages for FUTA Also Taxable for State Yes Taxable Wages for FUTA Also Taxable for State No Name of State Where Unemplymnt Cntrbtns Paid 10 4 6 6 5 9 0164 0165 0170 1 7 1 blank N 0000001 - 0000002 "X" or blank 0175 0180 10 11 1 1 NO ENTRY "X" or blank | 0185 11 1 NO ENTRY | 0190 12 1 "X" or blank 0195 12 1 NO ENTRY 0200 13 2 Standard Postal State Abbreviations Publication 1346 August 30, 2002 Part II Page 103 Section 3 SCHEDULE H PAGE 2 Field Identification No. ----- -------------0210 State Reporting Num on State Unemplymnt Tax Retrn Cntrbtns Paid to State Unemplymnt Fund Total Taxable Wages for FUTA (Section A) FUTA Tax State Name 1 State Reporting Num on State Unemplymnt Tx Ret 1 Taxable Payroll for Unemplymnt Cntrbtns 1 Beginning Date of State Experience Rate Period 1 Ending Date of State Experience Rate Period 1 State Experience Rate 1 Unemployment Tax Credit at .054 - 1 Unemplymnt Tax Credit at Maximum Pct - 1 Additional Tax Credit 1 Contributions Paid to State Unemployment Fund 1 State Name 2 Household Employment Taxes Form Ref. ---14 Length -----15 Field Description ----------------AN 0220 15 12 N or "0%bRATE" 0230 0240 0250 0260 16 17 18(a) 18(b) 12 12 2 15 N N NO ENTRY NO ENTRY 0270 18(c) 12 NO ENTRY 0280 18(d) 8 NO ENTRY 0285 18(d) 8 NO ENTRY 0290 0300 0310 18(e) 18(f) 18(g) 6 12 12 NO ENTRY NO ENTRY NO ENTRY 0320 0330 18(h) 18(i) 12 12 NO ENTRY NO ENTRY 0340 18(a) August 30, 2002 2 NO ENTRY Part II Page 104 Section 3 Publication 1346 SCHEDULE H PAGE 2 Field Identification No. ----- -------------0350 State Reporting Num on State Unemplymnt Tx Ret 2 Taxable Payroll For Unemplymnt Cntrbtns 2 Beginning Date of State Experience Rate Period 2 Ending Date of State Experience Rate Period 2 State Experience Rate 2 Unemployment Tax Credit at .054 - 2 Unemplymnt Tax Credit at Maximum Pct - 2 Additional Tax Credit 2 Contributions to State Unemployment Fund 2 Total Additional Tax Credit Total Contributions to State Unemployment Funds Tentative Total Tax Credit Total Taxable Wages for FUTA (Section B) Gross FUTA Tax Amount Household Employment Taxes Form Ref. ---18(b) Length -----15 Field Description ----------------NO ENTRY 0360 18(c) 12 NO ENTRY 0370 18(d) 8 NO ENTRY 0375 18(d) 8 NO ENTRY 0380 0390 0400 18(e) 18(f) 18(g) 6 12 12 NO ENTRY NO ENTRY NO ENTRY 0410 0420 18(h) 18(i) 12 12 NO ENTRY NO ENTRY 0440 0450 19(h) 19(i) 12 12 NO ENTRY NO ENTRY 0460 0470 0480 20 21 22 12 12 12 NO ENTRY NO ENTRY NO ENTRY Publication 1346 August 30, 2002 Part II Page 105 Section 3 SCHEDULE H PAGE 2 Field Identification No. ----- -------------0490 0500 0510 Maximum Tax Credit Amount Total Tax Credit Allowed FUTA Tax (Subtract line 24 from line 22) Total Taxes from Line 8 Total Combined Taxes Plus Futa Taxes Required to File Form 1040 - Yes Required to File Form 1040 - No Household Employment Taxes Form Ref. ---23 24 25 Length -----12 12 12 Field Description ----------------NO ENTRY NO ENTRY NO ENTRY 0520 0530 26 27 12 12 N N 0540 0550 28 28 1 1 "X" or blank NO ENTRY Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 106 Section 3 SCHEDULE J Field Identification No. ----- -------------Byte Count Farm Income Averaging Form Ref. ---Length -----4 Field Description ----------------"0307" for Fixed; "nnnn" for variable format Value "****" "SCHbbJ" "1040bb" "PG01b" N (Primary SSN) Start of Record Sentinel 0000 0001 0002 0003 Record ID Schedule Type Page Number Taxpayer Identification Number Filler Schedule Occurrence Number Taxable Income Elected Farm Income Subtract Line 2 from Line 1 Tax on Line 3 Taxable Income from 1999 One-third Elected Farm Income Add Lines 5 and 6 Tax on Line 7 Taxable Income from 2000 Amount from Line 6 Add Lines 9 and 10 Tax on Line 11 1 2 3 4 5 6 7 8 9 10 11 12 August 30, 2002 4 6 6 5 9 0004 0005 0010 0020 0030 0040 0050 0060 0070 0080 0090 0100 0110 0120 1 7 12 12 12 12 12 12 12 12 12 12 12 12 blank N 0000001 N N N N N N N N N N N N Part II Page 107 Section 3 | | Publication 1346 SCHEDULE J Field Identification No. ----- -------------0130 0140 0150 0160 0170 0180 0190 0200 0210 0220 Taxable Income from 2001 One-third Elected Farm Income Add Lines 13 and 14 Tax on Line 15 Add Lines 4, 8, 12, and 16 Tax from 1999 Tax Return Tax from 2000 Tax Return Tax from 2001 Tax Return Add Lines 18 through 20 Subtract Line 21 from Line 17 Farm Income Averaging Form Ref. ---13 14 15 16 17 18 19 20 21 22 Length -----12 12 12 12 12 12 12 12 12 12 Field Description ----------------N N N N N N N N N N | | | | Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 108 Section 3 SCHEDULE R PAGE 1 Field Identification No. ----- -------------Byte Count Credit for the Elderly or the... Form Ref. ---Length -----4 Field Description ----------------"0053" for Fixed; "nnnn" for variable format Value "****" "SCHbbR" "1040bb" "PG01b" N (Primary SSN) Start of Record Sentinel 0000 0001 0002 0003 Record ID Schedule Type Page Number Taxpayer Identification Number Filler Schedule Occurrence Number Over 65 Retire/Disabled Both Over 65 Both Under 65, One Retired Both Under 65, Both Retired One Over 65, Other Retired One Over 65, Other Not Retired Over 65, Did Not Live With Spouse Under 65, Did Not Live With Spouse Prior Year Statement Indicator 1 2 3 4 5 6 7 8 9 II-2 4 6 6 5 9 0004 0005 0010 0020 0030 0040 0050 0060 0070 0080 0090 0100 1 7 1 1 1 1 1 1 1 1 1 1 blank N 0000001 "X" or blank "X" or blank "X" or blank "X" or blank "X" or blank "X" or blank "X" or blank "X" or blank "X" or blank "X" or blank Publication 1346 August 30, 2002 Part II Page 109 Section 3 SCHEDULE R PAGE 1 Field Identification No. ----- -------------- Credit for the Elderly or the... Form Ref. ---Length -----Field Description ----------------- Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 110 Section 3 SCHEDULE R PAGE 2 Field Identification No. ----- -------------Byte Count Credit for the Elderly or the... Form Ref. ---Length -----4 Field Description ----------------"0247" for Fixed; "nnnn" for variable format Value "****" "SCHbbR" "1040bb" "PG02b" N (Primary SSN) | Start of Record Sentinel 0130 0131 0132 0133 Record ID Schedule Type Page Number Taxpayer Identification Number Filler Schedule Occurrence Number Write Amount Taxable Disability Smaller of Write Amount or Taxable Nontaxable SSB/RRB Nontaxable Other Pensions & Annuities Form 1040 AGI Exemption Amount Adjusted AGI Amount Half Adjusted AGI Adjusted Credit Net Credit Amount Credit 10 11 12 13a 13b 13c 14 15 16 17 18 19 20 4 6 6 5 9 0134 0135 0140 0150 0160 0163 0167 0170 0180 0190 0200 0210 0220 0230 0250 1 7 12 12 12 12 12 12 12 12 12 12 12 12 12 blank N 0000001 N, 5000, 7500 or 3750 N N N N N N N, 7500, 10000 or 5000 N N N N N Publication 1346 August 30, 2002 Part II Page 111 Section 3 SCHEDULE R PAGE 2 Field Identification No. ----- -------------0260 Total Tax Before Credits & Other Taxes Foreign & Child/ Dependent Care Credits Total Tax Less Credits Credit for Elderly or Disabled Credit for the Elderly or the... Form Ref. ---21 Length -----12 Field Description ----------------N | 0270 22 12 N | 0280 0290 23 24 12 12 N N | | Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 112 Section 3 SCHEDULE 3 PAGE 1 Field Identification No. ----- -------------Byte Count Credit for the Elderly or... Form Ref. ---Length -----4 Field Description ----------------"0053" for Fixed; "nnnn" for variable format Value "****" "SCHbb3" "1040Ab" "PG01b" N (Primary SSN) Start of Record Sentinel 0000 0001 0002 0003 Record ID Schedule Type Page Number Taxpayer Identification Number Filler Schedule Occurrence Number Over 65 Retire/Disabled Both Over 65 Both Under 65, One Retired Both Under 65, Both Retired One Over 65, Other Retired One Over 65, Other Not Retired Over 65, Did Not Live With Spouse Under 65, Did Not Live With Spouse Prior Year Statement Indicator 1 2 3 4 5 6 7 8 9 II-2 4 6 6 5 9 0004 0005 0010 0020 0030 0040 0050 0060 0070 0080 0090 0100 1 7 1 1 1 1 1 1 1 1 1 1 blank N 0000001 "X" or blank "X" or blank "X" or blank "X" or blank "X" or blank "X" or blank "X" or blank "X" or blank "X" or blank "X" or blank Publication 1346 August 30, 2002 Part II Page 113 Section 3 SCHEDULE 3 PAGE 1 Field Identification No. ----- -------------- Credit for the Elderly or... Form Ref. ---Length -----Field Description ----------------- Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 114 Section 3 SCHEDULE 3 PAGE 2 Field Identification No. ----- -------------Byte Count Credit for the Elderly or... Form Ref. ---Length -----4 Field Description ----------------"0223" for Fixed; "nnnn" for variable format Value "****" "SCHbb3" "1040Ab" "PG02b" N (Primary SSN) | Start of Record Sentinel 0130 0131 0132 0133 Record ID Schedule Type Page Number Taxpayer Identification Number Filler Schedule Occurrence Number Write Amount Taxable Disability Smaller of Write Amount or Taxable Disability Nontaxable SSB/RRB Nontaxable Other Pensions & Annuities Form 1040A AGI Exemption Amount Adjusted AGI Amount Half Adjusted AGI Adjusted Credit Net Credit Amount Percentage of Net Credit 10 11 12 4 6 6 5 9 0134 0135 0140 0150 0160 1 7 12 12 12 blank N 0000001 N, 5000, 7500 or 3750 N N 0163 0167 0170 0180 0190 0200 0210 0220 0230 0240 13a 13b 13c 14 15 16 17 18 19 20 12 12 12 12 12 12 12 12 12 12 N N N N N, 7500, 10000 or 5000 N N N N N | --| Part II Page 115 Section 3 Publication 1346 August 30, 2002 SCHEDULE 3 PAGE 2 Field Identification No. ----- -------------0260 Tax Less Child & Dependent Care Expenses Credits Credit for Elderly or Disabled Credit for the Elderly or... Form Ref. ---21 Length -----12 Field Description ----------------N | 0270 22 12 N | Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 116 Section 3 SCHEDULE SE Field Identification No. ----- -------------Byte Count Self-Employment Tax Form Ref. ---Length -----4 Field Description ----------------"0353" for Fixed; "nnnn" for variable format Value "****" "SCHbSE" "1040bb" "PG01b" N (Primary SSN) Start of Record Sentinel 0000 0001 0002 0003 Record ID Schedule Type Page Number Taxpayer Identification Number Filler Schedule Occurrence Number Name of SelfEmployed SSN of Self-Employed Exempt/Form 4361 Box Net Farm Profit/Loss Net Non-Farm Profit/ Loss Exempt-Notary Literal Exempt-Notary Amt Total Net Earnings/ Loss Min. Profit for SE Tax Optional Method Amount Combined SE Amount 1 2 3 3 3 4a 4b 4c August 30, 2002 4 6 6 5 9 0004 0005 0010 0020 0025 0030 0040 0050 0060 0070 0075 0077 0079 1 7 35 9 1 12 12 13 12 12 12 12 12 blank N 0000001 - 0000002 A N "X" or blank N N Value "EXEMPT-NOTARY" or blank N N N N N Part II Page 117 Section 3 Publication 1346 SCHEDULE SE Field Identification No. ----- -------------0081 0082 0084 W-2 Wages from Churches Min. Allowable Church Wages Combined SE and Allowable Church Wages SST Wages/RRT Comp Unreported Tips Total Wages/ Unreported Tips Allowable SE Amount Tax Base Amount SE Base Amount Self-Employment Tax Deduction for 1/2 of Self-Employment Tax Farm Optional Meth Amt Non-Farm Opt Meth Amt Non-Farm Opt Base Amount Self-Employment Tax Form Ref. ---5a 5b 6 Length -----12 12 12 Field Description ----------------N N N 0088 0090 0100 0110 0150 0159 0160 0165 8a 8b 8c 9 10 11 12 13 12 12 12 12 12 12 12 12 N N N N N N N N 0170 0180 0190 15 16 17 12 12 12 N N N Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 118 Section 3 Schedule SE (Short Form) - Conversion Guide If the Short Schedule SE was prepared or could have been prepared, it must be electronically filed as a Schedule SE using the following fields: Field No. 010 020 030 040 050 060 070 075 160 165 Identification Name of Self-Employed SSN of Self-Employed Net Farm Profit/Loss Net Non-Farm Profit/Loss Exempt-Notary Literal Exempt-Notary Amt Total Net Earnings/Loss Min. Profit for SE Tax Self-Employment Tax Deduction for 1/2 of Self-Employment Tax Schedule SE Line Reference 1 2 3 3 3 4 5 6 Publication 1346 August 30, 2002 Part II Page 119 Section 3 INTENTIONAL BLANK PAGE Publication 1346 August 30, 2002 Part II Page 120 Section 3 SECTION 4 FORMS Form Record Identification Each page of incremented. Field# a form will have a new Form Record with the Page Number Identification Byte Count Start of Record Sentinel Length 4 4 6 6 5 9 1 7 Description (see form) for fixed; "nnnn" for variable Value "****" Value "FRMbbb" Value "nnnnbb" Value "Pgnnb", nn = 0l to 04 N (Primary Social Security) Number Blank Number limited to the maximum number of forms allowed 0000 0001 0002 0003 0004 0005 Record ID Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number (Begin data fields of the Form record layout.) Publication 1346 August 30, 2002 Part II Page 121 Section 4 INTENTIONAL BLANK PAGE Publication 1346 August 30, 2002 Part II Page 122 Section 4 FORM W-2 Field Identification No. ----- -------------Byte Count Wage and Tax Statement Form Ref. ---Length -----4 Field Description ----------------"0764" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" "W-2bbb" "PG01b" N (Primary SSN) Start of Record Sentinel 0000 0001 0002 0003 Record ID Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number Control Number Void Ind Employer Identification Number Employer Name Control b a 4 6 6 5 9 0004 0005 0020 0030 0040 1 7 14 1 9 blank N 0000001 - 0000050 AN or blank "X" or blank N 0045 c 4 First 4 significant characters of employer's name, no leading or embedded spaces, allowable characters are alpha, numeric, hyphen, ampersand, spaces may be present only as last two positions AN Allowable special characters are: ampersand (&), hyphen (-), slash (/), comma (,), plus (+) and blank ( ) 0050 Employer Name c 35 Publication 1346 August 30, 2002 Part II Page 123 Section 4 FORM W-2 Field Identification No. ----- -------------0055 Employer Name Line 2 Wage and Tax Statement Form Ref. ---c Length -----35 Field Description ----------------AN, in care of addressee, or address continuation. Allowable special characters are space, ampersand, slash, hyphen and percent (%) AN Allowable special characters are: ampersand (&), hyphen (-), slash (/), comma (,), percent (%), and Literal "NONE" AN, Allowable special Character is space A (Standard Postal State Abbreviations) or period (.) N (Left-justified) N (W-2 Social Security Number) AN Allowable special characters: hyphen (-) or blank AN Allowable special characters are ampersand (&), hyphen (-), slash (/), comma (,) and percent (%) or blank AN AN, Allowable special character is space A (Standard Postal State Abbreviations) or period (.) N (Left-justified) N N Part II Page 124 Section 4 0060 Employer Address c 35 0070 0073 Employer City Employer State c c 22 2 0075 0080 0090 Employer Zip Code Employee SSN Employee Name c d e 12 9 35 0100 Employee Address f 35 0105 0110 0113 Employee Address Continuation Employee City Employee State f f f 35 22 2 0115 0120 0130 Employee Zip Code Wages Withholding f 1 2 August 30, 2002 12 12 12 Publication 1346 FORM W-2 Field Identification No. ----- -------------0140 0150 0160 0170 0180 0190 0200 0210 0220 0242 0244 Social Security Wages Social Security Tax Medicare Wages and Tips Medicare Tax Withheld Social Security Tips Allocated Tips Advance EIC Payment Dependent Care Benefits Nonqualified Plans Employer's Use Code 1 Year 1 (for Prior Year USERRA Contribution) Employer's Use Amount 1 Employer's Use Code 2 Year 2 (for Prior Year USERRA Contribution) Employer's Use Amount 2 Employer's Use Code 3 Year 3 (for Prior Year USERRA Contribution) Wage and Tax Statement Form Ref. ---3 4 5 6 7 8 9 10 11 12a 12a Length -----12 12 12 12 12 12 12 12 12 1 2 Field Description ----------------N N N N N N N N N A N (YY) or blank 0246 0252 0254 12a 12b 12b 12 1 2 N A N (YY) or blank 0256 0257 0258 12b 12c 12c 12 1 2 N A N (YY) or blank Publication 1346 August 30, 2002 Part II Page 125 Section 4 FORM W-2 Field Identification No. ----- -------------0259 0260 0261 Employer's Use Amount 3 Employer's Use Code 4 Year 4 (for Prior Year USERRA Contribution) Employer's Use Amount 4 Statutory Employee Ind Retirement Plan Ind Third-Party Sick Pay Ind Other Deducts/ Benefits Type 1 Other Deducts/ Benefits Amt 1 Other Deducts/ Benefits Type 2 Other Deducts/ Benefits Amt 2 Other Deducts/ Benefits Type 3 Other Deducts/ Benefits Amt 3 State Name 1 Employer's State ID Number 1 State Wages 1 State Income Tax 1 Local Wages/Tips 1 Wage and Tax Statement Form Ref. ---12c 12d 12d Length -----12 1 2 Field Description ----------------N A N (YY) or blank 0262 0265 0267 0269 0270 0272 0280 0282 0290 0292 0370 0380 0390 0400 0405 12d 13 13 13 14 14 14 14 14 14 15 15 16 17 18 August 30, 2002 12 1 1 1 8 12 8 12 8 12 2 14 12 12 12 N "X" or blank "X" or blank "X" or blank AN N 'See 1st Occ.' 'See 1st Occ.' 'See 1st Occ.' 'See 1st Occ.' A (Standard Postal State Abbreviations) AN or blank N N N Part II Page 126 Section 4 Publication 1346 FORM W-2 Field Identification No. ----- -------------0407 0410 0440 0450 0460 0470 0475 0477 0480 0510 Local Income Tax 1 Name of Locality 1 State Name 2 Employer's State ID Number 2 State Wages 2 State Income Tax 2 Local Wages/Tips 2 Local Income Tax 2 Name of Locality 2 W-2 Indicator Wage and Tax Statement Form Ref. ---19 20 15 15 16 17 18 19 20 Length -----12 9 2 14 12 12 12 12 9 1 Field Description ----------------N AN 'See 1st Occ.' AN or blank N N N N AN "N" = non-standard (for altered, typed or handwritten forms) "S" = standard W-2 Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 127 Section 4 INTENTIONAL BLANK PAGE Publication 1346 August 30, 2002 Part II Page 128 Section 4 FORM W-2C Field Identification No. ----- -------------Byte Count Corrected Wage and Tax Statement Form Ref. ---Length -----4 Field Description ----------------"0857" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" "W-2Cbb" "PG01b" N (Primary SSN) Start of Record Sentinel 0000 0001 0002 0003 Record ID Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number Corrected Tax Year Corrected Form Employee Name a a b 4 6 6 5 9 0004 0005 0010 0020 0030 1 7 4 2 35 blank N 0000001 - 0000010 N "c" or "AS" or "GU" or "CM" or "VI" or blank AN Allowable special characters: hyphen (-) or blank AN Allowable special characters are ampersand (&), hyphen(-), slash (/), comma (,), percent (%) or blank AN, Allowable special character is space A (Standard Postal State Abbreviations) or period (.) N (Left-Justified) "X" or blank 0040 Employee Address b 35 0050 0060 Employee City Employee State b b 22 2 0070 0080 Employee Zip Code Corrected Name Box b b 12 1 Publication 1346 August 30, 2002 Part II Page 129 Section 4 FORM W-2C Field Identification No. ----- -------------0090 Employer Name Corrected Wage and Tax Statement Form Ref. ---c Length -----35 Field Description ----------------AN Allowable special characters are: ampersand (&), hyphen (-), slash (/), comma (,), plus (+) and blank ( ) AN, in care of addressee, or address continuation. Allowable special characters are space, ampersand, slash, hyphen and percent (%) AN Allowable special characters are: ampersand (&), hyphen (-), slash (/),comma (,), percent (%), and Literal "NONE" AN, Allowable special character is space A (Standard Postal State Abbreviations) or period (.) N (Left-Justified) N N First 4 significant characters of employer's name, no leading or embedded spaces, allowable characters are alpha, numeric, hyphen, ampersand, spaces may be present only as last two positions AN or blank Part II Page 130 Section 4 0100 Employer Name Line 2 c 35 0110 Employer Address c 35 0120 0130 Employer City Employer State c c 22 2 0140 0150 0160 0170 Employer Zip Code Employee's Correct SSN Employer's Federal EIN Employer's Name Control c d e e 12 9 9 4 0180 Employer's State ID Number f August 30, 2002 14 Publication 1346 FORM W-2C Field Identification No. ----- -------------0190 0200 Employee's Incorrect SSN Employee's Incorrect Name Previously Reported Wages, Tips, other Comp. Correct Wages,Tips, other Comp. Previously Reported Federal Inc Tax Withholding Correct Federal Inc Tax Withholding Previously Reported Social Security Wages Correct Social Security Wages Previously Reported Social Security Tax Withheld Correct Social Security Tax Withheld Previously Reported Medicare Wages & Tips Correct Medicare Wages & Tips Previously Reported Medicare Tax Withheld Correct Medicare Tax Withheld Corrected Wage and Tax Statement Form Ref. ---g h Length -----9 35 Field Description ----------------N AN Allowable special characters: hyphen (-) or blank N 0210 1 12 0220 0230 1 2 12 12 N N 0240 0250 2 3 12 12 N N 0260 0270 3 4 12 12 N N 0280 4 12 N 0290 5 12 N 0300 0310 5 6 12 12 N N 0320 6 August 30, 2002 12 N Part II Page 131 Section 4 Publication 1346 FORM W-2C Field Identification No. ----- -------------0330 0340 0350 0360 0370 0380 0390 Previously Reported Social Security Tips Correct Social Security Tips Previously Reported Allocated Tips Correct Allocated Tips Previously Reported Advance EIC Correct Advance EIC Previously Reported Dependent Care Benefits Correct Dependent Care Benefits Previously Reported Nonqualified Plans Correct Nonqualified Plans Previously Reported Elective Deferrals Name & Code Correct Elective Deferrals Name and Code Previously Reported Statutory Employee Box Previously Reported Retirement Plan Box Previously Reported Third Party Sick Pay Box Corrected Wage and Tax Statement Form Ref. ---7 7 8 8 9 9 10 Length -----12 12 12 12 12 12 12 Field Description ----------------N N N N N N N 0400 0410 0420 0430 10 11 11 12 12 12 12 12 N N N N 0440 12 12 N 0450 13 1 "X" or blank 0460 0470 13 13 1 1 "X" or blank "X" or blank Publication 1346 August 30, 2002 Part II Page 132 Section 4 FORM W-2C Field Identification No. ----- -------------0480 0490 0500 0510 Correct Statutory Employee Box Correct Retirement Plan Box Correct Third Party Sick Pay Box Previously Reported Other Deducts/ Benefits Type Correct Other Deducts/Benefits Type Previously Reported Other Deducts/ Benefits Amt Correct Other Deducts/Benefits Amt Previously Reported State Name Correct State Name Previously Reported Employer's State ID Number Correct Employer's State ID Number Previously Reported State Wages, Tips Correct State Wages, Tips Previously Reported State Income Tax Correct State Income Tax Corrected Wage and Tax Statement Form Ref. ---13 13 13 14 Length -----1 1 1 8 Field Description ----------------"X" or blank "X" or blank "X" or blank AN 0520 14 8 AN 0530 14 12 N 0540 0550 0560 0570 14 15 15 15 12 2 2 14 N A (Standard Postal State Abbreviations) A (Standard Postal State Abbreviations) AN or blank 0580 0590 0600 0610 0620 15 16 16 17 17 14 12 12 12 12 AN or blank N N N N Publication 1346 August 30, 2002 Part II Page 133 Section 4 FORM W-2C Field Identification No. ----- -------------0630 0640 0650 0660 0670 0680 Previously Reported Local Wages, Tips Correct Local Wages, Tips Previously Reported Local Income Tax Correct Local Income Tax Previously Reported Locality Name Correct Locality Name Corrected Wage and Tax Statement Form Ref. ---18 18 19 19 20 20 Length -----12 12 12 12 9 9 Field Description ----------------N N N N AN AN Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 134 Section 4 FORM W-2G Field Identification No. ----- -------------Byte Count Certain Gambling Winnings Form Ref. ---Length -----4 Field Description ----------------"0520" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" "W-2Gbb" "PG01b" N (Primary SSN) Start of Record Sentinel 0000 0001 0002 0003 Record ID Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number Payer Name Control 4 6 6 5 9 0004 0005 0015 1 7 4 blank N 0000001 - 0000030 First 4 significant characters of payer's name, no leading or embedded spaces, allowable characters are alpha, numeric, hyphen, ampersand, spaces may be present only as last two positions AN Allowable special characters are: ampersand (&), hyphen (-), slash (/), comma (,), plus (+) and blank ( ) AN, in care of addressee, or address continuation. Allowable special characters are space, ampersand, slash, hyphen and percent (%) AN Allowable special characters are: ampersand (&), hyphen (-), slash (/), comma (,), percent (%) and literal "NONE" Part II Page 135 Section 4 0020 Payer Name 35 0021 Payer Name Line 2 35 0022 Payer's Address 35 Publication 1346 August 30, 2002 FORM W-2G Field Identification No. ----- -------------0023 0024 0025 0026 Payer's City Payer's State Payer's Zip Code Payer Identification Number Payer Telephone Number Gross Winnings, etc. Withholding Type of Wager Date Won Transaction Race Winnings from Identical Wagers Cashier Winner's Name Winner's Address Certain Gambling Winnings Form Ref. ---Length -----22 2 12 9 Field Description ----------------AN Allowable special character is space A (Standard Postal State Abbreviations) or period N (left-justified) N 0030 0040 0050 0080 0090 0100 0105 0120 0130 0140 0142 10 1 2 3 4 5 6 7 8 12 12 13 8 13 13 12 13 35 35 N N N AN DT AN AN N AN AN Allowable special character is hyphen (-) AN Allowable special characters are ampersand (&), hyphen (-), slash (/), comma (,), percent (%) and literal "NONE" AN AN Allowable special character is space A (Standard Postal State Abbreviations) or period (.) Part II Page 136 Section 4 0143 0144 0146 Winner's Address Continuation Winner's City Winner's State 35 22 2 Publication 1346 August 30, 2002 FORM W-2G Field Identification No. ----- -------------0148 0150 0160 0180 0190 0200 0201 0210 Winner's Zip Code SSN Window First I.D. Second I.D. State Name Payer's State I.D. No. State Income Tax Withheld Certain Gambling Winnings Form Ref. ---Length -----12 9 10 11 12 13 13 14 9 13 13 13 2 14 12 Field Description ----------------N (left-justified) N (W-2G Social Security Number) AN AN AN A (Standard Postal State Abbreviations) AN N Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 137 Section 4 INTENTIONAL BLANK PAGE Publication 1346 August 30, 2002 Part II Page 138 Section 4 FORM W-2GU Field Identification No. ----- -------------Byte Count Guam Wage and Tax Statement Form Ref. ---Length -----4 Field Description ----------------"0600" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" "W-2GUb" "PG01b" N (Primary SSN) Start of Record Sentinel 0000 0001 0002 0003 Record ID Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number Control Number Void Ind Employer Identification Number Employer Name Control b a 4 6 6 5 9 0004 0005 0020 0030 0040 1 7 14 1 9 blank N (0000001 - 0000010) AN, or blank "X", or blank N 0045 c 4 First 4 significant characters of employer's name, no leading or embedded spaces, allowable characters are alpha, numeric, hyphen, ampersand, spaces may be present only as last two positions AN, Allowable special characters are: ampersand (&), hyphen(-), slash (/), comma (,), plus (+) and blank ( ) 0050 Employer Name c 35 Publication 1346 August 30, 2002 Part II Page 139 Section 4 FORM W-2GU Field Identification No. ----- -------------0055 Employer Name Line 2 Guam Wage and Tax Statement Form Ref. ---c Length -----35 Field Description ----------------AN, in care of addressee, or address continuation. Allowable special characters are: space, ampersand, slash, hyphen and percent (%) AN, Allowable special characters are: ampersand (&), hyphen (-), slash (/), comma (,), percent (%), and Literal "NONE" AN, Allowable special character is space A (Standard Postal State Abbreviation) or period (.) N (Left-justified) N (W-2GU Social Security Number) AN, Allowable special character is hyphen(-), or blank AN, Allowable special characters are: ampersand (&), hyphen (-), slash (/), comma (,), and percent (%), or blank AN AN, Allowable special character is space A (Standard Postal State Abbreviations) or period (.) N (Left-justified) N Part II Page 140 Section 4 0060 Employer Address c 35 0070 0073 Employer City Employer State c c 22 2 0075 0080 0090 Employer Zip Code Employee SSN Employee Name c d e 12 9 35 0100 Employee Address f 35 0105 0110 0113 Employee Address Continuation Employee City Employee State f f f 35 22 2 0115 0120 Employee Zip Code Wages f 1 August 30, 2002 12 12 Publication 1346 FORM W-2GU Field Identification No. ----- -------------0130 0140 0150 0160 0170 0180 0190 0200 0210 0220 0242 0244 Guam Withholding Social Security Wages Social Security Tax Medicare Wages and Tips Medicare Tax Withheld Social Security Tips Reserved Advanced EIC Payment Reserved Nonqualified Plans Employer's Use Code 1 Year 1 (for PriorYear USERRA Contribution) Employer's Use Amount 1 Employer's Use Code 2 Year 2 (for PriorYear USERRA Contribution) Employer's Use Amount 2 Employer's Use Code 3 Year 3 (for PriorYear USERRA Contribution) Guam Wage and Tax Statement Form Ref. ---2 3 4 5 6 7 8 9 10 11 12a 12a Length -----12 12 12 12 12 12 3 12 3 12 1 2 Field Description ----------------N N N N N N NO ENTRY N NO ENTRY N A N, (YY) or blank 0246 0252 0254 12a 12b 12b 12 1 2 N A N, (YY) or blank 0256 0257 0258 12b 12c 12c 12 1 2 N A N, (YY) or blank Publication 1346 August 30, 2002 Part II Page 141 Section 4 FORM W-2GU Field Identification No. ----- -------------0259 0260 0261 Employer's Use Amount 3 Employer's Use Code 4 Year 4 (for PriorYear USERRA Contribution) Employer's Use Amount 4 Statutory Employee Ind Retirement Plan Ind Deferred Compensation Ind Other Deducts/ Benefits Type 1 Other Deducts/ Benefits Amt 1 Other Deducts/ Benefits Type 2 Other Deducts/ Benefits Amt 2 Other Deducts/ Benefits Type 3 Other Deducts/ Benefits Amt 3 W-2GU Indicator Guam Wage and Tax Statement Form Ref. ---12c 12d 12d Length -----12 1 2 Field Description ----------------N A N, (YY) or blank 0262 0265 0267 0269 0270 0272 0280 0282 0290 0292 0300 12d 13 13 13 14 14 14 14 14 14 12 1 1 1 8 12 8 12 8 12 1 N "X", or blank "X", or blank "X", or blank AN N 'See 1st Occ.' 'See 1st Occ.' 'See 1st Occ.' 'See 1st Occ.' "N" = non-standard (for altered, typed or handwritten forms) "S" = standard W-2GU Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 142 Section 4 FEC RECORD Field Identification No. ----- -------------Byte Count Foreign Employer Compensation Record Form Ref. ---Length -----4 Field Description ----------------"0545" for Fixed; "nnnn" for variable format Value "****" "FECbbb" blank "PG01b" N (Primary SSN) Start of Record Sentinel 0000 0001 0002 0003 Record ID Reserved Page Number Taxpayer Identification Number Filler Record Occurrence Number SSN or ITIN of Employee of Foreign Employer Employee Name Control 4 6 6 5 9 0004 0005 0010 1 7 9 blank N 0000001 - 0000010 N (Social Security Number, or Individual Taxpayer Identification Number) First 4 significant characters of taxpayer's last name, no leading or embedded spaces; allowable characters are alpha, hyphen, and space (see special instructions) AN, Taxpayer's name allowable special characters are: space and hyphen (-) AN, ("in care of" addressee, or first line of the address if more than one line is needed) Allowable special characters are: space, ampersand, slash, hyphen, comma and percent Part II Page 143 Section 4 0020 4 0030 Employee Name Line 1 35 0040 Employee Name Line 2 35 Publication 1346 August 30, 2002 FEC RECORD Field Identification No. ----- -------------0050 Street Address Foreign Employer Compensation Record Form Ref. ---Length -----35 Field Description ----------------AN, Allowable special characters are: space, ampersand, slash, and hyphen A, Allowable special character is space A (Standard Postal State Abbreviations) N (left-justified) A, Allowable special character is space AN, Allowable special character is space) A, Allowable special character is space "X" or blank (if "X", enter "00" for Post of Duty Code) N (from POD Code Table, for foreign residence, or "00", for U.S. residence) AN, Allowable special characters are space, slash, hyphen, ampersand, and percent AN, ("in care of" addressee, or first line of the address if more than one line is needed) Allowable special characters are: space, ampersand, slash, hyphen, and percent 0060 0070 0080 0090 0100 0110 0120 City State Abbreviation Zip Code Foreign Sate or Province Foreign Postal Code Foreign Country Services Performed While Residing in U.S. Yes Ind Post of Duty Code 22 2 12 35 20 35 1 0130 2 0140 Foreign Employer's Name 45 0150 Foreign Employer's Street Address Continuation 35 Publication 1346 August 30, 2002 Part II Page 144 Section 4 FEC RECORD Field Identification No. ----- -------------0160 Foreign Employer's Street Address Foreign Employer Compensation Record Form Ref. ---Length -----35 Field Description ----------------AN, Allowable special characters are: space, ampersand, slash, comma, hyphen and percent AN, Allowable special character is space A, Allowable special character is space AN, Allowable special character is space A, Allowable special character is space AN, Allowable special characters are space, slash, and hyphen (as available for the location) N 0170 0180 0190 0200 0210 Foreign Employer's City Foreign Emplyer's State or Province Foreign Employer's Postal Code Foreign Employer's Country Foreign Employer's Identification Number 22 35 20 35 16 0220 Foreign Employer Compensation Amount 12 Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 145 Section 4 INTENTIONAL BLANK PAGE Publication 1346 August 30, 2002 Part II Page 146 Section 4 FORM 970 Field Identification No. ----- -------------Byte Count Application to Use LIFO Inventory Method Form Ref. ---Length -----4 Field Description ----------------"0385" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" "970bbb" "PG01b" N (Primary SSN) Start of Record Sentinel 0000 0001 0002 0003 Record ID Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number SSN First Election Box Subsequent Election Box Elects LIFO Method For Tax Year Ending LIFO Method Goods Valued At Cost "Yes" Box Valued At Cost "No" Box If No, explanation Inventory Taken at Actual Cost "Yes" Box Inventory Taken at Actual Cost "No" Box A A C C C D 4 6 6 5 9 0004 0005 0020 0030 0040 0050 *0060 0070 0080 @0090 0100 1 7 9 1 1 8 25 1 1 6 1 blank N 0000001 - 0000002 N "X" or blank "X" or blank DT (YYYYMMDD) AN or "STMbnn" "X" or blank "X" or blank "STMbnn" or blank "X" or blank 0110 D 1 "X" or blank Publication 1346 August 30, 2002 Part II Page 147 Section 4 FORM 970 Field Identification No. ----- -------------@0120 0130 0140 0150 Actual Cost "No" Explanation Nature of Business Inventory Method Used Until Now Adjustment Included in Income over 3 years "Y" Box Adjustment Included in Income over 3 years "N" Box Adjustment "No" Explanation Goods Not Inventoried Under LIFO Goods Treated as Acquired "Y" Box Goods Treated as Acquired "N" Box Goods Treated as Acquired "N" Explanation Credit Statements "Yes" Box Credit Statements "No" Box Credit Statements Yes To Whom (Name) Credit Statements Yes Date Show Inventory Method Used Application to Use LIFO Inventory Method Form Ref. ---D 1 2 3 Length -----6 50 35 1 Field Description ----------------"STMbnn" or blank AN AN "X" or blank 0160 3 1 "X" or blank @0170 *0180 3 4a 6 25 "STMbnn" or blank AN or "STMbnn" or blank 0190 0200 @0210 5 5 5 1 1 6 "X" or blank "X" or blank "STMbnn" or blank 0220 0230 *0240 +0245 0250 6a 6a 6b 6b 6c 1 1 35 8 35 "X" or blank "X" or blank AN or "STMbnn" or blank DT (YYYYMMDD) AN Publication 1346 August 30, 2002 Part II Page 148 Section 4 FORM 970 Field Identification No. ----- -------------0260 0270 Most Recent Purchases Box Earliest Acquisitions During Year Box Average Cost of Purchases During the Year Box Other Cost Method Box Other Cost Method Explanation Taxpayer Selects Month Unit Method Box Dollar Value Method Box Statements Describing Contents of Pool Line, Type or Class of Goods Box Pooling Method Box Natural Business Unit Box Multiple Pools Box Raw Materialcontent Box Simplified Dollarvalue Method Box Other Pooling Method Box Application to Use LIFO Inventory Method Form Ref. ---7a 7a Length -----1 1 Field Description ----------------"X" or blank "X" or blank 0280 7a 1 "X" or blank 0290 @0300 0310 0320 0330 @0340 7a 7a 7b 8 8 9 1 6 9 1 1 6 "X" or blank "STMbnn" or blank A "X" or blank "X" or blank "STMbnn" or blank 0350 0360 0370 0380 0390 0400 0410 9 9 9 9 9 9 9 1 1 1 1 1 1 1 "X" or blank "X" or blank "X" or blank "X" or blank "X" or blank "X" or blank "X" or blank Publication 1346 August 30, 2002 Part II Page 149 Section 4 FORM 970 Field Identification No. ----- -------------@0420 @0430 0440 0450 0460 0470 0480 0490 @0500 Other Pooling Method Explanation Description of LIFO Computation Method Double Extension Box New Vehicle Alternative LIFO Index Box Link-chain Box Used Vehicle Alternative LIFO Other Method Box Other Cost Computing Method Explanation Published Price Describe Cost System Used Commissioner's Permission to Change "Yes" Box Commissioner's Permission to Change "No" Box Copy of Grant Letter Retained by Filer Used LIFO Method Before "Yes" Box Used LIFO Before Explanation Used LIFO Method Before "No" Box Application to Use LIFO Inventory Method Form Ref. ---9 10 10 10 10 10 10 10 10 Length -----6 6 1 1 1 1 1 1 6 Field Description ----------------"STMbnn" or blank "STMbnn" or blank "X" or blank "X" or blank "X" or blank "X" or blank "X" or blank "X" or blank "STMbnn" or blank 0510 @0520 0530 10 11 12 1 6 1 "X" or blank "STMbnn" or blank "X" or blank 0540 12 1 "X" or blank 0550 12 1 "Y" or blank 0560 @0570 0580 13 13 13 August 30, 2002 1 6 1 "X" or blank "STMbnn" or blank "X" or blank Part II Page 150 Section 4 Publication 1346 FORM 970 Field Identification No. ----- -------------- Application to Use LIFO Inventory Method Form Ref. ---Length -----Field Description ----------------- Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 151 Section 4 INTENTIONAL BLANK PAGE Publication 1346 August 30, 2002 Part II Page 152 Section 4 FORM 982 Field Identification No. ----- -------------Byte Count Reduction of Tax Attributes Due to Discharge ... Form Ref. ---Length -----4 Field Description ----------------"0256" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" "982bbb" "PG01b" N (Primary SSN) Start of Record Sentinel 0000 0001 0002 0003 Record ID Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number Identifying Number Discharge Of Indebtedness In A Title 11 Case Discharge Of Indebtedness To The Extent Insolvent Discharge Of Qualified Farm Indebtedness Discharge Of Qualified Real Prop Bus Indebtedness Total Amount Of Discharged Indebtedness Treat All Property As Depreciable Yes Box 1a 4 6 6 5 9 0004 0005 0010 0020 1 7 9 1 blank N 0000001-0000002 N "X" or blank 0030 1b 1 "X" or blank 0040 1c 1 "X" or blank 0050 1d 1 "X" or blank 0060 2 12 N 0070 3 1 "X" or blank Publication 1346 August 30, 2002 Part II Page 153 Section 4 FORM 982 Field Identification No. ----- -------------0080 Treat All Property As Depreciable - No Box Attach Description Of Transactions Amt Excluded From Inc:Discharge Of Qual Real Prop Amt Excluded From Inc:Under Section 108(b)(5) Amt Excluded From Inc:To Reduce Net Operating Loss Amt Excluded From Inc:To Reduce Gen Bus Credit Amt Excluded From Inc:To Reduce Min Tax Credit Amt Excluded From Inc:To Reduce Net Cap Loss Amt Excluded From Inc:To Reduce Basis Depreciable Property Used Or Held Land Used Or Held Other Property Used Or Held Passive Activity Loss And Credit Carryovers Foreign Tax Credit Carryover Reduction of Tax Attributes Due to Discharge ... Form Ref. ---3 Length -----1 Field Description ----------------"X" or blank @0085 0090 Part II 4 6 12 "STMbnn" or blank N 0100 5 12 N 0110 6 12 N 0120 7 12 N 0130 8 12 N 0140 9 12 N 0150 0160 10 11a 12 12 N N 0170 0180 0190 11b 11c 12 12 12 12 N N N 0200 13 August 30, 2002 12 N Part II Page 154 Section 4 Publication 1346 FORM 982 Field Identification No. ----- -------------0210 Amount Excluded Under Section 1081(b) Tax Year Beginning Tax Year Ending State Of Incorporation Statement Describing Transactions Under Sec 1081 Reduction of Tax Attributes Due to Discharge ... Form Ref. ---Part III Length -----12 Field Description ----------------N 0220 0230 0240 @0250 Part III Part III Part III Part III 8 8 2 6 DT DT AN "STMbnn" or blank Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 155 Section 4 INTENTIONAL BLANK PAGE Publication 1346 August 30, 2002 Part II Page 156 Section 4 FORM 1099-G Field Identification No. ----- -------------Byte Count Certain Government Payments Form Ref. ---Length -----4 Field Description ----------------"0466" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" "1099Gb" "PG01b" N (Primary SSN) Start of Record Sentinel 0000 0001 0002 0003 Record ID Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number Void Indicator Corrected Box Payer's Name Control 4 6 6 5 9 0004 0005 0008 0010 0020 1 7 1 1 4 blank N 0000001 - 0000010 "X" or blank "X" or blank First 4 significant characters of payer's name, no leading or embedded spaces. Allowable characters are alpha, numeric, hyphen, and ampersand. Spaces may be present as last two positions. AN, Allowable special characters are: ampersand (&), hyphen (-), slash (/), comma (,), plus (+) and blank ( ) AN, In care of addressee, or address continuation. Allowable special characters are space, ampersand, slash, hyphen and percent (%) Part II Page 157 Section 4 0030 Payer's Name 35 0040 Payer's Name Line 2 35 Publication 1346 August 30, 2002 FORM 1099-G Field Identification No. ----- -------------0050 Payer's Address Certain Government Payments Form Ref. ---Length -----35 Field Description ----------------AN, Allowable special characters are: ampersand (&), hyphen(-), slash (/), comma (,), percent (%) and Literal " NONE" AN, Allowable special character is space A (Standard Postal State Abbreviations) or Period (.) N (Left-Justified) N N 0060 0070 Payer's City Payer's State 22 2 0080 0085 0090 Payer's Zip Code Telephone Number Payer's Federal Identification Number Recipient's SSN Recipient's Name Recipient's Address 12 10 9 0100 0110 0120 9 35 35 N AN, Allowable special character is hyphen (-) AN, Allowable special characters are: ampersand (&), hyphen(-), slash (/), comma (,), percent (%) and Literal " NONE" AN AN, Allowable special character is space A (Standard Postal State Abbreviations) or Period (.) N (Left-Justified) AN or blank N or blank Part II Page 158 Section 4 0125 0130 0140 Recipient's Address Continuation Recipient's City Recipient's State 35 22 2 0150 0160 0170 Recipient's Zip Code Account Number Unemployment Compensation 1 August 30, 2002 12 30 12 Publication 1346 FORM 1099-G Field Identification No. ----- -------------0180 State or Local Income Tax Refunds, Credits, Offset Tax Year other than Current Year Withholding Taxable Grants Agriculture Payments Trade or Business Income State Withholding Certain Government Payments Form Ref. ---2 Length -----12 Field Description ----------------N or blank 0190 0200 0220 0230 0240 0250 3 4 6 7 8 4 12 12 12 1 12 N or blank N or blank N or blank N or blank "X" or blank N or blank Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 159 Section 4 INTENTIONAL BLANK PAGE Publication 1346 August 30, 2002 Part II Page 160 Section 4 FORM 1099-R Field Identification No. ----- -------------Byte Count Distributions From Pensions, Annuitites, ... Form Ref. ---Length -----4 Field Description ----------------"0637" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" "1099Rb" "PG01b" N (Primary SSN) Start of Record Sentinel 0000 0001 0002 0003 Record ID Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number Corrected Box Payer Name Control 4 6 6 5 9 0004 0005 0010 0015 1 7 1 4 blank N 0000001 - 0000010 "X" or blank First 4 significant characters of payer's name, no leading or embedded spaces; allowable characters are alpha, numeric, hyphen, ampersand, spaces may be present only as last two positions AN Allowable special characters are: ampersand (&), hyphen (-), slash (/), comma (,), plus (+) and blank ( ) AN, in care of addressee, or address continuation. Allowable special characters are space, ampersand, slash, hyphen and percent (%) 0020 Payer Name 35 0025 Payer Name Line 2 35 Publication 1346 August 30, 2002 Part II Page 161 Section 4 FORM 1099-R Field Identification No. ----- -------------0030 Payer Address Distributions From Pensions, Annuitites, ... Form Ref. ---Length -----35 Field Description ----------------AN Allowable special characters are: ampersand (&), hyphen (-), slash (/), comma (,), percent (%) and Literal "NONE" AN Allowable special character is space A (Standard Postal State Abbreviations) or period (.) N N (left-justified) 0040 0042 Payer City Payer State 22 2 0044 0050 Payer Zip Code Payer Identification Number SSN Recipient's Name Recipient's Address 12 9 0060 0070 0080 9 35 35 N AN Allowable special character is: hyphen (-) AN Allowable special characters are: ampersand (&), hyphen (-), slash (/), comma (,), percent (%) and Literal "NONE" AN AN Allowable special character is space A (Standard Postal State Abbreviations) or period (.) N (left-justified) 0085 0090 0092 Recipient's Address Continuation Recipient's City Recipient's State 35 22 2 0094 0100 0110 0120 Recipient's Zip Code Account Number Gross Distribution Taxable Amount 1 2a August 30, 2002 12 30 12 12 AN or blank N N Part II Page 162 Section 4 Publication 1346 FORM 1099-R Field Identification No. ----- -------------0130 0140 0150 0160 0170 0180 Tax Amount Not Determined Ind Total Distribution Ind Taxable Amount for Capital Gain Withholding Employee Insurance Contribution Unrealized Securities Appreciation Distribution Code IRA/SEP/SIMPLE Ind Other Distribution Recipient's Other Distribution Percentage Recipient's Total Distribution Percentage Recipient's Total Contributions State Income Tax W/ Held - 1 State Name - 1 Payer State I.D. No. - 1 State Distribution 1 Local Income Tax W/ Held - 1 Distributions From Pensions, Annuitites, ... Form Ref. ---2b 2b 3 4 5 6 Length -----1 1 12 12 12 12 Field Description ----------------"X" or blank "X" or blank N N N N 0190 0200 0210 0220 7 7 8 8 2 1 12 6 AN or blank "X" or blank N R 0230 9a 6 R 0231 0240 0246 0250 0255 0260 9b 10(1) 11(1) 11(1) 12(1) 13(1) August 30, 2002 12 12 2 14 12 12 N N A (Standard Postal State Abbreviations) AN N N Part II Page 163 Section 4 Publication 1346 FORM 1099-R Field Identification No. ----- -------------0270 0275 0280 0286 0290 0300 0310 0320 0330 Name of Locality - 1 Local Distribution 1 State Income Tax W/ Held - 2 State Name - 2 Payer Sate I.D. No. - 2 State Distribution 2 Local Income Tax W/ Held - 2 Name of Locality - 2 Local Distribution 2 Distributions From Pensions, Annuitites, ... Form Ref. ---14(1) 15(1) 10(2) 11(2) 11(2) 12(2) 13(2) 14(2) 15(2) Length -----9 12 12 2 14 12 12 9 12 Field Description ----------------AN N N A (Standard Postal State Abbreviations) AN N N AN N Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 164 Section 4 FORM 1116 PAGE 1 Field Identification No. ----- -------------Byte Count Foreign Tax Credit Form Ref. ---Length -----4 Field Description ----------------"1030" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" "1116bb" "PG01b" N (Primary SSN) Start of Record Sentinel 0000 0001 0002 0003 Record ID Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number Alt. Min. Tax Literal Passive Income High Wthldg Tax Interest Financial Services Income Shipping Income DISC Dividends FSC Distributions Lump Sum Distributions Section 901(j) Income Income Re-Sourced By Treaty Limitation Income a b c d e f g h i j August 30, 2002 4 6 6 5 9 0004 0005 0010 0020 0030 0040 0050 0060 0070 0080 0093 0096 0098 1 7 3 1 1 1 1 1 1 1 1 1 1 blank N 0000001 - 0000020 "AMT" or blank "X" or blank "X" or blank "X" or blank "X" or blank "X" or blank "X" or blank "X" or blank "X" or blank "X" or blank "X" or blank Part II Page 165 Section 4 Publication 1346 FORM 1116 PAGE 1 Field Identification No. ----- -------------0100 0130 0140 0150 0160 0170 0180 0185 0190 0200 @0205 0210 0220 @0225 0230 0240 0250 0260 0270 0280 Country of Residence Foreign Country A Gross Foreign Income A Foreign Country B Gross Foreign Income B Foreign Country C Gross Foreign Income C Type of Income Gross Income From Foreign Source Allocable Expenses A Allocable Expense Statement A Item/Std Deduction A Other Deductions A Other Deduction Statement A Total Deductions A Category Foreign Income A All Gross Income A Foreign/All Income Ratio A Apportioned Ded. A Wrksht. Mortgage Int. A Foreign Tax Credit Form Ref. ---k lA 1A lB 1B lC 1C 1 1 2A Length -----16 16 12 16 12 16 12 20 12 12 6 3(a)A 3(b)A 12 12 6 3(c)A 3(d)A 3(e)A 3(f)A 3(g)A 4(a)A August 30, 2002 12 12 12 6 12 12 Field Description ----------------A, Allowable special character is space. A, Allowable special character is space. N 'See 1st Occ.' N 'See 1st Occ.' N AN N N "STMbnn" or blank N N "STMbnn" or blank N N N R N N Part II Page 166 Section 4 Publication 1346 FORM 1116 PAGE 1 Field Identification No. ----- -------------0290 0300 0310 0320 @0325 0330 0340 @0345 0350 0360 0370 0380 0390 0400 0410 0420 0430 0440 @0445 Other Interest Exp. A Foreign Source Loss A Applicable Ded/ Losses A Allocable Expenses B Allocable Expense Statement B Item/Std Deduction B Other Deductions B Other Deduction Statement B Total Deductions B Category Foreign Income B All Gross Income B Foreign/All Income Ratio B Apportioned Ded. B Wrksht. Mortgage Int. B Other Interest Exp. B Foreign Source Loss B Applicable Ded/ Losses B Allocable Expenses C Allocable Expense Statement C Foreign Tax Credit Form Ref. ---4(b)A 5A 6A 2B Length -----12 12 12 12 6 3(a)B 3(b)B 12 12 6 3(c)B 3(d)B 3(e)B 3(f)B 3(g)B 4(a)B 4(b)B 5B 6B 2C 12 12 12 6 12 12 12 12 12 12 6 August 30, 2002 Field Description ----------------N N N N "STMbnn" or blank N N "STMbnn" or blank N N N R N N N N N N "STMbnn" or blank Part II Page 167 Section 4 Publication 1346 FORM 1116 PAGE 1 Field Identification No. ----- -------------0450 0460 @0465 0470 0480 0490 0500 0510 0520 0530 0540 0550 0560 0570 0580 0590 0600 0610 Item/Std Deduction C Other Deductions C Other Deduction Statement C Total Deductions C Category Foreign Income C All Gross Income C Foreign/All Income Ratio C Apportioned Ded. C Wrksht. Mortgage Int. C Other Interest Exp. C Foreign Source Loss C Applicable Ded/ Losses C Appl. Ded/Losses Total Taxable Income From Foreign Source Taxes Paid Indicator Taxes Accrued Indicator Date Paid/Accrued A Taxes Wthld on Dividends Foreign Curr. A Taxes Wthld Rent/ Roy. Foreign Curr. A Foreign Tax Credit Form Ref. ---3(a)C 3(b)C Length -----12 12 6 3(c)C 3(d)C 3(e)C 3(f)C 3(g)C 4(a)C 4(b)C 5C 6C 6 7 m n oA pA 12 12 12 6 12 12 12 12 12 12 12 1 1 8 12 Field Description ----------------N N "STMbnn" or blank N N N R N N N N N N N "X" or blank "X" or blank DT N 0620 qA 12 N Part II Page 168 Section 4 Publication 1346 August 30, 2002 FORM 1116 PAGE 1 Field Identification No. ----- -------------0630 Taxes Wthld on Interest Foreign Curr. A Other Taxes Paid/ Accrued Foreign Curr. A Taxes Wthld on Dividends U.S. Curr. A Taxes Wthld on Rent/ Roy. U.S. Curr. A Taxes Wthld on Interest U.S. Curr. A Other Taxes Paid/ Accrued U.S. Curr. A Total Foreign Taxes Paid/Accrued U.S. Curr. A Date Paid/Accrued B Taxes Wthld on Dividends Foreign Curr. B Taxes Wthld on Rent/ Roy. Foreign Curr. B Taxes Wthld on Interest Foreign Curr. B Other Taxes Paid/ Accrued Foreign Curr. B Taxes Wthld on Dividends U.S. Curr. B Taxes Wthld on Rent/ Roy. U.S. Curr. B Foreign Tax Credit Form Ref. ---rA Length -----12 Field Description ----------------N 0640 sA 12 N 0650 tA 12 N 0660 0670 uA vA 12 12 N N 0680 0690 wA xA 12 12 N N 0700 0710 oB pB 8 12 DT N 0720 0730 qB rB 12 12 N N 0740 sB 12 N 0750 tB 12 N 0760 uB 12 N Part II Page 169 Section 4 Publication 1346 August 30, 2002 FORM 1116 PAGE 1 Field Identification No. ----- -------------0770 Taxes Wthld on Interest U.S. Curr. B Other Taxes Paid/ Accrued U.S. Curr. B Total Foreign Taxes Paid/Accrued U.S. Curr. B Date Paid/Acrued C Taxes Wthld on Dividends Foreign Curr. C Taxes Wthld on Rent/ Roy. Foreign Curr. C Taxes Wthld on Interest Foreign Curr. C Other Taxes Paid/ Acrued Foreign Curr. C Taxes Wthld on Dividends U.S. Curr. C Taxes Wthld on Rent/ Roy. U.S. Curr. C Taxes Wthld on Interest U.S. Curr. C Other Taxes Paid/ Acrued U.S. Curr. C Total Foreign Taxes Paid/Acrued U.S. Curr. C Foreign Audit Statement Foreign Tax Credit Form Ref. ---vB Length -----12 Field Description ----------------N 0780 0790 wB xB 12 12 N N 0800 0810 oC pC 8 12 DT N 0820 0830 qC rC 12 12 N N 0840 sC 12 N 0850 tC 12 N 0860 0870 uC vC 12 12 N N 0880 0890 wC xC 12 12 N N @0900 8 6 "STMbnn" or blank Publication 1346 August 30, 2002 Part II Page 170 Section 4 FORM 1116 PAGE 1 Field Identification No. ----- -------------0910 Total Foreign Tax Paid/Accrued Category Foreign Tax Credit Form Ref. ---8 Length -----12 Field Description ----------------N Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 171 Section 4 FORM 1116 PAGE 2 Field Identification No. ----- -------------Byte Count Foreign Tax Credit Form Ref. ---Length -----4 Field Description ----------------"0358" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" "1116bb" "PG02b" N (Primary SSN) Start of Record Sentinel 0920 0921 0922 0923 Record ID Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number Total Foreign Tax Paid/Acrued Repeated Carryback/Carryover Explanation Carryback/Carryover Amount Total Foreign Taxes Before Reduction Foreign Tax Reduction Explanation Foreign Tax Reduction Amount Foreign Tax Available for Credit Taxable Income/Loss From Foreign Source Adjustments Explanation 9 10 10 11 12 4 6 6 5 9 0924 0925 0930 @0940 0950 0960 @0970 1 7 12 6 12 12 6 blank N 0000001 - 0000020 N "STMbnn" or blank N N "STMbnn" or blank 0980 0990 1000 @1010 12 13 14 15 12 12 12 6 N N N "STMbnn" or blank Publication 1346 August 30, 2002 Part II Page 172 Section 4 FORM 1116 PAGE 2 Field Identification No. ----- -------------1020 1030 1040 1050 Adjustments to Taxable Income Net Taxable Income From Foreign Source Taxable Income Before Exemptions Foreign/Before Exempts. Taxable Income Ratio Tax From Return Max Allowable Credit Lump Sum Dist. Literal Gross Foreign Tax Credit Passive Income Credit High Withholding Credit Financial Service Credit Shipping Income Credit DISC Dividends Cr or Foreign Trade Incm or FSC Cr Lump Sum Dist. Credit Credit for Taxes on Income Re-Sourced by Treaty Credit for Taxes on General Limitation Income Foreign Tax Credit Form Ref. ---15 16 17 18 Length -----12 12 12 6 Field Description ----------------N N N R 1060 1070 1080 1090 1100 1110 1120 1130 1135 19 20 21 21 22 23 24 25 26 12 12 3 12 12 12 12 12 12 N N Value "LSD" or blank N N N N N N 1160 1175 27 28 12 12 N N 1177 29 12 N Publication 1346 August 30, 2002 Part II Page 173 Section 4 FORM 1116 PAGE 2 Field Identification No. ----- -------------1180 1185 Tentative Foreign Tax Credit Smaller of Tax From Return or Foreign Tax Credit International Boycott Credit Reduction Foreign Tax Credit Foreign Tax Credit Form Ref. ---30 31 Length -----12 12 Field Description ----------------N N 1190 32 12 N 1200 33 12 N Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 174 Section 4 FORM 1310 Field Identification No. ----- -------------Byte Count Stm of Person Claiming Refund Due a Deceased Taxpr Form Ref. ---Length -----4 Field Description ----------------"0371" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" "1310bb" "PG01b" N (Primary SSN) Start of Record Sentinel 0000 0001 0002 0003 Record ID Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number Tax Year Decedent Due Refund Name of Decedent 4 6 6 5 9 0004 0005 0010 0020 1 7 4 35 blank N 0000001 - 0000002 YYYY AN, allowable special characters are space, slash, and hyphen DT (YYYYMMDD) N First 4 significant characters of the refund claimer's last name, no leading or embedded spaces; allowable characters are alpha, hyphen or space (see special instructions) AN Refund claimer's name allowable special characters are: space, less-than (<), hyphen (-) and ampersand (&) Part II Page 175 Section 4 0030 0040 0050 Date of Death Decedent's SSN Name Control of Person Claiming Refund 8 9 4 0060 Name of Person Claiming Refund 35 Publication 1346 August 30, 2002 FORM 1310 Field Identification No. ----- -------------0070 0080 0090 0100 0110 SSN of Person Claiming Refund Reserved Reserved Reserved Street Address Stm of Person Claiming Refund Due a Deceased Taxpr Form Ref. ---Length -----9 35 35 22 35 Field Description ----------------N NO ENTRY NO ENTRY NO ENTRY AN, Allowable special characetrs are space, slash, and hyphen and Literal "None" AN A, Allowable special character is space A (Standard Postal State Abbreviations) N (left-justified) 1= APO/FPO Address, 2= Stateside Military Address, or blank NO ENTRY 0120 0130 0140 0150 0160 Apt. Number City State Abbreviation Zip Code Address Ind 5 22 2 12 1 0170 Surviving spouse requesting reissuance of refund Court appointed or certified rep Person other than A or B claiming decedent refund Valid Proof of Death is in my possession Did decedent leave a will "Yes" box Did decedent leave a will "No" box A 1 0180 0190 B C 1 1 NO ENTRY "X" or blank 0200 C 1 "X" or blank 0210 0220 1 1 August 30, 2002 1 1 "X" or blank "X" or blank Part II Page 176 Section 4 Publication 1346 FORM 1310 Field Identification No. ----- -------------0230 Court appointed personal rep "Yes" box Court appointd personal rep "No" box Personal rep will be appointed "Yes" box Personal rep will be appointed "No" box Refund paid out according to state laws "Yes" box Refund paid out according to state laws "No" box Person claiming refund signature Signature date Stm of Person Claiming Refund Due a Deceased Taxpr Form Ref. ---2a Length -----1 Field Description ----------------NO ENTRY 0240 2a 1 "X" or blank 0250 2b 1 NO ENTRY 0260 2b 1 "X" or blank 0270 3 1 "X" or blank 0280 3 1 NO ENTRY 0290 35 AN, Allowable special characters are space, slash, and hyphen DT (YYYYMMDD) 0300 8 Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 177 Section 4 INTENTIONAL BLANK PAGE Publication 1346 August 30, 2002 Part II Page 178 Section 4 FORM 2106 PAGE 1 Field Identification No. ----- -------------Byte Count Employee Business Expenses Form Ref. ---Length -----4 Field Description ----------------"0245" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" "2106bb" "PG01b" N (Primary SSN) Start of Record Sentinel 0000 0001 0002 0003 Record ID Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number Occupation SSN of Taxpayer With Employee Business Expense Vehicle Expenses Parking, Tolls, Local Transportation Travel Exp Away From Home Exclude Meals/Entertain Other Business Expenses Excluding Meals/Entertain Meals/Entertainment Expenses Total Expenses Excluding Meals/ Entertainment Total Meals/ Entertainment 1A 2A 3A 4 6 6 5 9 0004 0005 0008 0009 1 7 25 9 blank N 0000001 - 0000002 AN N 0010 0013 0017 12 12 12 N N N 0023 4A 12 N 0025 0027 5B 6A 12 12 N N 0031 6B August 30, 2002 12 N Part II Page 179 Section 4 Publication 1346 FORM 2106 PAGE 1 Field Identification No. ----- -------------0033 Other Reimbursements Not Reported on W-2 Meals/Entertainment Reimburse Not Reported on W-2 Unreimbursed Business Expense Unreimbursed Meals Expense Allowable Business Deduction Allowable Meals Deduction Unreimbursed Employee Business Expense Employee Business Expenses Form Ref. ---7A Length -----12 Field Description ----------------N 0041 7B 12 N 0100 0105 0115 0120 0125 8A 8B 9A 9B 10 12 12 12 12 12 N N N N N Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 180 Section 4 FORM 2106 PAGE 2 Field Identification No. ----- -------------Byte Count Employee Business Expenses Form Ref. ---Length -----4 Field Description ----------------"0585" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" "2106bb" "PG02b" N (Primary SSN) Start of Record Sentinel 0127 0128 0129 0130 Record ID Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number Vehicle Date (1) Total Miles (1) Business Miles (1) Percent of Use (1) Average Distance (1) Miles Commuting (1) Other Personal Miles (1) Vehicle Date (2) Total Miles (2) Business Miles (2) Percent of Use (2) Average Distance (2) Miles Commuting (2) Other Personal Miles(2) 11(a) 12(a) 13(a) 14(a) 15(a) 16(a) 17(a) 11(b) 12(b) 13(b) 14(b) 15(b) 16(b) 17(b) August 30, 2002 4 6 6 5 9 0131 0132 0134 0135 0145 0155 0165 0175 0185 0195 0205 0215 0225 0235 0245 0256 1 7 8 6 6 6 6 6 6 8 6 6 6 6 6 6 blank N 0000001 - 0000002 DT N N R N N N DT N N R N N N Part II Page 181 Section 4 Publication 1346 FORM 2106 PAGE 2 Field Identification No. ----- -------------0270 0275 0280 0283 0290 0295 0300 0305 0315 0325 0335 0345 0355 0358 0370 0375 0380 0383 0437 0439 0441 0443 Another Vehicle Yes Another Vehicle No Personal Use Yes Personal Use No Evidence Yes Evidence No Written Yes Written No Standard Mileage Deduc. Gas, Oil (1) Rentals (1) Inclusion Amount (1) Rental minus Inclusion (1) Value (1) Motor Vehicle Expense (1) Percent Business Expense (1) Depreciation/Ln 38 (1) Total Actual Expense (1) Gas, Oil (2) Rentals (2) Inclusion Amount (2) Rental minus Inclusion (2) Employee Business Expenses Form Ref. ---18 18 19 19 20 20 21 21 22 23(a) 24a(a) 24b(a) 24c(a) 25(a) 26(a) 27(a) 28(a) 29(a) 23(b) 24a(b) 24b(b) 24c(b) August 30, 2002 Length -----1 1 1 1 1 1 1 1 12 12 12 12 12 12 12 12 12 12 12 12 12 12 Field Description ----------------"X" or blank "X" or blank "X" or blank "X" or blank "X" or blank "X" or blank "X" or blank "X" or blank N N N N N N N N N N N N N N Part II Page 182 Section 4 Publication 1346 FORM 2106 PAGE 2 Field Identification No. ----- -------------0445 0447 0449 0451 0453 0490 0495 0505 Value (2) Motor Vehicle Expense (2) Percent Business Expense (2) Depreciation/Ln 38 (2) Total Actual Expense (2) Vehicle 1 Basis Vehicle 1 Section 179 Deduction Vehicle 1 Depreciation Recovery Vehicle 1 Depreciation Method Line 32(a) multiplied by Line 33(a) percentage Depreciation Subtotal (1) Limitation Amount (1) Line 36(a) multiplied by Line 14(a) Depreciation/Ln 28(a) Vehicle 2 Basis Vehicle 2 Section 179 Deduction Employee Business Expenses Form Ref. ---25(b) 26(b) 27(b) 28(b) 29(b) 30(a) 31(a) 32(a) Length -----12 12 12 12 12 12 12 12 Field Description ----------------N N N N N N N N 0515 33(a) 13 Value = (literal in Depreciation Method Chart) N 0530 34(a) 12 0540 0544 0546 35(a) 36(a) 37(a) 12 12 12 N N N 0550 0560 0600 38(a) 30(b) 31(b) 12 12 12 N N N Publication 1346 August 30, 2002 Part II Page 183 Section 4 FORM 2106 PAGE 2 Field Identification No. ----- -------------0602 Vehicle 2 Depreciation Recovery Vehicle 2 Depreciation Method Line 32(b) multiplied by Line 33(b) percentage Depreciation Subtotal (2) Limitation Amount (2) Line 36(b) multiplied by Line 14(b) Depreciation/Line 28(b) Employee Business Expenses Form Ref. ---32(b) Length -----12 Field Description ----------------N 0604 33(b) 13 Value = (literal in Depreciation Method Chart) N 0606 34(b) 12 0610 0612 0614 35(b) 36(b) 37(b) 12 12 12 N N N 0616 38(b) 12 N Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 184 Section 4 FORM 2106-EZ Field Identification No. ----- -------------Byte Count Unreimbursed Employee Business Form Ref. ---Length -----4 Expenses Field Description ----------------"0195" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" "2106Zb" "PG01b" N (Primary SSN) Start of Record Sentinel 0000 0001 0002 0003 Record ID Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number Occupation SSN of Taxpayer With Employee Business Expense Vehicle Expenses Parking Fees, Tolls, Transportation Travel Expense Business Expenses Total Meals/ Entertainment Expenses Meals/Entertainment Expenses Allowed Total Expenses Vehicle Date Business Miles 1 2 4 6 6 5 9 0004 0005 0008 0009 1 7 25 9 blank N 0000001 - 0000002 AN N 0010 0013 12 12 N N 0017 0023 0025 3 4 5 12 12 12 N N N 0027 0031 0134 0145 5 6 7 8a August 30, 2002 12 12 8 6 N N DT N Part II Page 185 Section 4 Publication 1346 FORM 2106-EZ Field Identification No. ----- -------------0175 0185 0270 0275 0280 0283 0290 0295 0300 0305 Commuting Miles Other Personal Miles Another Vehicle for Personal Use - Yes Another Vehicle for Personal Use - No Vehicle Available Yes Vehicle Available No Evidence - Yes Evidence - No Written Evidence Yes Written Evidence No Unreimbursed Employee Business Form Ref. ---8b 8c 9 9 10 10 11a 11a 11b 11b Length -----6 6 1 1 1 1 1 1 1 1 Expenses Field Description ----------------N N "X" or blank "X" or blank "X" or blank "X" or blank "X" or blank "X" or blank "X" or blank "X" or blank Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 186 Section 4 FORM 2120 Field Identification No. ----- -------------Byte Count Multiple Support Declaration Form Ref. ---Length -----4 Field Description ----------------"0493" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" "2120bb" "PG01b" N (Primary SSN) Start of Record Sentinel 0000 0001 0002 0003 Record ID Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number Calendar Year Person Supported First Name Person Supported Last Name Eligible Person First Name 1 Eligible Person Last Name 1 Eligible Person SSN 1 Eligible Person Street Address 1 4 6 6 5 9 0004 0005 0010 0020 0030 *0040 +0045 +0050 +0060 1 7 4 10 15 10 15 9 35 blank N 0000001 YYYY AN (First Name) AN (Last Name) AN (First Name) or "STMbnn" AN N AN, Allowable special characters are space, slash, hyphen, literal "NONE" A, Allowable special character is space A (Standard Postal State Abbreviation) Part II Page 187 Section 4 +0070 +0080 Eligible Person City 1 Eligible Person State Abbreviation 1 August 30, 2002 22 2 Publication 1346 FORM 2120 Field Identification No. ----- -------------+0090 0100 0105 0110 0120 Eligible Person Zip Code 1 Eligible Person First Name 2 Eligible Person Last Name 2 Eligible Person SSN 2 Eligible Person Street Address 2 Multiple Support Declaration Form Ref. ---Length -----12 10 15 9 35 Field Description ----------------N (left-justified) AN OR blank AN or blank N or blank AN, Allowable special characters are space, slash, hyphen, literal "NONE" or blank A, Allowable special character is space, or blank A, (Standard Postal State Abbreviation) or blank N (left-justified) or blank 'See 2nd Occ.' 'See 2nd Occ.' 'See 2nd Occ.' 'See 2nd Occ.' 'See 2nd Occ.' 'See 2nd Occ.' 'See 2nd Occ.' 0130 Eligible Prson City 2 Eligible Person State Abbreviation 2 Eligible Person Zip Code 2 Eligible Person First Name 3 Eligible Person Last Name 3 Eligible Person SSN 3 Eligible Person Street Address 3 Eligible Person City 3 Eligible Person State Abbreviation 3 Eligible Person Zip Code 3 August 30, 2002 22 0140 2 0150 0160 0165 0170 0180 0190 0200 0210 12 10 15 9 35 22 2 12 Publication 1346 Part II Page 188 Section 4 FORM 2120 Field Identification No. ----- -------------0220 0225 0230 0240 0250 0260 0270 0280 Eligible Person First Name 4 Eligible Person Last Name 4 Eligible Person SSN 4 Eligible Person Street Address 4 Eligible Person City 4 Eligible Person State Abbreviation 4 Eligible Person Zip Code 4 Signed Statements in T/P Possession Indicator Multiple Support Declaration Form Ref. ---Length -----10 15 9 35 22 2 12 1 Field Description ----------------'See 2nd Occ.' 'See 2nd Occ.' 'See 2nd Occ.' 'See 2nd Occ.' 'See 2nd Occ.' 'See 2nd Occ.' 'See 2nd Occ.' "X" Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 189 Section 4 INTENTIONAL BLANK PAGE Publication 1346 August 30, 2002 Part II Page 190 Section 4 FORM 2210 PAGE 1 Field Identification No. ----- -------------Byte Count Underpayment of Estimated Tax by ... Form Ref. ---Length -----4 Field Description ----------------"0327" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" "2210bb" "PG01b" N (Primary SSN) Start of Record Sentinel 0000 0001 0002 0003 Record ID Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number Identifying Number Waiver Box Annualized Installment Method Box Actually Withheld Box Required Installment Box Current Year Tax After Credits Other Taxes Tax Subtotal Earned Income Credit Additional Child Tax Credit Credit for Federal Tax of Fuels 1a 1b 4 6 6 5 9 0004 0005 0010 0020 0030 1 7 9 1 1 blank N 0000001 N "X" or blank "X" or blank 0040 0054 0060 0070 0080 0090 0095 0100 1c 1d 2 3 4 5 6 7 August 30, 2002 1 1 12 12 12 12 12 12 "X" or blank "X" or blank N N N N N N Part II Page 191 Section 4 Publication 1346 FORM 2210 PAGE 1 Field Identification No. ----- -------------0110 0120 0130 0140 0150 0160 0170 0180 Credit Subtotals Current Year Tax Minimum Current Year Tax Current Year Withheld Tax Net Tax Due Prior Year's Tax Required Annual Payment Current Year Withheld Tax/Short Method Total Estimated Tax Paid Tax Paid Subtotal Total Underpayment Minimum Underpayment Due Dt Paid Multiplied Amount Waived Literal/ Short Method Waived Amount/Short Method Waiver Explanation/ Short Method Underpayment Penalty/Short Method Underpayment of Estimated Tax by ... Form Ref. ---8 9 10 11 12 13 14 15 Length -----12 12 12 12 12 12 12 12 Field Description ----------------N N N N N N N N 0190 0200 0210 0220 0230 0235 0236 @0237 0240 16 17 18 19 20 21 21 21 21 12 12 12 12 12 13 12 6 12 N N N N N Value "AMOUNTbWAIVED" or blank N "STMbnn" or blank N Record Terminus Character Publication 1346 August 30, 2002 1 Value "#" Part II Page 192 Section 4 FORM 2210 PAGE 2 Field Identification No. ----- -------------Byte Count Underpayment of Estimated Tax by ... Form Ref. ---Length -----4 Field Description ----------------"0568" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" "2210bb" "PG02b" N (Primary SSN) Start of Record Sentinel 0250 0251 0252 0253 Record ID Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number Required Installment A Required Installment B Required Installment C Required Installment D Estimated Tax Paid and Withheld A Estimated Tax Paid and Withheld B Estimated Tax Paid and Withheld C Estimated Tax Paid and Withheld D Applied Overpayment A Underpayment A 22(a) 22(b) 22(c) 22(d) 23(a) 23(b) 23(c) 23(d) 27(a) 29(a) August 30, 2002 4 6 6 5 9 0254 0255 0260 0270 0280 0290 0300 0302 0304 0306 0310 0320 1 7 12 12 12 12 12 12 12 12 12 12 blank N 0000001 N N N N N N N N N N Part II Page 193 Section 4 Publication 1346 FORM 2210 PAGE 2 Field Identification No. ----- -------------0330 0350 0360 0370 0380 0390 0400 0410 0430 0440 0450 0460 0470 0480 0490 0510 0520 0530 0540 0560 0581 Overpayment A Previous Column Overpayment B Tax To Be Applied B Taxes Due Column B Applied Overpayment B Applied Underpayment B Underpayment B Overpayment B Previous Column Overpayment C Tax To Be Applied C Taxes Due Column C Applied Overpayment C Applied Underpayment C Underpayment C Overpayment C Previous Column Overpayment D Tax To Be Applied D Taxes Due Column D Applied Overpayment D Underpayment D Number of Days Computed A Underpayment of Estimated Tax by ... Form Ref. ---30(a) 24(b) 25(b) 26(b) 27(b) 28(b) 29(b) 30(b) 24(c) 25(c) 26(c) 27(c) 28(c) 29(c) 30(c) 24(d) 25(d) 26(d) 27(d) 29(d) 31(a) August 30, 2002 Length -----12 12 12 12 12 12 12 12 12 12 12 12 12 12 12 12 12 12 12 12 3 Field Description ----------------N N N N N N N N N N N N N N N N N N N N N Part II Page 194 Section 4 Publication 1346 FORM 2210 PAGE 2 Field Identification No. ----- -------------0585 0591 0592 0594 0598 0601 0604 0605 0606 0610 0620 0631 0632 0635 0640 0645 0650 0716 @0717 0720 Penalty A Period 2 Days Computed A Period 2 Penalty A Period 3 Days Computed A Period 3 Penalty A Number of Days Computed B Penalty B Period 2 Days Computed B Period 2 Penalty B Period 3 Days Computed B Period 3 Penalty B Period 2 Days Computed C Period 2 Penalty C Period 3 Days Computed C Period 3 Penalty C Period 3 Days Computed D Period 3 Penalty D Waived Amount Waiver Explanation Total Underpayment Penalty Underpayment of Estimated Tax by ... Form Ref. ---32(a) 33(a) 34(a) 35(a) 36(a) 31(b) 32(b) 33(b) 34(b) 35(b) 36(b) 33(c) 34(c) 35(c) 36(c) 35(d) 36(d) 37 37 37 Length -----12 3 12 3 12 3 12 3 12 3 12 3 12 3 12 3 12 12 6 12 Field Description ----------------N N N N N N N N N N N N N N N N N N "STMbnn" or blank N Publication 1346 August 30, 2002 Part II Page 195 Section 4 FORM 2210 PAGE 2 Field Identification No. ----- -------------- Underpayment of Estimated Tax by ... Form Ref. ---Length -----Field Description ----------------- Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 196 Section 4 FORM 2210 PAGE 3 Field Identification No. ----- -------------Byte Count Underpayment of Estimated Tax by ... Form Ref. ---Length -----4 Field Description ----------------"1363" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" "2210bb" "PG03b" N (Primary SSN) Start of Record Sentinel 2510 2511 2512 2513 Record ID Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number AGI Amount Period A Annualized Income A Itemized Deductions A Annualized Itemized Deductions A Return Standard Deductions A Installment Deduction Amount A Net Income Amount A Exemption Claimed Amt A Taxable Income Amt A Tentative Tax Amt A Annualized SE Tax A Other Taxes A 1(a) 3(a) 4(a) 6(a) 7(a) 8(a) 9(a) 10(a) 11(a) 12(a) 13(a) 14(a) August 30, 2002 4 6 6 5 9 2514 2515 2520 2530 2540 2550 2560 2570 2580 2590 2600 2610 2620 2630 1 7 12 12 12 12 12 12 12 12 12 12 12 12 blank N 0000001 N N N N N N N N N N N N Part II Page 197 Section 4 Publication 1346 FORM 2210 PAGE 3 Field Identification No. ----- -------------2640 2650 2660 2670 2680 2690 2700 2720 2730 2740 2750 2760 2770 2780 2790 2800 2810 2820 2830 2840 2850 Tax Before Credits A Allowed Credits A Net Tax Due Amount A Applicable Tax Due Amount A Tax Due Amount A Installment Tax Amount A Aggregate Tax Due Amount A Required Installment Amount A AGI Amount Period B Annualized Income B Itemized Deductions B Annualized Itemized Deductions B Return Standard Deduction B Installment Deduction Amount B Net Income Amount B Exemption Claimed Amt B Taxable Income Amt B Tentative Tax Amt B Annualized SE Tax B Other Taxes B Tax Before Credits B Underpayment of Estimated Tax by ... Form Ref. ---15(a) 16(a) 17(a) 19(a) 21(a) 22(a) 24(a) 25(a) 1(b) 3(b) 4(b) 6(b) 7(b) 8(b) 9(b) 10(b) 11(b) 12(b) 13(b) 14(b) 15(b) Length -----12 12 12 12 12 12 12 12 12 12 12 12 12 12 12 12 12 12 12 12 12 Field Description ----------------N N N N N N N N N N N N N N N N N N N N N Part II Page 198 Section 4 Publication 1346 August 30, 2002 FORM 2210 PAGE 3 Field Identification No. ----- -------------2860 2870 2880 2890 2900 2910 2920 Allowed Credits B Net Tax Due Amount B Applicable Tax Due Amount B Accumulated Installment Amt B Tax Due Amount B Installment Tax Amount B Accumulated Adjusted Tax Amount B Aggregate Tax Due Amount B Required Installment Amount B AGI Amount Period C Annualized Income C Itemized Deductions C Annualized Itemized Deductions C Return Standard Deduction C Installment Deduction Amount C Net Income Amount C Exemption Claimed Amt C Taxable Income Amt C Tentative Tax Amt C Underpayment of Estimated Tax by ... Form Ref. ---16(b) 17(b) 19(b) 20(b) 21(b) 22(b) 23(b) Length -----12 12 12 12 12 12 12 Field Description ----------------N N N N N N N 2930 2950 2960 2970 2980 2990 3000 3010 3020 3030 3040 3050 24(b) 25(b) 1(c) 3(c) 4(c) 6(c) 7(c) 8(c) 9(c) 10(c) 11(c) 12(c) August 30, 2002 12 12 12 12 12 12 12 12 12 12 12 12 N N N N N N N N N N N N Part II Page 199 Section 4 Publication 1346 FORM 2210 PAGE 3 Field Identification No. ----- -------------3060 3070 3080 3090 3100 3110 3120 3130 3140 3150 Annualized SE Tax C Other Taxes C Tax Before Credits C Allowed Credits C Net Tax Due Amount C Applicable Tax Due Amount C Accumulated Installment Amt C Tax Due Amount C Installment Tax Amount C Accumulated Adjusted Tax Amount C Aggregate Tax Due Amount C Required Installment Amount C AGI Amount Period D Annualized Income D Itemized Deductions D Annualized Itemized Deductions D Return Standard Deduction D Installment Deduction Amount D Net Income Amount D Underpayment of Estimated Tax by ... Form Ref. ---13(c) 14(c) 15(c) 16(c) 17(c) 19(c) 20(c) 21(c) 22(c) 23(c) Length -----12 12 12 12 12 12 12 12 12 12 Field Description ----------------N N N N N N N N N N 3160 3180 3190 3200 3210 3220 3230 3240 3250 24(c) 25(c) 1(d) 3(d) 4(d) 6(d) 7(d) 8(d) 9(d) August 30, 2002 12 12 12 12 12 12 12 12 12 N N N N N N N N N Part II Page 200 Section 4 Publication 1346 FORM 2210 PAGE 3 Field Identification No. ----- -------------3260 3270 3280 3290 3300 3310 3320 3330 3340 3350 3360 3370 3380 Exemption Claimed Amt D Taxable Income Amt D Tentative Tax Amt D Annualized SE Tax D Other Taxes D Tax Before Credits D Allowed Credits D Net Tax Due Amount D Applicable Tax Due Amount D Accumulated Installment Amt D Tax Due Amount D Installment Tax Amount D Accumulated Adjusted Tax Amount D Aggregate Tax Due Amount D Required Installment Amount D Net SE Earnings A SST/RRT Wages A Net Prorated Social Security Tax Limit A Annualized SST/RRT Wages A Underpayment of Estimated Tax by ... Form Ref. ---10(d) 11(d) 12(d) 13(d) 14(d) 15(d) 16(d) 17(d) 19(d) 20(d) 21(d) 22(d) 23(d) Length -----12 12 12 12 12 12 12 12 12 12 12 12 12 Field Description ----------------N N N N N N N N N N N N N 3390 3400 3410 3430 3435 3440 24(d) 25(d) 26(a) 28(a) 29(a) 31(a) 12 12 12 12 12 12 N N N N N N Publication 1346 August 30, 2002 Part II Page 201 Section 4 FORM 2210 PAGE 3 Field Identification No. ----- -------------3445 Annualized Net SelfEmployment Earnings A Annualized SE Tax A Net SE Earnings B SST/RRT Wages B Net Prorated Social Security Tax Limit B Annualized SST/RRT Wages B Annualized Net SelfEmployment Earnings B Annualized SE Tax B Net SE Earnings C SST/RRT Wages C Net Prorated Social Security Tax Limit C Annualized SST/RRT Wages C Annualized Net SelfEmployment Earnings C Annualized SE Tax C Net SE Earnings D SST/RRT Wages D Net Prorated Social Security Tax Limit D Annualized SST/RRT Wages D Underpayment of Estimated Tax by ... Form Ref. ---33(a) Length -----12 Field Description ----------------N 3510 3520 3540 3545 3550 3555 34(a) 26(b) 28(b) 29(b) 31(b) 33(b) 12 12 12 12 12 12 N N N N N N 3620 3630 3650 3655 3660 3665 34(b) 26(c) 28(c) 29(c) 31(c) 33(c) 12 12 12 12 12 12 N N N N N N 3730 3740 3760 3765 3770 34(c) 26(d) 28(d) 29(d) 31(d) 12 12 12 12 12 N N N N N Publication 1346 August 30, 2002 Part II Page 202 Section 4 FORM 2210 PAGE 3 Field Identification No. ----- -------------3775 Annualized Net SelfEmployment Earnings D Annualized SE Tax D Underpayment of Estimated Tax by ... Form Ref. ---33(d) Length -----12 Field Description ----------------N 3840 34(d) 12 N Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 203 Section 4 INTENTIONAL BLANK PAGE Publication 1346 August 30, 2002 Part II Page 204 Section 4 FORM 2210F Field Identification No. ----- -------------Byte Count Underpayment of Estimated Tax by Farmers... Form Ref. ---Length -----4 Field Description ----------------"0275" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" "2210Fb" "PG01b" N (Primary SSN) Start of Record Sentinel 0000 0001 0002 0003 Record ID Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number Identifying Number Waiver of Penalty Box Filing Status Changed Box Current Year Tax After Credits Other Taxes Taxes Subtotal Earned Income Credit Additional Child Tax Credit Credit for Federal Tax on Fuels Credit Subtotal Current Year Tax Two Thirds Credit 1a 1b 2 3 4 5 6 7 8 9 10 August 30, 2002 4 6 6 5 9 0004 0005 0010 0013 0016 0020 0030 0040 0050 0055 0060 0070 0080 0090 1 7 9 1 1 12 12 12 12 12 12 12 12 12 blank N 0000001 N "X" or blank "X" or blank N N N N N N N N N Part II Page 205 Section 4 Publication 1346 FORM 2210F Field Identification No. ----- -------------0100 0110 0120 0130 0140 Withholding Taxes Current Taxes Owed Prior Year's Tax Required Annual Payment Amounts Withheld/ Amounts Paid or Credited Underpayment Earlier of Payment or Tax Due Date Penalty Days Waived Amount Waiver Explanation Underpayment Penalty/Farmers Fisherman Underpayment of Estimated Tax by Farmers... Form Ref. ---11 12 13 14 15 Length -----12 12 12 12 12 Field Description ----------------N N N N N 0150 0160 0170 0176 @0177 0180 16 17 18 19 19 19 12 8 3 12 6 12 N DT N N "STMbnn" or blank N Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 206 Section 4 FORM 2439 Field Identification No. ----- -------------Byte Count Notice to Shareholder of Undistributed LT Cap Gain Form Ref. ---Length -----4 Field Description ----------------"0402" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" "2439bb" "PG01b" N (Primary SSN) Start of Record Sentinel 0000 0001 0002 0003 Record ID Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number Void Indicator Box Corrected Indicator Box Fiscal Year Beginning Fiscal Year Ending Company or Trust Name Control 4 6 6 5 9 0004 0005 0010 0020 0030 0040 0050 1 7 1 1 8 8 4 blank N 0000001 - 0000004 "X" or blank "X" or blank DT or blank DT or blank First 4 significant characters of payer's name, no leading or embedded spaces; allowable characters are alpha, numeric, hyphen, ampersand, spaces may be present only as last two positions AN, Allowable special characters are: ampersand (&), hyphen (-), slash (/), comma (,), plus (+) and space Part II Page 207 Section 4 0060 Company or Trust Name Line 1 35 Publication 1346 August 30, 2002 FORM 2439 Field Identification No. ----- -------------0070 Company or Trust Name Line 2 Notice to Shareholder of Undistributed LT Cap Gain Form Ref. ---Length -----35 Field Description ----------------AN, in care of addressee, or address continuation. Allowable special characters are space, ampersand, slash, hyphen and percent (%) AN, Allowable special characters are: ampersand (&), hyphen (-), slash (/), comma (,), percent (%) and literal "NONE" AN, Allowable special character is space A (Standard Postal State Abbreviations) or period N (left-justified) N 0080 Company or Trust Address 35 0090 0100 0110 0120 Company or Trust City Company or Trust State Company or Trust Zip Code Company or Trust Identification Number Shareholder Identification Number Shareholder's Name 22 2 12 9 0130 9 N 0140 35 AN, Allowable special characters is: hyphen (-) AN, Allowable special characters are: ampersand (&), hyphen (-), slash (/), comma (,), percent (%) and literal "NONE" AN, Allowable special character is space A (Standard Postal State Abbreviations) Part II Page 208 Section 4 0150 Shareholder's Address 35 0160 0170 Shareholder's City Shareholder's State August 30, 2002 22 2 Publication 1346 FORM 2439 Field Identification No. ----- -------------0180 0190 Shareholder's Zip Code Total Undistributed Long Term Capital Gains 28% Rate Gain Qualified 5-Year Gain Unrecaptured Sec 1250 Gain Section 1202 Gain Tax Paid By Regulated Investment Company Notice to Shareholder of Undistributed LT Cap Gain Form Ref. ---Length -----12 1a 12 Field Description ----------------N (left-justified) N 0200 0205 0210 0220 0230 1b 1c 1d 1e 2 12 12 12 12 12 N N N N N Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 209 Section 4 INTENTIONAL BLANK PAGE Publication 1346 August 30, 2002 Part II Page 210 Section 4 FORM 2441 PAGE 1 Field Identification No. ----- -------------Byte Count Child and Dependent Care Expenses Form Ref. ---Length -----4 Field Description ----------------"0482" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" "2441bb" "PG01b" N (Primary SSN) Start of Record Sentinel 0000 0001 0002 0003 Record ID Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number Name of Care Provider 1 Care Provider Name Control 1 1(a) 1(a) 4 6 6 5 9 0004 0005 *0010 +0015 1 7 16 4 blank N 0000001 AN or "STMbnn" First Four Significant Characters of Individual's last name or of the business name, no leading or embedded spaces; allowable characters are alpha, numeric, hyphen, ampersand; spaces may be present in last three positions AN AN N or "STMbnn" "S" = SSN or ITIN, "E" = EIN, or blank N AN Part II Page 211 Section 4 +0020 +0030 *+0040 +0045 Street Address 1 City/State/Zip 1 SSN/EIN 1 SSN/EIN Type 1 1(b) 1(b) 1(c) 1(c) 28 28 9 1 +0050 0060 Amount Paid 1 Name of Care Provider 2 1(d) 1(a) August 30, 2002 12 16 Publication 1346 FORM 2441 PAGE 1 Field Identification No. ----- -------------+0065 0070 0080 0090 +0095 0100 *0110 +0115 +0120 Care Provider Name Control 2 Street Address 2 City/State/Zip 2 SSN/EIN 2 SSN/EIN Type 2 Amount Paid 2 Qualifying Person First Name - 1 Qualifying Person Last Name - 1 Qualifying Person Name Control - 1 Child and Dependent Care Expenses Form Ref. ---1(a) 1(b) 1(b) 1(c) 1(c) 1(d) 2(a) 2(a) 2(a) Length -----4 28 28 9 1 12 10 15 4 Field Description ----------------'See 1st Occ.' AN AN N 'See 1st Occ.' N AN (first name, blank) or "STMbnn" AN (last name) or blank First 4 significant characters of person's last name, no leading or embedded spaces; allowable characters are alpha, hyphen, or space N N AN (first name, blank) 'See 1st Occ.' 'See 1st Occ.' 'See 1st Occ.' 'See 1st Occ.' N Part II Page 212 Section 4 +0214 +0215 0217 0218 0221 0223 0225 0230 Qualifying Person SSN - 1 Qualified Expenses 1 Qualifying Person First Name - 2 Qualifying Person Last Name - 2 Qualifying Person Name Control - 2 Qualifying Person SSN - 2 Qualified Expenses 2 Total Qualified Expenses or Limit 2(b) 2(c) 2(a) 2(a) 2(a) 2(b) 2(c) 3 August 30, 2002 9 12 10 15 4 9 12 12 Publication 1346 FORM 2441 PAGE 1 Field Identification No. ----- -------------0260 0270 0290 Primary Earned Income Spouse's Earned Income Base Amount/Smaller of Expenses or Income Adjusted Gross Income Applicable Percentage Prior Year Expense Explanation Prior Year Expense Literal Prior Year Expense Prior Year Qualifying Person Name Prior Year Qualifying Person SSN Credit for Child & Dependent Care Child and Dependent Care Expenses Form Ref. ---4 5 6 Length -----12 12 12 Field Description ----------------N N N 0295 0300 @0315 0318 0320 0324 7 8 9 9 9 9 12 6 6 3 12 35 N R "STMbnn" or blank "PYE" or blank N AN 0326 9 9 N 0330 9 12 N Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 213 Section 4 FORM 2441 PAGE 2 Field Identification No. ----- -------------Byte Count Child and Dependent Care Expenses Form Ref. ---Length -----4 Field Description ----------------"0223" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" "2441bb" "PG02b" N (Primary SSN) Start of Record Sentinel 0340 0341 0342 0343 Record ID Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number Employer Paid Benefits Forfeited Amount Adjusted Paid Benefits Qualified Expenses Smaller of Adjusted or Qualified Earned Income Spouse Earned Income Tentative Exclusion Excluded Benefit Taxable Benefit Allowed Cared for Amt. Excluded Benefit Repeated 10 11 12 13 14 15 16 17 18 19 20 21 August 30, 2002 4 6 6 5 9 0344 0345 0350 0353 0356 0360 0370 0380 0390 0400 0410 0420 0440 0450 1 7 12 12 12 12 12 12 12 12 12 12 12 12 blank N 0000001 N N N N N N N N N N N N Part II Page 214 Section 4 Publication 1346 FORM 2441 PAGE 2 Field Identification No. ----- -------------0460 0465 0470 Net Allowable Amount Total Qualified Expenses Smaller of Qualified Expenses Child and Dependent Care Expenses Form Ref. ---22 23 24 Length -----12 12 12 Field Description ----------------N N N Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 215 Section 4 INTENTIONAL BLANK PAGE Publication 1346 August 30, 2002 Part II Page 216 Section 4 SCHEDULE 2 PAGE 1 Field Identification No. ----- -------------Byte Count Child and Dependent Care... Form Ref. ---Length -----4 Field Description ----------------"0506" for Fixed; "nnnn" for variable format Value "****" "SCHbb2" "1040Ab" "PG01b" N (Primary SSN) | Start of Record Sentinel 0000 0001 0002 0003 Record ID Schedule Type Page Number Taxpayer Identification Number Filler Schedule Occurrence Number Name of Care Provider 1 Care Provider Name Control 1 1(a) 1(a) 4 6 6 5 9 0004 0005 *0010 +0015 1 7 16 4 blank N 0000001 AN or "STMbnn" First Four Significant Characters of Individual's Last Name or of The Business Name, No Leading or Embedded Spaces; Allowable Characters Are Alpha, Numeric, Hyphen, Ampersand; Spaces May Be Present in Last Three Positions AN AN N or "STMbnn" "S" = SSN or ITIN, "E" = EIN, or blank N Part II Page 217 Section 4 +0020 +0030 *+0040 +0045 Street Address 1 City/State/Zip 1 SSN/EIN 1 SSN/EIN Type 1 1(b) 1(b) 1(c) 1(c) 28 28 9 1 +0050 Amount Paid 1 1(d) August 30, 2002 12 Publication 1346 SCHEDULE 2 PAGE 1 Field Identification No. ----- -------------0060 +0065 0070 0080 0090 +0095 0100 *0110 +0115 +0120 Name of Care Provider 2 Care Provider Name Control 2 Street Address 2 City/State/Zip 2 SSN/EIN 2 SSN/EIN Type 2 Amount Paid 2 Qualifying Person First Name - 1 Qualifying Person Last Name - 1 Qualifying Person Name Control - 1 Child and Dependent Care... Form Ref. ---1(a) 1(a) 1(b) 1(b) 1(c) 1(c) 1(d) 2(a) 2(a) 2(a) Length -----16 4 28 28 9 1 12 10 15 4 Field Description ----------------AN 'See 1st Occ.' AN AN N 'See 1st Occ.' N AN (first name, blank) or "STMbnn" AN (last name) or blank First 4 significant characters of person's last name, no leading or embedded spaces; allowable characters are alpha, hyphen, or space N N AN (first name, blank) 'See 1st Occ.' 'See 1st Occ.' 'See 1st Occ.' 'See 1st Occ.' Part II Page 218 Section 4 +0214 +0215 0217 0218 0221 0223 0225 Qualifying Person SSN - 1 Qualified Expenses 1 Qualifying Person First Name - 2 Qualifying Person Last Name - 2 Qualifying Person Name Control - 2 Qualifying Person SSN - 2 Qualified Expenses 2 2(b) 2(c) 2(a) 2(a) 2(a) 2(b) 2(c) 9 12 10 15 4 9 12 Publication 1346 August 30, 2002 SCHEDULE 2 PAGE 1 Field Identification No. ----- -------------0230 0260 0270 0290 0295 0300 @0315 0318 0320 0324 Total Qualified Expenses or Limit Primary Earned Income Spouse's Earned Income Smaller of Expenses or Income Adjusted Gross Income Applicable Percentage Prior Year Expense Explanation Prior Year Expense Literal Prior Year Expense Prior Year Qualifying Person Name Prior Year Qualifying Person SSN Percentage of Qualified Expenses or Income Tax Credit for Child & Dependent Care Child and Dependent Care... Form Ref. ---3 4 5 6 7 8 9 9 9 9 Length -----12 12 12 12 12 6 6 3 12 35 Field Description ----------------N N N N N R "STMbnn" or blank "CPYE" or blank N AN | 0326 9 9 N 0328 9 12 N | 0332 0336 10 11 12 12 N N -| | | Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 219 Section 4 SCHEDULE 2 PAGE 2 Field Identification No. ----- -------------Byte Count Child and Dependent Care... Form Ref. ---Length -----4 Field Description ----------------"0223" for Fixed; "nnnn" for variable format Value "****" "SCHbb2" "1040Ab" "PG02b" N (Primary SSN) Start of Record Sentinel 0340 0341 0342 0343 Record ID Schedule Type Page Number Taxpayer Identification Number Filler Schedule Occurrence Number Employer Paid Benefits Forfeited Amount Adjusted Paid Benefits Qualified Expenses Smaller of Adjusted or Qualified Earned Income Spouse Earned Income Tentative Exclusion Excluded Benefit Taxable Benefit Allowed Cared for Amt. Excluded Benefit Repeated 12 13 14 15 16 17 18 19 20 21 22 23 August 30, 2002 4 6 6 5 9 0344 0345 0350 0353 0356 0360 0370 0380 0390 0400 0410 0420 0440 0450 1 7 12 12 12 12 12 12 12 12 12 12 12 12 blank N 0000001 N N N N N N N N N N N N | | | | | | | | | | | | Part II Page 220 Section 4 Publication 1346 SCHEDULE 2 PAGE 2 Field Identification No. ----- -------------0460 0465 0470 Net Allowable Amount Total Qualified Expenses Smaller of Qualified Expenses Child and Dependent Care... Form Ref. ---24 25 26 Length -----12 12 12 Field Description ----------------N N N | | | Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 221 Section 4 INTENTIONAL BLANK PAGE Publication 1346 August 30, 2002 Part II Page 222 Section 4 FORM 2555 PAGE 1 Field Identification No. ----- -------------Byte Count Foreign Earned Income Form Ref. ---Length -----4 Field Description ----------------"1100" for Fixed; "nnnn" for variable format Value "****" Value "FRMbbb" "2555bb" "PG01b" N (Primary SSN) Start of Record Sentinel 0000 0001 0002 0003 Record ID Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number Name of Taxpayer with Foreign Earned Income 4 6 6 5 9 0004 0005 0006 1 7 35 blank N 0000001 - 0000002 AN Taxpayer's name allowable special characters are: space, less-than (<), hyphen (-) and ampersand (&) N (Your Social Security Number) "WAIVER" or blank "STMbnn" or blank AN, Allowable special characters are space, slash, hyphen and literal "NONE" N AN AN, Allowable Special Characters are: space, slash, hyphen, ampersand, and percent Part II Page 223 Section 4 0007 0008 @0009 0010 Taxpayer SSN Waiver Waiver Explanation Foreign Address 1 9 6 6 70 0015 0020 0030 Post of Duty Occupation Employer's Name 1 2 3 2 25 45 Publication 1346 August 30, 2002 FORM 2555 PAGE 1 Field Identification No. ----- -------------0040 Employer's US Address Foreign Earned Income Form Ref. ---4a Length -----70 Field Description ----------------AN, Allowable Special Characters are space, slash, hyphen and literal "NONE" AN, Allowable Special Characters are space, slash, hyphen and literal "NONE" "X" or blank "X" or blank "X" or blank "X" or blank 0050 Employer's Foreign Address 4b 70 0060 0070 0080 0090 Employer is a Foreign Entity Employer is a US Company Employer is Self Employer is a Foreign Affiliate of a US Company Other Employer Other Employer (specify) Last Year Filed No Form 2555/2555EZ Filed Revoked Exclusions Yes Revoked Exclusions No Yes - Type of Exclusion/Tax Year Country - Citizen/ National Separate Foreign Residence - Yes 5a 5b 5c 5d 1 1 1 1 0100 0105 0110 0120 0130 0140 @0150 0160 5e 5e 6a 6b 6c 6c 6d 7 1 35 4 1 1 1 6 35 "X" or blank AN Values "1982" through "2000" or blank "X" or blank "X" or blank "X" or blank "STMbnn" or blank AN, Allowable Special Characters are: space, slash, hyphen "X" or blank 0170 8a 1 Publication 1346 August 30, 2002 Part II Page 224 Section 4 FORM 2555 PAGE 1 Field Identification No. ----- -------------0180 *0190 Separate Foreign Residence - No Yes - City & Country of Foreign Residence Number of Days at That Address Tax Homes Date(s) Established Date Bona Fide Residence Began Date Bona Fide Residence Ended Living Qtrs Purchased House Living Qtrs Rented House/Apt Living Qtrs Rented Room Living Qtrs Employer Furnished Family Living with you - Yes Family Living with you - No Yes - Relationship Foreign Earned Income Form Ref. ---8a 8b Length -----1 35 Field Description ----------------"X" or blank AN, "STMbnn" or blank +0200 *0210 +0215 0220 0225 0230 0240 0250 0260 0270 0280 *0290 8b 9 9 10 10 11a 11b 11c 11d 12a 12a 12b 3 35 8 8 8 1 1 1 1 1 1 11 Value Range 000-999 AN, "STMbnn" or blank DT or blank DT or blank MMDDYYYY or blank, and literal "CONTINUE" "X" or blank "X" or blank "X" or blank "X" or blank "X" or blank "X" or blank Values: "CHILD", "FOSTERCHILD", "GRANDCHILD", "GRANDPARENT", "PARENT", "BROTHER", "SISTER", "AUNT", "UNCLE", "NEPHEW", "NIECE", "NONE", "SON", "DAUGHTER", "SPOUSE", "OTHER" or "STMbnn" AN Part II Page 225 Section 4 +0295 Period 12b August 30, 2002 25 Publication 1346 FORM 2555 PAGE 1 Field Identification No. ----- -------------0300 0310 0320 0330 *0340 +0342 +0344 +0346 0348 0350 0352 0354 0356 0358 0360 0370 0372 0374 Statement to Authorities - Yes Statement to Authorities - No Req'd to pay income tax - Yes Req'd to pay income tax - No Date Arrived in US 1 Date Left US - 1 Number of Days in US on Business - 1 Income Earned in US on Business - 1 Date Arrived in US 2 Date Left US - 2 Number of Days in US on Business - 2 Income Earned in US on Business - 2 Date Arrived in US 3 Date Left US - 3 Number of Days in US on Business - 3 Income Earned in US on Business - 3 Date Arrived in US 4 Date Left US - 4 Foreign Earned Income Form Ref. ---13a 13a 13b 13b 14a(1) 14b(1) 14c(1) 14d(1) 14a(2) 14b(2) 14c(2) 14d(2) 14a(3) 14b(3) 14c(3) 14d(3) 14a(4) 14b(4) August 30, 2002 Length -----1 1 1 1 8 8 3 12 8 8 3 12 8 8 3 12 8 8 Field Description ----------------"X" or blank "X" or blank "X" or blank "X" or blank DT or blank, "STMbnn" DT or blank Value Range 000-999 N DT or blank 'See 1st Occ.' 'See 1st Occ.' 'See 1st Occ.' 'See 2nd Occ.' 'See 1st Occ.' 'See 1st Occ.' 'See 1st Occ.' 'See 2nd Occ.' 'See 1st Occ.' Part II Page 226 Section 4 Publication 1346 FORM 2555 PAGE 1 Field Identification No. ----- -------------0376 0378 0380 0382 0384 0386 0388 0390 0392 0394 0396 0398 0400 0402 0404 0406 0408 0410 Number of Days in US on Business - 4 Income Earned in US on Business - 4 Date Arrived in US 5 Date Left US - 5 Number of Days in US on Business - 5 Income Earned in US on Business - 5 Date Arrived in US 6 Date Left US - 6 Number of Days in US on Business - 6 Income Earned in US on Business - 6 Date Arrived in US 7 Date Left US - 7 Number of Days in US on Business - 7 Income Earned in US on Business - 7 Date Arrived in US 8 Date Left US - 8 Number of Days in US on Business - 8 Income Earned in US on Business - 8 Foreign Earned Income Form Ref. ---14c(4) 14d(4) 14a(5) 14b(5) 14c(5) 14d(5) 14a(6) 14b(6) 14c(6) 14d(6) 14a(7) 14b(7) 14c(7) 14d(7) 14a(8) 14b(8) 14c(8) 14d(8) August 30, 2002 Length -----3 12 8 8 3 12 8 8 3 12 8 8 3 12 8 8 3 12 Field Description ----------------'See 1st Occ.' 'See 1st Occ.' 'See 2nd Occ.' 'See 1st Occ.' 'See 1st Occ.' 'See 1st Occ.' 'See 2nd Occ.' 'See 1st Occ.' 'See 1st Occ.' 'See 1st Occ.' 'See 2nd Occ.' 'See 1st Occ.' 'See 1st Occ.' 'See 1st Occ.' 'See 2nd Occ.' 'See 1st Occ.' 'See 1st Occ.' 'See 1st Occ.' Part II Page 227 Section 4 Publication 1346 FORM 2555 PAGE 1 Field Identification No. ----- -------------@0415 0420 0430 0440 @0450 0460 0470 0480 *0490 +0495 *+0500 +0510 Earned Income Computation Contractual terms/ other conditions Visa Type Visa Limit Stay Yes Visa Limit Stay Yes, Explanation Visa Limit Stay - No Home is US - Yes Home in US - No Yes - Home Address Home Status Occupant Names Occupant Relationship Foreign Earned Income Form Ref. ---14d 15a 15b 15c 15c 15c 15d 15d 15e 15e 15e 15e Length -----6 80 30 1 6 1 1 1 60 6 35 11 Field Description ----------------"STMbnn" or blank AN AN "X" or blank "STMbnn" or blank "X" or blank "X" or blank "X" or blank AN or "STMbnn" "RENTED" or blank AN or "STMbnn" Values: "CHILD", "FOSTERCHILD", "GRANDCHILD", "GRANDPARENT", "PARENT", "BROTHER", "SISTER", "AUNT", "UNCLE", "NEPHEW", "NIECE", "NONE", "SON", "DAUGHTER", "SPOUSE", "OTHER" Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 228 Section 4 FORM 2555 PAGE 2 Field Identification No. ----- -------------Byte Count Foreign Earned Income Form Ref. ---Length -----4 Field Description ----------------"0763" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" "2555bb" "PG02b" N (Primary SSN) Start of Record Sentinel 0520 0521 0522 0523 Record ID Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number Physical Presence Test FROM Physical Presence Test THROUGH Principal Country of Employment No Travel Statement Country Name - 1 16 16 17 18 18a(1) 4 6 6 5 9 0524 0525 0530 0540 0550 @0560 *0570 1 7 8 8 35 6 35 blank N 0000001 - 0000002 DT MMDDYYYY or blank, and literal "CONTINUE" AN "STMbnn" or blank AN, Allowable Special Character is: space, "STMbnn" or blank DT DT Value Range 000-999 Value Range 000-999 N +0580 +0590 +0600 +0610 +0620 Arrival Date - 1 Departure Date - 1 Full Days in Country - 1 Number of Days in US on Business - 1 Income Earned in US on Business - 1 18b(1) 18c(1) 18d(1) 18e(1) 18f(1) 8 8 3 3 12 Publication 1346 August 30, 2002 Part II Page 229 Section 4 FORM 2555 PAGE 2 Field Identification No. ----- -------------0630 Country Name - 2 Foreign Earned Income Form Ref. ---18a(2) Length -----35 Field Description ----------------AN, Allowable Special Character is: space or blank 'See 1st Occ.' 'See 1st Occ.' 'See 1st Occ.' 'See 1st Occ.' 'See 1st Occ.' 'See 2nd Occ.' 'See 1st Occ.' 'See 1st Occ.' 'See 1st Occ.' 'See 1st Occ.' 'See 1st Occ.' 'See 2nd Occ.' 'See 1st Occ.' 'See 1st Occ.' 'See 1st Occ.' 'See 1st Occ.' 'See 1st Occ.' "STMbnn" or blank Part II Page 230 Section 4 0640 0650 0660 0670 0680 0690 0700 0710 0720 0730 0740 0750 0760 0770 0780 0790 0800 @0805 Arrival Date - 2 Departure Date - 2 Full Days in Country - 2 Number of Days in US on Business Income Earned in US on Business Country Name - 3 Arrival Date - 3 Departure Date - 3 Full Days in Country - 3 Number of Days in US on Business - 3 Income Earned in US on Business - 3 Country Name - 4 Arrival Date - 4 Departure Date - 4 Full Days in Country - 4 Number of Days in US on Business - 4 Income Earned in US on Business - 4 Earned Income Computation 18b(2) 18c(2) 18d(2) 18e(2) 18f(2) 18a(3) 18b(3) 18c(3) 18d(3) 18e(3) 18f(3) 18a(4) 18b(4) 18c(4) 18d(4) 18e(4) 18f(4) 18f August 30, 2002 8 8 3 3 12 35 8 8 3 3 12 35 8 8 3 3 12 6 Publication 1346 FORM 2555 PAGE 2 Field Identification No. ----- -------------0810 0820 Total wages, salaries, etc. Share of Income Business or Profession Partnership's name, address and type of income Share of Income Partnership Market Value of Property - Home Noncash Income Home Market Value of Property - Meals Noncash Income Meals Market Value of Property - Car Noncash Income - Car Other Property type Other Property Amount Total Property Amount Cost of Living/ Overseas Differential Family Education Home Leave Foreign Earned Income Form Ref. ---19 20a Length -----12 12 Field Description ----------------N N @0830 20b 6 "STMbnn" or blank 0840 @0850 0860 @0870 0880 @0890 0900 *0910 +0920 0925 0930 20b 21a 21a 21b 21b 21c 21c 21d 21d 21d 22a 12 6 12 6 12 6 12 35 12 12 12 N "STMbnn" N "STMbnn" N "STMbnn" N AN, "STMbnn" or blank N N N 0940 0950 0960 22b 22c 22d August 30, 2002 12 12 12 N N N Part II Page 231 Section 4 Publication 1346 FORM 2555 PAGE 2 Field Identification No. ----- -------------0970 *0980 +0990 0995 1000 *1010 Quarters Other purposes Type Other purpose Amount Total Other Purpose Amount Total Allowances Type of Other Foreign Earned Income Amount of Other Foreign Earned Income Total Amount of Other Foreign Earned Income Total Income Excludable Meals & Lodging Foreign Earned Income Foreign Earned Income Form Ref. ---22e 22f 22f 22f 22g 23 Length -----12 35 12 12 12 35 Field Description ----------------N AN, "STMbnn" N N N AN, "STMbnn" +1020 23 12 N 1025 23 12 N 1030 1040 1050 24 25 26 12 12 12 N N N Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 232 Section 4 FORM 2555 PAGE 3 Field Identification No. ----- -------------Byte Count Foreign Earned Income Form Ref. ---Length -----4 Field Description ----------------"0272" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" "2555bb" "PG03b" N (Primary SSN) Start of Record Sentinel 1060 1061 1062 1063 Record ID Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number Foreign Earned Income Repeated Claiming Housing Exclusion or Housing Deduction Qualified Housing Expenses Number of Days in Qualifying Period Number of Days X $28.92 or Enter $10,577 Total Qualified Housing Expenses Employer-Provided Amounts Employer-Provided Percentage Housing Exclusion 28 29 30 27 4 6 6 5 9 1064 1065 1070 1075 1 7 12 1 blank N 0000001 - 0000002 N "Y" or "N" 1080 1090 1100 12 3 12 N Value Range 000-365 N 1110 1120 1130 1140 31 32 33 34 August 30, 2002 12 12 6 12 N N R (Please see Part I, Sect 5.01.2.b) N Part II Page 233 Section 4 Publication 1346 FORM 2555 PAGE 3 Field Identification No. ----- -------------1160 1180 1200 Number of Days in Qualifying Period Number of Days Ratio Tentative Foreign Earned Income Exclusion Foreign Earned Income Exclusion Limit Foreign Earned Income Exclusion Total Housing and Foreign Earned Income Exclusions Allowable Deductions Computation Allowable Deductions Max. of Housing and Foreign Earned Inc. Exclusions Max. Qualified Housing Expenses Max. Foreign Earned Income Limit of Housing Deduction Prior Year Housing Deduction Carryover Amount Total Housing Deduction Foreign Earned Income Form Ref. ---36 37 38 Length -----3 6 12 Field Description ----------------Value Range 000-365 R (Please see Part I, Sect 5.01.2.b) N 1210 39 12 N 1220 1230 40 41 12 12 N N @1240 42 6 "STMbnn" or blank 1250 1260 42 43 12 12 N N 1270 1280 1290 1300 44 45 46 47 12 12 12 12 N N N NO ENTRY 1310 48 12 1 N Value "#" Part II Page 234 Section 4 Record Terminus Character Publication 1346 August 30, 2002 FORM 2555EZ PAGE 1 Field Identification No. ----- -------------Byte Count Foreign Earned Income Exclusion Form Ref. ---Length -----4 Field Description ----------------"0524" for Fixed; "nnnn" for variable format Value "****" Value "FRMbbb" "2555Zb" "PG01b" N (Your Social Security Number) blank N 0000001 - 0000002 AN Taxpayer's name allowable special characters are: space, less-than (<), hyphen (-) and ampersand (&) N (Your Social Security Number) "X" or blank "X" or blank DT or blank MMDDYYYY or blank, and literal "CONTINUE" "X" or blank "X" or blank Start of Record Sentinel 0000 0001 0002 0003 Record ID Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number Name of Taxpayer with Foreign Earned Income 4 6 6 5 9 0004 0005 0006 1 7 35 0007 0010 0020 0030 0040 0050 0060 Taxpayer SSN Bona Fide Residence - Yes Bona Fide Residence - No Date Bona Fide Residence Began Date Bona Fide Residence Ended Physically Present Yes Physically Present No 1a 1a 1b 1b 2a 2a 9 1 1 8 8 1 1 Publication 1346 August 30, 2002 Part II Page 235 Section 4 FORM 2555EZ PAGE 1 Field Identification No. ----- -------------0070 0080 0090 0100 0110 Physical Presence Test FROM Physical Presence Test THROUGH Tax Home Test - Yes Tax Home Test - No Foreign Address Foreign Earned Income Exclusion Form Ref. ---2b 2b 3 3 4 Length -----8 8 1 1 70 Field Description ----------------DT MMDDYYYY or blank, and literal "CONTINUE" "X" or blank NO ENTRY AN, Allowable special characters are space, slash, hyphen and literal "NONE" N AN AN, Allowable Special Characters are: space, slash, hyphen, ampersand, and percent AN, Allowable Special Characters are: space, slash, hyphen and literal "NONE" AN, Allowable Special Characters are space, slash, hyphen and literal "NONE" "X" or blank "X" or blank "X" or blank AN Values "1982" through "2000" or blank "X" or blank Part II Page 236 Section 4 0115 0120 0130 Post of Duty Occupation Employer's Name 4 5 6 2 25 35 0140 Employer's US Address 7 70 0150 Employer's Foreign Address 8 70 0160 0170 0180 0190 0200 0210 Employer is a US Business Employer is a Foreign Business Other Employer Other Employer (specify) Last Year Filed No Form 2555/2555EZ Filed 9a 9b 9c 9c 10a 10b August 30, 2002 1 1 1 35 4 1 Publication 1346 FORM 2555EZ PAGE 1 Field Identification No. ----- -------------0220 0230 0240 *0250 +0260 0270 Revoked Exclusions Yes Revoked Exclusions No Yes - Effective Revocation Tax Year Tax Homes Date(s) Established Country - Citizen/ National Foreign Earned Income Exclusion Form Ref. ---10c 10c 10d 11a 11a 11b Length -----1 1 4 35 8 35 Field Description ----------------"X" or blank "X" or blank YYYY AN, "STMbnn" or blank DT or blank AN, Allowable Special Characters are: space, slash, hyphen Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 237 Section 4 FORM 2555EZ PAGE 2 Field Identification No. ----- -------------Byte Count Foreign Earned Income Exclusion Form Ref. ---Length -----4 Field Description ----------------"0375" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" "2555Zb" "PG02b" N (Primary SSN) Start of Record Sentinel 0280 0281 0282 0283 Record ID Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number Date Arrived in US 1 Date Left US - 1 Number of Days in US on Business - 1 Income Earned in US on Business - 1 Date Arrived in US 2 Date Left US - 2 Number of Days in US on Business - 2 Income Earned in US on Business - 2 Date Arrived in US 3 Date Left US - 3 Number of Days in US on Business - 3 12a(1) 12b(1) 12c(1) 12d(1) 12a(2) 12b(2) 12c(2) 12d(2) 12a(3) 12b(3) 12c(3) August 30, 2002 4 6 6 5 9 0284 0285 *0290 +0300 +0310 +0320 0330 0340 0350 0360 0370 0380 0390 1 7 8 8 3 12 8 8 3 12 8 8 3 blank N 0000001 - 0000002 DT, "STMbnn" or blank DT or blank Value Range 000-999 N DT or blank 'See 1st Occ.' 'See 1st Occ.' 'See 1st Occ.' 'See 2nd Occ.' 'See 1st Occ.' 'See 1st Occ.' Part II Page 238 Section 4 Publication 1346 FORM 2555EZ PAGE 2 Field Identification No. ----- -------------0400 0410 0420 0430 0440 0450 0460 0470 0480 0490 0500 0510 0520 0530 0540 0550 0560 0570 Income Earned in US on Business - 3 Date Arrived in US 4 Date Left US - 4 Number of Days in US on Business - 4 Income Earned in US on Business - 4 Date Arrived in US 5 Date Left US - 5 Number of Days in US on Business - 5 Income Earned in US on Business - 5 Date Arrived in US 6 Date Left US - 6 Number of Days in US on Business - 6 Income Earned in US on Business - 6 Date Arrived in US 7 Date Left US - 7 Number of Days in US on Business - 7 Income Earned in US on Business - 7 Date Arrived in US 8 Foreign Earned Income Exclusion Form Ref. ---12d(3) 12a(4) 12b(4) 12c(4) 12d(4) 12a(5) 12b(5) 12c(5) 12d(5) 12a(6) 12b(6) 12c(6) 12d(6) 12a(7) 12b(7) 12c(7) 12d(7) 12a(8) Length -----12 8 8 3 12 8 8 3 12 8 8 3 12 8 8 3 12 8 Field Description ----------------'See 1st Occ.' 'See 2nd Occ.' 'See 1st Occ.' 'See 1st Occ.' 'See 1st Occ.' 'See 2nd Occ.' 'See 1st Occ.' 'See 1st Occ.' 'See 1st Occ.' 'See 2nd Occ.' 'See 1st Occ.' 'See 1st Occ.' 'See 1st Occ.' 'See 2nd Occ.' 'See 1st Occ.' 'See 1st Occ.' 'See 1st Occ.' 'See 2nd Occ.' Part II Page 239 Section 4 Publication 1346 August 30, 2002 FORM 2555EZ PAGE 2 Field Identification No. ----- -------------0580 0590 0600 0610 0620 0630 0640 @0645 1160 1165 1175 1180 1200 Date Left US - 8 Number of Days in US on Business - 8 Income Earned in US on Business - 8 Date Arrived in US 9 Date Left US - 9 Number of Days in US on Business - 9 Income Earned in US on Business - 9 Earned Income Computation Number of Days in Qualifying Period 365-Day Yes 365-Day No Number of Days Ratio Foreign Earned Income Exclusion Limit Total Foreign Earned Income Max. of Foreign Earned Inc. Exclusion Foreign Earned Income Exclusion Form Ref. ---12b(8) 12c(8) 12d(8) 12a(9) 12b(9) 12c(9) 12d(9) 12d 14 15 15 15 16 Length -----8 3 12 8 8 3 12 6 3 1 1 6 12 Field Description ----------------'See 1st Occ.' 'See 1st Occ.' 'See 1st Occ.' 'See 2nd Occ.' 'See 1st Occ.' 'See 1st Occ.' 'See 1st Occ.' "STMbnn" or blank Value Range 000-365 "X" or blank "X" or blank R (Please see Part I, Sect 05, Para 02(b)) N 1210 1260 17 18 12 12 N N Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 240 Section 4 FORM 3468 Field Identification No. ----- -------------Byte Count Investment Credit Form Ref. ---Length -----4 Field Description ----------------"0556" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" Value "3468bb" Value "PG01b" Primary SSN | Start of Record Sentinel 0000 0001 0002 0003 Record ID Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number Identifying Number Section 47(d)(5) Election Box Rehabilitation Credit Attachment Qualified Rehabilitation Pre1936 Buildings Calculated Expenditures Pre1936 Buildings Historic Structure Certification on File Certified Historic Structures Calculated Expenditures Certified Historic Struct. 1a 1a 1b 4 6 6 5 9 0004 0005 0010 0020 @0025 0030 1 7 9 1 6 12 Blank N 0000001 NO ENTRY "X" or blank "STMbnn" or blank N | 0040 1b 12 N 0045 1c 1 "Y" or blank 0050 0060 1c 1c 12 12 N N Publication 1346 August 30, 2002 Part II Page 241 Section 4 FORM 3468 Field Identification No. ----- -------------0070 Qualified Rehabilitation NPS Number Date of NPS Approval Rehabilitation Test Period Beginning Date Rehabilitation Test Period End Date Adjusted Basis of Building Amount Qualified Rehabilitation Expenditures Amount Rehabilitation Credit (Schedule K1, Form 1065-B) Energy Credit Calculated Expenditures Energy Credit Reforestation Credit Calculated Expenditures Reforestation Credit Credit from Cooperatives Tax Reform Act Literal Tax Reform Act Section Current Year Investment Credit (add lines 1b-4) Investment Credit Form Ref. ---1c(1) Length -----18 Field Description ----------------AN or blank - allowable special character: hyphen (-) DT DT 0071 0074 1c(2) 1d(1) 8 8 0075 0076 0077 1d(1) 1d(2) 1d(3) 8 12 12 DT N N 0080 1e 12 NO ENTRY 0090 0100 2 2 12 12 N N 0110 0120 3 3 12 12 N N 0130 0140 0150 0160 4 5 5 5 12 7 9 12 N "TRAbSEC" or blank AN or Blank N Publication 1346 August 30, 2002 Part II Page 242 Section 4 FORM 3468 Field Identification No. ----- -------------@0165 0170 0180 0190 Allowable Credit Attachment Regular Tax Before Credits Alternative Minimum Tax Regular Tax Plus Alternative Minimum Tax Foreign Tax Credit Child and Dependent Care Expenses Credit (F2441) Elderly or Disabled Credit (Sch R) Education Credits (Form 8863) Credit for Qualified Retirement Savings Child Tax Credit Mortgage Interest Credit (Form 8396) Adoption Credit (Form 8839) First Time DC Home Buyer Credit (Form 8859) Possessions Tax Credit (Form 5735) Fuel Credit Nonconventional Electric Vehicle Credit (Form 8834) Investment Credit Form Ref. ---5 6 7 8 Length -----6 12 12 12 Field Description ----------------"STMbnn" or blank N N N 0200 0210 9a 9b 12 12 N N 0220 0230 0235 9c 9d 9e 12 12 12 N N N | 0240 0250 0260 0270 9f 9g 9h 9i 12 12 12 12 N N N N 0280 0290 0300 9j 9k 9l August 30, 2002 12 12 12 NO ENTRY N N Part II Page 243 Section 4 Publication 1346 FORM 3468 Field Identification No. ----- -------------0310 0320 0340 0350 0355 0360 0370 0380 Total Credits (Add Lines 9a - 9l) Net Income Tax Net Regular Tax Enter 25% of Excess Tentative Minimum Tax Greater of Line 12 or Line 13 Subtract Line 14 from Line 10 Investment Credit Allowed for Current Year Investment Credit Form Ref. ---9m 10 11 12 13 14 15 16 Length -----12 12 12 12 12 12 12 12 Field Description ----------------N N N N N N N N --| | | | | Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 244 Section 4 FORM 3800 Field Identification No. ----- -------------Byte Count General Business Credit Form Ref. ---Length -----4 Field Description ----------------"0646" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" "3800bb" "PG01b" N (Primary SSN) Start of Record Sentinel 0000 0001 0002 0003 Record ID Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number Current Year Investment Credit Current Year Work Opportunity Credit Current Year Welfare To Work Credit Current Year Credit for Alcohol Used As Fuel Current Year Credit for Increasing Research Current Year LowIncome Housing Credit Current Year Enhanced Oil Recovery Credit Current Year Disabled Access Credit 1a 1b 1c 4 6 6 5 9 0004 0005 0020 0030 0040 1 7 12 12 12 blank N 0000001 N N N 0050 1d 12 N 0060 1e 12 N 0070 1f 12 N 0080 1g 12 N 0090 1h 12 N Publication 1346 August 30, 2002 Part II Page 245 Section 4 FORM 3800 Field Identification No. ----- -------------0100 Current Year Renewable Electricity Production Current Year Indian Employment Credit Current Year Credit for Employer Social Security Current Year Orphan Drug Credit Current Year New Markets Credit Credit for Small Empoyer Pension Plan Startup Cost Credit for EmployerProvided Child Care Facilities Current Year Credit for Contributions Current Yr TransAlaska Pipeline Attach Statement Current Year TransAlaska Pipeline Credit CY General Credits Electing Large Partnership Current Year General Business Credit Passive Activity Credits Subtract Line 3 from Line 2 General Business Credit Form Ref. ---1i Length -----12 Field Description ----------------N 0110 0120 1j 1k 12 12 N N 0130 0135 0137 1l 1m 1n 12 12 12 N NO ENTRY NO ENTRY | 0139 1o 12 NO ENTRY | 0140 @0145 1p 1q 12 6 N | "STMbnn" or blank | 0150 1q 12 N | 0160 1r 12 N | 0170 2 12 N 0180 0190 3 4 August 30, 2002 12 12 N N Part II Page 246 Section 4 Publication 1346 FORM 3800 Field Identification No. ----- -------------0200 0210 Passive Activity Credits Allowed Carryforward of General Business Credit Credit Computation Attachment Carryback of General Business Credit Tentative General Business Credit Regular Tax Before Credits Alternative Minimum Tax Regular Tax Plus Alternative Minimum Tax Foreign Tax Credit Child & Dependent Care Credit (Form 2441) Elderly or Disabled Credit (Sch R) Education Credits Credit for Qualified Retirement Savings Child Tax Credit Mortgage Interest Credit (Form 8396) Adoption Credit (Form 8839) General Business Credit Form Ref. ---5 6 Length -----12 12 Field Description ----------------N N @0215 0220 6 7 6 12 "STMbnn" or blank NO ENTRY 0230 0240 0250 0260 8 9 10 11 12 12 12 12 N N N N 0270 0280 12a 12b 12 12 N N 0290 0300 0305 12c 12d 12e 12 12 12 N N N | 0310 0320 0330 12f 12g 12h August 30, 2002 12 12 12 N N N Part II Page 247 Section 4 Publication 1346 FORM 3800 Field Identification No. ----- -------------0340 DC First-Time Homebuyer Credit (Form 8859) Possession Tax Credit (Form 5735) Nonconventional Fuel Source Credit Electric Vehicle Credit (Form 8834) Total Credits (Add Lines 12a - 12l) Net Income Tax Net Regular Tax Enter 25% of Excess Tentative Minimum Tax Greater of Line 15 or Line 16 Subtract Line 17 from Line 13 Section Literal Attach Corporation Computation General Business Credit Form Ref. ---12i Length -----12 Field Description ----------------N 0350 0360 0370 0380 0390 0410 0420 0425 0430 0440 0450 0460 12j 12k 12l 12m 13 14 15 16 17 18 19 19 12 12 12 12 12 12 12 12 12 12 9 6 NO ENTRY N N N N N N N N N --| | | | | | "SECb41(G)" or blank | NO ENTRY | --| --| 0490 General Business Credit Allowed for Current Year 19 12 N Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 248 Section 4 FORM 3903 Field Identification No. ----- -------------Byte Count Moving Expenses Form Ref. ---Length -----4 Field Description ----------------"0118" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" "3903bb" "PG01b" N (Primary SSN) Start of Record Sentinel 0000 0001 0002 0003 Record ID Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number Armed Forces Permanent Change of Station Literal Transport Goods Exp Moving Expenses Amt Total Moving Expenses Excludable Moving Expense Reimbursements Tot Moving Expenses>Moving Reimbursement-No Box Tot Moving Expenses>Moving Reimbursements-Yes Box Moving Exp Deduction 1 2 3 4 4 6 6 5 9 0004 0005 0010 1 7 13 blank N 0000001 - 0000002 "MILITARYbMOVE" or blank 0040 0042 0044 0052 12 12 12 12 N N N N 0060 5 1 "X" or blank 0070 5 1 "X" or blank 0180 5 12 1 N Value "#" Part II Page 249 Section 4 Record Terminus Character Publication 1346 August 30, 2002 INTENTIONAL BLANK PAGE Publication 1346 August 30, 2002 Part II Page 250 Section 4 FORM 4136 PAGE 1 Field Identification No. ----- -------------Byte Count Credit for Federal Tax Paid on Fuels Form Ref. ---Length -----4 Field Description ----------------"0331" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" "4136bb" "PG01b" N (Primary SSN) Start of Record Sentinel 0000 0001 0002 0003 Record ID Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number Off-Highway Business Use Gallons Use On Farm For Farming Purpose Gallons Nontaxable Use of Gasoline Type - 1 Nontaxable Use of Gasoline Gallons - 1 Nontaxable Use of Gasoline Type - 2 Nontaxable Use of Gasoline Gallons - 2 Nontaxable Use of Gasoline Credit Amount Gasohol 10% Alcohol Type Gasohol 10% Alcohol Gallons 1a(c) 1b(c) 4 6 6 5 9 0004 0005 0010 0020 1 7 6 6 blank N 0000001 N N 0030 0040 0050 0060 0070 1c(a) 1c(c) 1c(a) 1c(c) 1c(d) 2 6 2 6 12 Values "03, 04, 05, 07" or blank N Values "03, 04, 05, 07" or blank N N 0080 0090 1d(a) 1d(c) August 30, 2002 2 6 Values "01, 02, 03, 04, 05, 07" or blank N Part II Page 251 Section 4 Publication 1346 FORM 4136 PAGE 1 Field Identification No. ----- -------------0100 Nontaxable Use of Gasohol 10% Credit Amount Gasohol 7.7% Alcohol Type Gasohol 7.7% Alcohol Gallons Nontaxable Use of Gasohol 7.7% Credit Amount Gasohol 5.7% Alcohol Type Gasohol 5.7% Alcohol Gallons Nontaxable Use of Gasohol 5.7% Credit Amount Commercial Aviation Gasoline Gallons Nontaxable Use of Commercial Aviation Gas Cr Amt Nontaxable Use of Aviation Gasoline Type - 1 Nontaxable Use of Aviation Gasoline Gallons - 1 Nontaxable Use of Aviation Gasoline Type - 2 Nontaxable Use of Aviation Gasoline Gallons - 2 Nontaxable Use of Aviation Gas Tax Credit Amt Credit for Federal Tax Paid on Fuels Form Ref. ---1d(d) Length -----12 Field Description ----------------N 0110 0120 0130 1e(a) 1e(c) 1e(d) 2 6 12 Values "01, 02, 03, 04, 05, 07" or blank N N 0140 0150 0160 1f(a) 1f(c) 1f(d) 2 6 12 Values "01, 02, 03, 04, 05, 07" or blank N N 0170 0180 2a(c) 2a(d) 6 12 N N 0190 2b(a) 2 Values "01, 03, 09, 10" or blank N 0200 2b(c) 6 0210 2b(a) 2 Values "01, 03, 09, 10" or blank N 0220 2b(c) 6 0230 2b(d) 12 N Publication 1346 August 30, 2002 Part II Page 252 Section 4 FORM 4136 PAGE 1 Field Identification No. ----- -------------@0240 Evidence of Dyed Diesel Fuel Explanation Evidence of Dyed Diesel Fuel Exception Box Nontaxable Use of Diesel Fuel Type - 1 Nontaxable Use of Diesel Fuel Gallons - 1 Nontaxable Use of Diesel Fuel Type - 2 Nontaxable Use of Diesel Fuel Gallons - 2 Nontaxable Use of Diesel Fuel Credit Amt Diesel Fuel Train Use Gallons NonTaxable Diesel Fuel Train Use Credit Amt Diesel Fuel Certain Intercity Local Bus Use Gallon Diesel Fuel Certain Intercity & Bus Use Credit Amt Evidence of Dyed Kerosene Explanation Evidence of Dyed Kerosene Box Nontaxable Use of Kerosene Type - 1 Credit for Federal Tax Paid on Fuels Form Ref. ---3 Length -----6 Field Description ----------------"STMbnn" or blank 0250 3 1 "X" or blank 0260 0270 3a(a) 3a(c) 2 6 Values "02, 03, 06, 07, 08" or blank N 0280 0290 3a(a) 3a(c) 2 6 Values "02, 03, 06, 07, 08" or blank N 0300 3a(d) 12 N 0310 0320 3b(c) 3b(d) 6 12 N N 0330 3c(c) 6 N 0340 3c(d) 12 N @0350 0360 0370 4 4 4a(a) 6 1 2 "STMbnn" or blank "X" or blank Values "02, 03, 06, 07, 08" or blank Part II Page 253 Section 4 Publication 1346 August 30, 2002 FORM 4136 PAGE 1 Field Identification No. ----- -------------0380 0390 0400 0410 Nontaxable Use of Kerosene Gallons - 1 Nontaxable Use of Kerosene Type - 2 Nontaxable Use of Kerosene Gallons - 2 Nontaxable Use of Kerosene Credit Amount Kerosene Train Use Gallons Nontaxable Kerosene Train Use Credit Amount Kerosene Certain Intercity Local Bus Use Gallons Kerosene Certain Intercity Local Bus Use Credit Am Credit for Federal Tax Paid on Fuels Form Ref. ---4a(c) 4a(a) 4a(c) 4a(d) Length -----6 2 6 12 Field Description ----------------N Values "02, 03, 06, 07, 8" or blank N N 0420 0430 4b(c) 4b(d) 6 12 N N 0440 4c(c) 6 N 0445 4c(d) 12 N Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 254 Section 4 FORM 4136 PAGE 2 Field Identification No. ----- -------------Byte Count Credit for Federal Tax Paid on Fuels Form Ref. ---Length -----4 Field Description ----------------"0334" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" "4136bb" "PG02b" N (Primary SSN) Start of Record Sentinel 0450 0451 0452 0453 Record ID Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number Commercial Aviation Fuel Gasoline Gallons Nontaxable Use of Commercial Aviation Fuel Cr Amt Nontaxable Use of Aviation Fuel Type 1 Nontaxable Use of Aviation Fuel Gallons - 1 Nontaxable Use of Aviation Fuel Other $.219 Cr Amt Nontaxable Use of Aviation Fuel Type 2 Nontaxable Use of Aviation Fuel Gallons - 2 5a(c) 4 6 6 5 9 0454 0455 0460 1 7 6 blank N 0000001 N 0470 5a(d) 12 N 0480 5b(a) 2 Values "01, 03, 09, 10, 11" or blank N 0490 5b(c) 6 0500 5b(d) 12 N 0510 5c(a) 2 Values "01, 03, 09, 10, 11" or blank N 0520 5c(c) 6 Publication 1346 August 30, 2002 Part II Page 255 Section 4 FORM 4136 PAGE 2 Field Identification No. ----- -------------0530 Nontaxable Use of Aviation Fuel Tax Credit Amt Undyed Diesel Fuel UV Registration No Evidence of Dyed Diesel Fuel Explanation Evidence of Dyed Diesel Fuel Exception Box Use of Undyed Diesel For Farming Purpose Gallons Use of Undyed Diesel By State or Local Gov Gallons Sales by Vendors of Undyed Diesel Credit Amount Customer Information Attachment Undyed Kerosene UV Registration No Undyed Kerosene UP Registration No Evidence of Dyed Kerosene Explanation Evidence of Dyed Kerosene Exception Box Use of Undyed Kerosene for Farming Purpose Gallons Credit for Federal Tax Paid on Fuels Form Ref. ---5c(d) Length -----12 Field Description ----------------N 0550 @0560 6 6 11 6 AN (UVNNNNNNNNN) "STMbnn" or blank 0570 6 1 "X" or blank 0580 6a(c) 6 N 0590 6b(c) 6 N 0600 6b(d) 12 N @0605 6b 6 "STMbnn" or blank 0610 0620 @0630 0640 7 7 7 7 11 11 6 1 AN (UVNNNNNNNNN) AN (UPNNNNNNNNN) "STMbnn" or blank "X" or blank 0650 7a(c) 6 N Publication 1346 August 30, 2002 Part II Page 256 Section 4 FORM 4136 PAGE 2 Field Identification No. ----- -------------0660 Use of Undyed Kero by State or Local Gov Gallons Customer Information Attachment Other Sales of Undyed Kerosene Gallons Sales by Vendors of Undyed Kerosene Credit Amount Certain Intercity and Local Buses Gallons Use of LPG in Certain Intercity and Buses Cr Amt Qualified Local and School Buses Gallons Use of LPG in Qualified Local & School Buses Cr Am Gasohol Blenders 10% Alcohol Gasoline Gallons Gasohol Blenders 10% Alcohol Gallons Gasohol Blenders 10% Credit Amount Gasohol Blenders 7.7% Alcohol Gasoline Gallons Gasohol Blenders 7.7% Alcohol Gallons Gasohol Blenders 7.7% Credit Amount Credit for Federal Tax Paid on Fuels Form Ref. ---7b(c) Length -----6 Field Description ----------------N @0665 7b 6 "STMbnn" or blank 0670 7c(c) 6 N 0680 7c(d) 12 N 0690 8a(c) 6 N 0700 8a(d) 12 N 0710 0720 8b(c) 8b(d) 6 12 N N 0730 9a(b) 6 N 0740 0750 0760 9a(c) 9a(d) 9b(b) 6 12 6 N N N 0770 0780 9b(c) 9b(d) 6 12 N N Part II Page 257 Section 4 Publication 1346 August 30, 2002 FORM 4136 PAGE 2 Field Identification No. ----- -------------0790 Gasohol Blenders 5.7% Alcohol Gasoline Gallons Gasohol Blenders 5.7% Alcohol Gallons Gasohol Blenders 5.7% Credit Amount Total Income Tax Credit Amount Credit for Federal Tax Paid on Fuels Form Ref. ---9c(b) Length -----6 Field Description ----------------N 0800 0810 0820 9c(c) 9c(d) 10 6 12 12 N N N Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 258 Section 4 FORM 4137 Field Identification No. ----- -------------Byte Count Social Security and Medicare Tax on ... Form Ref. ---Length -----4 Field Description ----------------"0391" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" "4137bb" "PG01b" N (Primary SSN) Start of Record Sentinel 0000 0001 0002 0003 Record ID Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number Tip Income Name Tip Income SSN Employer's Name 1 Employer's Name 2 Employer's Name 3 Total Tips Received Total Tips Reported Taxable Tips Unreported Tips Line 3 minus Line 4 Total Social Security Wages and Tips Line 6 minus Line 7 Tips Subject To Medicare Only Literal 1 2 3 4 5 7 4 6 6 5 9 0004 0005 0010 0020 *0030 0040 0050 0060 0070 0080 0090 0100 0110 1 7 35 9 50 50 50 12 12 12 12 12 12 blank N 0000001 - 0000002 AN N AN or "STMbnn" AN AN N N N N N N 0120 0124 8 9 12 10 N "1.45%bTIPS" Publication 1346 August 30, 2002 Part II Page 259 Section 4 FORM 4137 Field Identification No. ----- -------------0127 0130 0140 0190 0200 Tips Subject to Medicare Only Amount Unreported Tips Subject to SST Social Security Tax on Tips Medicare Tax on Tips F1040 Social Security Medicare Tax on Tips Social Security and Medicare Tax on ... Form Ref. ---9 9 10 11 12 Length -----12 12 12 12 12 Field Description ----------------N N N N N Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 260 Section 4 FORM 4255 Field Identification No. ----- -------------Byte Count Recapture of Investment Credit Form Ref. ---Length -----4 Field Description ----------------"0635" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" "4255bb" "PG01b" N (Primary SSN) | Start of Record Sentinel 0000 0001 0002 0003 Record ID Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number Identifying Number Property Desc. (1) Original Rate (1) Cost or Other Basis (1) Original Credit (1) Date Property Placed in Serv. (1) Date Property Qualification (1) Number of Full yrs between dates (1) Recapture Percentage (1) Tentative Recap. Tax (1) Property Desc. (2) Original Rate (2) A 1A 2A 3A 4A 5A 6A 7A 8A B 1B August 30, 2002 4 6 6 5 9 0004 0005 0009 *0010 +0020 *+0023 +0080 +0084 +0090 +0100 +0110 +0120 0130 0140 1 7 9 56 6 12 12 8 8 2 6 12 56 6 blank N 0000001 NO ENTRY AN or "STMbnn" R N or "STMbnn" N YYYYMMDD YYYYMMDD N, "00", or blank R N AN R Part II Page 261 Section 4 | | | Publication 1346 FORM 4255 Field Identification No. ----- -------------0143 0200 0204 0210 0220 0230 0240 0250 0260 0263 0320 0324 0330 0340 0350 0360 0370 0380 0383 Cost or Other Basis (2) Original Credit (2) Date Property Placed in Serv. (2) Date Property Qualification (2) Number of Full yrs between dates (2) Recapture Percentage (2) Tentative Recap. Tax (2) Property Desc. (3) Original Rate (3) Cost or Other Basis (3) Original Credit (3) Date Property Placed in Serv. (3) Date Property Qualification (3) Number of Full yrs between dates (3) Recapture Percentage (3) Tentative Recap. Tax (3) Property Desc. (4) Original Rate (4) Cost or Other Basis (4) Recapture of Investment Credit Form Ref. ---2B 3B 4B 5B 6B 7B 8B C 1C 2C 3C 4C 5C 6C 7C 8C D 1D 2D August 30, 2002 Length -----12 12 8 8 2 6 12 56 6 12 12 8 8 2 6 12 56 6 12 Field Description ----------------N N YYYYMMDD YYYYMMDD 'See 1st Occ.' R N AN R N N YYYYMMDD YYYYMMDD 'See 1st Occ.' R N AN R N Part II Page 262 Section 4 | | | | Publication 1346 FORM 4255 Field Identification No. ----- -------------0440 0444 0450 0460 0470 0480 0483 0486 0490 @0495 0500 Original Credit (4) Date Property Placed in Serv. (4) Date Property Qualification (4) Number of Full yrs between dates (4) Recapture Percentage (4) Tentative Recap. Tax (4) "Tax From Attached" Literal Tax Amount Line 8 col A-D Recapture Tax Statement Tax from Property Ceasing to be At Risk Lines 9 and 10 Total Portion of Orig. Credit Total Increase Tax Recapture of Investment Credit Form Ref. ---3D 4D 5D 6D 7D 8D 9 9 9 10 10 Length -----12 8 8 2 6 12 17 12 12 6 12 Field Description ----------------N YYYYMMDD YYYYMMDD 'See 1st Occ.' R N "TAX FROM ATTACHED" or Blank N N "STMbnn" or blank NO ENTRY | | 0510 0520 0530 11 12 13 12 12 12 N N N Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 263 Section 4 INTENTIONAL BLANK PAGE Publication 1346 August 30, 2002 Part II Page 264 Section 4 FORM 4562 PAGE 1 Field Identification No. ----- -------------Byte Count Depreciation and Amortization Form Ref. ---Length -----4 Field Description ----------------"0822" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" "4562bb" "PG01b" N (Primary SSN) Start of Record Sentinel 0000 0001 0002 0003 Record ID Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number Activity Section 179 Property Cost for Current Year Section 179 Property Adjusted Overall Dollar Limitation Adjusted Class of Property 1 Cost 1 Elected Cost 1 Class of Property 2 Cost 2 Elected Cost 2 Listed Property Section 179 Property Total Elect Cost 2 4 6 6 5 9 0004 0005 0010 0012 1 7 30 12 blank N 0000001 - 0000030 AN N 0014 0018 *0020 +0030 +0040 0050 0060 0070 0080 0081 4 5 6(a)1 6(b)1 6(c)1 6(a)2 6(b)2 6(c)2 7(c) 8 12 12 20 12 12 20 12 12 12 12 N N AN or "STMbnn" N N AN N N N N Publication 1346 August 30, 2002 Part II Page 265 Section 4 FORM 4562 PAGE 1 Field Identification No. ----- -------------0083 0088 Tentative Deduction Prior Year Carryover of Disallowed Deduction Business Income Limitation Section 179 Expense Deduction Next Year Carryover Amount Special depreciation allowance Section 168(f)(1) Property Explanation Prop Subject to Sect 168(f)(1) Election ACRS Explanation ACRS/Other Depreciation MACRS Deductions General Asset Account Election 3-Year Cost 3-Year Recovery 3-Yr Convention 3-Year Method Figuring 3-Year Deduction 5-Year Cost Depreciation and Amortization Form Ref. ---9 10 Length -----12 12 Field Description ----------------N N 0090 0092 0094 0096 11 12 13 14 12 12 12 12 N N N N @0098 0101 15 15 6 12 "STMbnn" or blank N @0103 0105 0107 0109 *0111 +0113 +0115 +0120 +0130 *0140 16 16 17 18 19a(c) 19a(d) 19a(e) 19a(f) 19a(g) 19b(c) August 30, 2002 6 12 12 1 12 2 2 7 12 12 "STMbnn" or blank N N "X" or blank N or "STMbnn" N Values "HY", "MM" or "MQ" AN N N or "STMbnn" Part II Page 266 Section 4 Publication 1346 FORM 4562 PAGE 1 Field Identification No. ----- -------------+0150 +0155 +0160 +0170 *0172 +0174 +0175 +0176 +0178 *0180 +0190 +0195 +0200 +0210 *0220 +0230 +0235 +0240 +0250 *0275 +0285 +0287 5-Year Recovery 5-Yr Convention 5-Yr Method Figuring 5-Year Deduction 7-Year Cost 7-Year Recovery 7-Yr Convention 7-Yr Method Figuring 7-Year Deduction 10-Year Cost 10-Year Recovery 10-Yr Convention 10-Yr Method Figuring 10-Year Deduction 15-Yr Cost 15-yr Recovery 15-Yr Convention 15-Yr Method 15-Year Deduction 20-Yr Cost 20-Yr Recovery 20-Yr Convention Depreciation and Amortization Form Ref. ---19b(d) 19b(e) 19b(f) 19b(g) 19c(c) 19c(d) 19c(e) 19c(f) 19c(g) 19d(c) 19d(d) 19d(e) 19d(f) 19d(g) 19e(c) 19e(d) 19e(e) 19e(f) 19e(g) 19f(c) 19f(d) 19f(e) August 30, 2002 Length -----2 2 7 12 12 2 2 7 12 12 2 2 7 12 12 2 2 7 12 12 2 2 Field Description ----------------N Values "HY", "MM" or "MQ" AN N N or "STMbnn" N Values "HY", "MM" or "MQ" AN N N or "STMbnn" N Values "HY", "MM" or "MQ" AN N N or "STMbnn" N Values "HY", "MM" or "MQ" AN N N or "STMbnn" N Values "HY", "MM" or "MQ" Part II Page 267 Section 4 Publication 1346 FORM 4562 PAGE 1 Field Identification No. ----- -------------+0295 +0305 *0307 +0309 +0311 *0313 20-Yr Method 20-Year Deduction 25-Yr Cost 25-Yr Convention 25-Year Deduction Residential Rental Prop Date in Service 1 Residential Rental Prop Cost 1 Residential Rental Prop Deprec Ded 1 Residential Rental Prop Date in Service 2 Residential Rental Prop Cost 2 Residential Rental Prop Deprec Ded 2 Nonresidential Real Prop Date in Service 1 Nonresidential Real Prop Cost 1 Nonresidential Real Prop Deprec Ded 1 Nonresidential Real Prop Date in Service 2 Nonresidential Real Prop Cost 2 Nonresidential Recovery 2 Depreciation and Amortization Form Ref. ---19f(f) 19f(g) 19g(c) 19g(e) 19g(g) 19h(b)1 Length -----7 12 12 2 12 6 Field Description ----------------AN N N or "STMbnn" Values "HY", "MM" or "MQ" N Value "MMYYYY" or "STMbnn" N N Value "MMYYYY" +0317 +0333 0337 19h(c)1 19h(g)1 19h(b)2 12 12 6 0343 0357 *0363 19h(c)2 19h(g)2 19i(b)1 12 12 6 N N Value "MMYYYY" or "STMbnn" N N Value "MMYYYY" or "STMbnn" N N Part II Page 268 Section 4 +0367 +0383 *0387 19i(c)1 19i(g)1 19i(b)2 12 12 6 +0393 +0400 19i(c)2 19i(d)2 August 30, 2002 12 3 Publication 1346 FORM 4562 PAGE 1 Field Identification No. ----- -------------+0407 0410 0415 0420 0425 0430 0435 0440 0445 0450 0455 0497 0500 0505 Nonresidential Real Prop Deprec Ded 2 Class-Life Cost Class-Life Recovery Class-Life Convention Class-Life Deduction 12-Yr Cost 12-Yr Convention 12-Yr Deduction 40-Yr Prop Date in Service 40-Yr Cost 40-Yr Deduction Listed Property Total Depreciation Sec 263A Current Year Cost Depreciation and Amortization Form Ref. ---19i(g)2 20a(c) 20a(d) 20a(e) 20a(g) 20b(c) 20b(e) 20b(g) 20c(b) 20c(c) 20c(g) 21 22 23 Length -----12 12 3 2 12 12 2 12 6 12 12 12 12 12 Field Description ----------------N N N Values "HY", "MM" or "MQ" N N Values "HY", "MM" or "MQ" N YYYYMM or blank N N N N N Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 269 Section 4 FORM 4562 PAGE 2 Field Identification No. ----- -------------Byte Count Depreciation and Amortization Form Ref. ---Length -----4 Field Description ----------------"0871" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" "4562bb" "PG02b" N (Primary SSN) Start of Record Sentinel 0510 0511 0512 0513 Record ID Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number Evidence - Yes Evidence - No Written - Yes Written - No Special description allowance Description 1/ Over 50% Date Service 1/ Over 50% Percent Use 1/ Over 50% Cost or Basis 1/ Over 50% Deprec Basis 1/ Over 50% Recovery Period 1/ Over 50% 24a 24a 24b 24b 25 26(a)1 26(b)1 26(c)1 26(d)1 26(e)1 26(f)1 August 30, 2002 4 6 6 5 9 0514 0515 0762 0764 0766 0768 0773 *0775 +0780 +0790 +0800 +0810 +0815 1 7 1 1 1 1 12 9 8 6 12 12 2 blank N 0000001 - 0000030 "X" or blank "X" or blank "X" or blank "X" or blank N AN or "STMbnn" DT R N N N Part II Page 270 Section 4 Publication 1346 FORM 4562 PAGE 2 Field Identification No. ----- -------------+0822 +0830 +0840 0850 0860 0870 0880 0890 0895 0902 0910 0920 0930 0940 0950 0960 0970 Method 1/Over 50% Deprec Deduction 1/ Over 50% 179 Expense 1/ Over 50% Description 2/ Over 50% Date Service 2/ Over 50% Percent Use 2/ Over 50% Cost or Basis 2/ Over 50% Deprec Basis 2/ Over 50% Recovery Period 2/ Over 50% Method 2/Over 50% Deprec Deduction 2/ Over 50% 179 Expense 2/ Over 50% Description 3/ Over 50% Dt Service 3/ Over 50% Percent Use 3/ Over 50% Cost or Basis 3/ Over 50% Deprec Basis 3/ Over 50% Depreciation and Amortization Form Ref. ---26(g)1 26(h)1 26(i)1 26(a)2 26(b)2 26(c)2 26(d)2 26(e)2 26(f)2 26(g)2 26(h)2 26(i)2 26(a)3 26(b)3 26(c)3 26(d)3 26(e)3 Length -----7 12 12 9 8 6 12 12 2 7 12 12 9 8 6 12 12 Field Description ----------------AN N N AN DT R N N N AN N N AN DT R N N Publication 1346 August 30, 2002 Part II Page 271 Section 4 FORM 4562 PAGE 2 Field Identification No. ----- -------------0975 0985 0990 1000 *1010 +1020 +1030 +1040 +1050 +1055 +1060 Recovery Period 3/ Over 50% Method 3/Over 50% Deprec Deduction 3/ Over 50% 179 Expense 3/ Over 50% Description 1/ < or = 50% Dt Service 1/ < or = 50% Percent Use 1/ < or = 50% Cost or Basis 1/ < or = 50% Deprec Basis 1/ < or = 50% Recovery Period 1/ < or = 50% Convention 1/ < or = 50% Deprec Deduction 1/ < or = 50% Description 2/ < or = 50% Dt Service 2/ < or = 50% Percent Use 2/ < or = 50% Cost or Basis 2/ < or = 50% Deprec Basis 2/ < or = 50% Depreciation and Amortization Form Ref. ---26(f)3 26(g)3 26(h)3 26(i)3 27(a)1 27(b)1 27(c)1 27(d)1 27(e)1 27(f)1 27(g)1 Length -----2 7 12 12 10 8 6 12 12 2 3 Field Description ----------------N AN N N AN or "STMbnn" DT R N N N Values: "HY", "MM", "MQ", "PRE" or blank N AN DT R N N Part II Page 272 Section 4 +1070 1090 1100 1110 1120 1130 27(h)1 27(a)2 27(b)2 27(c)2 27(d)2 27(e)2 August 30, 2002 12 10 8 6 12 12 Publication 1346 FORM 4562 PAGE 2 Field Identification No. ----- -------------1135 1140 Recovery Period 2/ < or = 50% Convention 2/ < or = 50% Deprec Deduction 2/ < or = 50% Description 3/ < or = 50% Dt Service 3/ < or = 50% Percent Use 3/ < or = 50% Cost or Basis 3/ < or = 50% Deprec Basis 3/ < or = 50% Recovery Period 3/ < or = 50% Convention 3/ < or = 50% Deprec Deduction 3/ < or - 50% Total Depreciation Total Sect 179 Expense Business Miles 1 Commuting Miles 1 Other Personal Miles 1 Total Miles 1 Business Miles 2 Depreciation and Amortization Form Ref. ---27(f)2 27(g)2 Length -----2 3 Field Description ----------------N Values: "HY", "MM", "MQ", "PRE" or blank N AN DT R N N N Values: "HY", "MM", "MQ", "PRE" or blank N N N N or "STMbnn" N N N N Part II Page 273 Section 4 1150 1170 1180 1190 1200 1210 1215 1220 27(h)2 27(a)3 27(b)3 27(c)3 27(d)3 27(e)3 27(f)3 27(g)3 12 10 8 6 12 12 2 3 1230 1500 1600 *1620 +1630 +1640 +1645 1660 27(h)3 28(h) 29(i) 30(a) 31(a) 32(a) 33(a) 30(b) August 30, 2002 12 12 12 6 6 6 6 6 Publication 1346 FORM 4562 PAGE 2 Field Identification No. ----- -------------1670 1680 1685 1700 1710 1720 1725 1740 1750 1760 1765 1780 1790 1800 1805 1820 1830 1840 1845 *1850 +1860 Commuting Miles 2 Other Personal Miles 2 Total Miles 2 Business Miles 3 Commuting Miles 3 Other Personal Miles 3 Total Miles 3 Business Miles 4 Commuting Miles 4 Other Personal Miles 4 Total Miles 4 Business Miles 5 Commuting Miles 5 Other Personal Miles 5 Total Miles 5 Business Miles 6 Commuting Miles 6 Other Personal Miles 6 Total Miles 6 Vehicle Available Yes 1 Vehicle Available No 1 Depreciation and Amortization Form Ref. ---31(b) 32(b) 33(b) 30(c) 31(c) 32(c) 33(c) 30(d) 31(d) 32(d) 33(d) 30(e) 31(e) 32(e) 33(e) 30(f) 31(f) 32(f) 33(f) 34(a) 34(a) Length -----6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 1 Field Description ----------------N N N N N N N N N N N N N N N N N N N "X", "STMbnn" or blank "X" or blank Publication 1346 August 30, 2002 Part II Page 274 Section 4 FORM 4562 PAGE 2 Field Identification No. ----- -------------+1863 Primary Use by Over 5% Owner/Relative Yes 1 Primary Use by Over 5% Owner/Relative No 1 Another Vehicle Yes 1 Another Vehicle No 1 Vehicle Available Yes 2 Vehicle Available No 2 Primary Use by Over 5% Owner/Relative Yes 2 Primary Use by Over 5% Owner/Relative No 2 Another Vehicle Yes 2 Another Vehicle No 2 Vehicle Available Yes 3 Vehicle Available No 3 Primary Use by Over 5% Owner/Relative Yes 3 Primary Use by Over 5% Owner/Relative No 3 Another Vehicle Yes 3 Another Vehicle No 3 Depreciation and Amortization Form Ref. ---35(a) Length -----1 Field Description ----------------"X" or blank +1867 35(a) 1 "X" or blank +1870 +1880 1910 1920 1923 36(a) 36(a) 34(b) 34(b) 35(b) 1 1 1 1 1 "X" or blank "X" or blank "X" or blank "X" or blank "X" or blank 1927 35(b) 1 "X" or blank 1930 1940 1970 1980 1983 36(b) 36(b) 34(c) 34(c) 35(c) 1 1 1 1 1 "X" or blank "X" or blank "X" or blank "X" or blank "X" or blank 1987 35(c) 1 "X" or blank 1990 2000 36(c) 36(c) 1 1 "X" or blank "X" or blank Part II Page 275 Section 4 Publication 1346 August 30, 2002 FORM 4562 PAGE 2 Field Identification No. ----- -------------2030 2040 2043 Vehicle Available Yes 4 Vehicle Available No 4 Primary Use by Over 5% Owner/Relative Yes 4 Primary Use by Over 5% Owner/Relative No 4 Another Vehicle Yes 4 Another Vehicle No 4 Vehicle Available Yes 5 Vehicle Available No 5 Primary Use by Over 5% Owner/Relative Yes 5 Primary Use by Over 5% Owner/Relative No 5 Another Vehicle Yes 5 Another Vehicle No 5 Vehicle Available Yes 6 Vehicle Available No 6 Primary Use by Over 5% Owner/Relative Yes 6 Depreciation and Amortization Form Ref. ---34(d) 34(d) 35(d) Length -----1 1 1 Field Description ----------------"X" or blank "X" or blank "X" or blank 2047 35(d) 1 "X" or blank 2050 2060 2090 2100 2103 36(d) 36(d) 34(e) 34(e) 35(e) 1 1 1 1 1 "X" or blank "X" or blank "X" or blank "X" or blank "X" or blank 2107 35(e) 1 "X" or blank 2110 2120 2150 2160 2163 36(e) 36(e) 34(f) 34(f) 35(f) 1 1 1 1 1 "X" or blank "X" or blank "X" or blank "X" or blank "X" or blank Publication 1346 August 30, 2002 Part II Page 276 Section 4 FORM 4562 PAGE 2 Field Identification No. ----- -------------2167 Primary Use by Over 5% Owner/Relative No 6 Another Vehicle Yes 6 Another Vehicle No 6 Commuting Statement Yes Commuting Statement No Non-Commuting Statement Yes Non-Commuting Statement No All Personal Use Yes All Personal Use No More Than 5 Yes More Than 5 No Meet Requirements Yes Meet Requirements No Descrip of Costs 1 Date Amortiz. 1 Amortizable Amt 1 Code Section 1 Amortization Period or Percentage 1 Amortization 1 Descrip of Costs 2 Date Amortiz. 2 Depreciation and Amortization Form Ref. ---35(f) Length -----1 Field Description ----------------"X" or blank 2170 2180 2190 2200 2210 2220 2230 2240 2250 2260 2270 2280 *2290 +2300 +2310 +2320 +2330 +2340 2350 2360 36(f) 36(f) 37 37 38 38 39 39 40 40 41 41 42(a)1 42(b)1 42(c)1 42(d)1 42(e)1 42(f)1 42(a)2 42(b)2 August 30, 2002 1 1 1 1 1 1 1 1 1 1 1 1 20 8 12 9 6 12 20 8 "X" or blank "X" or blank "X" or blank "X" or blank "X" or blank "X" or blank "X" or blank "X" or blank "X" or blank "X" or blank "X" or blank "X" or blank AN or "STMbnn" DT N AN AN N AN DT Part II Page 277 Section 4 Publication 1346 FORM 4562 PAGE 2 Field Identification No. ----- -------------2370 2380 2390 2400 2410 Amortizable Amt 2 Code Section 2 Amortization Period or Percentage 2 Amortization 2 Amortization PreCurrent Year Property Total Amortization Depreciation and Amortization Form Ref. ---42(c)2 42(d)2 42(e)2 42(f)2 43 Length -----12 9 6 12 12 Field Description ----------------N AN AN N N 2420 44 12 N Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 278 Section 4 FORM 4563 Field Identification No. ----- -------------Byte Count Exclusion of Income For Bona Fide Residents ... Form Ref. ---Length -----4 Field Description ----------------"0716" for Fixed; "nnnn" for variable format Value "****" Value "FRMbbb" "4563bb" "PG01b" N (Primary SSN) Start of Record Sentinel 0000 0001 0002 0003 Record ID Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number Name of Taxpayer with Exclusion Taxpayer SSN Date Bona Fide Residence Began Date Bona Fide Residence Ended Rented Room Rented House or Apartment Quarters Furnished by Employer Purchased Home Family Living with You - Yes Family Living with You - No 2 2 2 2 3a 3a 1 4 6 6 5 9 0004 0005 0010 0020 0030 0040 0050 0060 0070 0080 0090 0100 1 7 35 9 8 8 1 1 1 1 1 1 blank N 0000001 - 0000002 AN N DT MMDDYYYY or Blank, and literal "CONTINUE" "X" or blank "X" or blank "X" or blank "X" or blank "X" or blank "X" or blank Publication 1346 August 30, 2002 Part II Page 279 Section 4 FORM 4563 Field Identification No. ----- -------------*0110 Yes - Relationship Exclusion of Income For Bona Fide Residents ... Form Ref. ---3b Length -----11 Field Description ----------------Values: "CHILD", "FOSTERCHILD", "GRANDCHILD", "GRANDPARENT", "PARENT", "BROTHER", "SISTER", "AUNT", "UNCLE", "NEPHEW", "NIECE", "NONE", "SON", "DAUGHTER", "SPOUSE", "OTHER" or "STMbnn" AN "X" or blank +0120 0130 Period Maintain Home Outside American Samoa - Yes Maintain Home Outside American Samoa - No Home Address Home Status Occupant Name Occupant Relationship 3b 4a 25 1 0140 4a 1 "X" or blank *0150 +0160 *+0170 +0180 4b 4b 4b 4b 60 6 35 11 AN or "STMbnn" "RENTED" or blank AN or "STMbnn" Values: "CHILD", "FOSTERCHILD", "GRANDCHILD", "GRANDPARENT", "PARENT", "BROTHER", "SISTER", "AUNT", "UNCLE", "NEPHEW", "NIECE", "NONE", "SON", DAUGHTER", "SPOUSE", "OTHER" AN, Allowable Special Characters are: Space (), less-than (<), hyphen (-), and ampersand (&) 0190 Employer's Name 5 45 Publication 1346 August 30, 2002 Part II Page 280 Section 4 FORM 4563 Field Identification No. ----- -------------0200 Employer's Address Exclusion of Income For Bona Fide Residents ... Form Ref. ---5 Length -----70 Field Description ----------------AN, Allowable Special Characters are: space (), slash (/), hyphen (-), and literal "NONE" DT or blank, "STMbnn" DT or blank "nnn" or blank AN or blank DT or blank DT or blank "nnn" or blank AN or blank DT or blank DT or blank "nnn" or blank AN or blank DT or blank DT or blank *0210 +0220 +0230 +0240 0250 0260 0270 0280 0290 0300 0310 0320 0330 0340 Date Left American Samoa - 1 Date Returned To American Samoa - 1 Number of Days Absent - 1 Reason for Absence 1 Date Left American Samoa - 2 Date Returned To American Samoa - 2 Number of Days Absent - 2 Reason for Absence 2 Date Left American Samoa - 3 Date Returned To American Samoa - 3 Number of Days Absent - 3 Reason for Absence 3 Date Left American Samoa - 4 Date Returned to American Samoa - 4 6a-1 6b-1 6c-1 6d-1 6a-2 6b-2 6c-2 6d-2 6a-3 6b-3 6c-3 6d-3 6a-4 6b-4 8 8 3 35 8 8 3 35 8 8 3 35 8 8 Publication 1346 August 30, 2002 Part II Page 281 Section 4 FORM 4563 Field Identification No. ----- -------------0350 0360 0370 0380 0390 0400 0410 0420 0430 *0440 +0445 0450 0460 Number of Days Absent - 4 Reason for Absence 4 Wages, Salaries, Tips, etc. Taxable Interest Ordinary Dividends Business Income Capital Gain Rental Real Estate, Royalties, etc Farm Income Type of Other Income Amount of Other Income Total Other Income Amount Excluded From Gross Income Exclusion of Income For Bona Fide Residents ... Form Ref. ---6c-4 6d-4 7 8 9 10 11 12 13 14 14 14 15 Length -----3 35 12 12 12 12 12 12 12 6 12 12 12 Field Description ----------------"nnn" or blank AN or blank N N N N N N N "AN", "MSA", "LTC", or "STMbnn" or blank N N N Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 282 Section 4 FORM 4684 PAGE 1 Field Identification No. ----- -------------Byte Count Casualties and Thefts Form Ref. ---Length -----4 Field Description ----------------"0759" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" "4684bb" "PG01b" N (Primary SSN) Start of Record Sentinel 0000 0001 0002 0003 Record ID Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number Property Desc A (1) Cost or Other Basis (1) Insurance (1) Gain from Casualty or Theft (1) Fair Market Value Before Theft (1) Fair Market Value After Theft (1) Line 5 minus Line 6 (1) Smaller of Line 2 or Line 7 (1) Line 8 minus line 3 (1) Property Desc B (2) Cost or Other Basis (2) 1A 2A 3A 4A 5A 6A 7A 8A 9A 1B 2B August 30, 2002 4 6 6 5 9 0004 0005 *0010 +0020 +0030 *+0040 +0050 +0060 +0070 +0080 +0090 0100 0110 1 7 56 12 12 12 12 12 12 12 12 56 12 blank N 0000001 AN or "STMbnn" N N N or "STMbnn" N N N N N AN N Part II Page 283 Section 4 Publication 1346 FORM 4684 PAGE 1 Field Identification No. ----- -------------0120 0130 0140 0150 0160 0170 0180 0190 0200 0210 0220 0230 0240 0250 0260 0270 0280 0290 Insurance (2) Gain from Casualty or Theft (2) Fair Market Value Before Theft (2) Fair Market Value After Theft (2) Line 5 minus Line 6 (2) Smaller of Line 2 or Line 7 (2) Line 8 minus Line 3 (2) Property Desc C (3) Cost or Other Basis (3) Insurance (3) Gain from Casualty or Theft (3) Fair Market Value Before Theft (3) Fair Market Value After Theft (3) Line 5 minus Line 6 (3) Smaller of Line 2 or Line 7 (3) Line 8 minus Line 3 (3) Property Desc D (4) Cost or Other Basis (4) Casualties and Thefts Form Ref. ---3B 4B 5B 6B 7B 8B 9B 1C 2C 3C 4C 5C 6C 7C 8C 9C 1D 2D August 30, 2002 Length -----12 12 12 12 12 12 12 56 12 12 12 12 12 12 12 12 56 12 Field Description ----------------N N N N N N N AN N N N N N N N N AN N Part II Page 284 Section 4 Publication 1346 FORM 4684 PAGE 1 Field Identification No. ----- -------------0300 0310 0320 0330 0340 0350 0360 0370 0380 0390 0400 0410 0420 0430 0440 0450 Insurance (4) Gain from Casualty or Theft (4) Fair Market Value Before Theft (4) Fair Market Value After Theft (4) Line 5 minus Line 6 (4) Smaller of Line 2 or Line 7 (4) Line 8 minus Line 3 (4) Total Casualty or Theft Loss Casualty or Theft Loss Limit Net Casualty or Theft Loss Total Line 12 Amount Total Casualty or Theft Gain Line 14 more than Line 13 Line 13 more than Line 14 10% of Adjusted Gross Income Line 16 minus Line 17 Casualties and Thefts Form Ref. ---3D 4D 5D 6D 7D 8D 9D 10D 11D 12D 13D 14D 15D 16D 17D 18D Length -----12 12 12 12 12 12 12 12 12 12 12 12 12 12 12 12 Field Description ----------------N N N N N N N N N N N N N N N N Record Terminus Character Publication 1346 August 30, 2002 1 Value "#" Part II Page 285 Section 4 FORM 4684 PAGE 2 Field Identification No. ----- -------------Byte Count Casualties and Thefts Form Ref. ---Length -----4 Field Description ----------------"1075" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" "4684bb" "PG02b" N (Primary SSN) Start of Record Sentinel 0460 0461 0462 0463 Record ID Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number Property Desc A (1) Cost or Adj Basis (1) Insurance (1) Gain from Casualty or Theft (1) Fair Market Value Before Theft (1) Fair Market Value After Theft (1) Net Fair Market (1) Property Basis or Net Fair Market (1) Net Property Loss (1) Property Desc B (2) Cost or Adj Basis (2) 19A 20A 21A 22A 23A 24A 25A 26A 27A 19B 20B August 30, 2002 4 6 6 5 9 0464 0465 *0470 +0480 +0490 *+0500 +0510 +0520 +0530 +0540 +0550 0560 0570 1 7 56 12 12 12 12 12 12 12 12 56 12 blank N 0000001 AN or "STMbnn" N N N or "STMbnn" N N N N N AN N Part II Page 286 Section 4 Publication 1346 FORM 4684 PAGE 2 Field Identification No. ----- -------------0580 0590 0600 0610 0620 0630 0640 0650 0660 0670 0680 0690 0700 0710 0720 0730 0740 0750 0760 Insurance (2) Gain from Casualty or Theft (2) Fair Market Value Before Theft (2) Fair Market Value After Theft (2) Net Fair Market (2) Property Basis or Net Fair Market (2) Net Property Loss (2) Property Desc C (3) Cost or Adj Basis (3) Insurance (3) Gain from Casualty or Theft (3) Fair Market Value Before Theft (3) Fair Market Value After Theft (3) Net Fair Market (3) Property Basis or Net Fair Market (3) Net Property Loss (3) Property Desc D (4) Cost or Adj Basis (4) Insurance (4) Casualties and Thefts Form Ref. ---21B 22B 23B 24B 25B 26B 27B 19C 20C 21C 22C 23C 24C 25C 26C 27C 19D 20D 21D August 30, 2002 Length -----12 12 12 12 12 12 12 56 12 12 12 12 12 12 12 12 56 12 12 Field Description ----------------N N N N N N N AN N N N N N N N N AN N N Part II Page 287 Section 4 Publication 1346 FORM 4684 PAGE 2 Field Identification No. ----- -------------0770 0780 0790 0800 0810 0820 0830 *0840 +0850 +0860 Gain from Casualty or Theft (4) Fair Market Value Before Theft (4) Fair Market Value After Theft (4) Net Fair Market (4) Property Basis or Net Fair Market (4) Net Property Loss (4) Total Casualty or Theft Loss Short - Casualty or Theft Desc (1) Short - Trade or Rental Property (1) Short - Income Producing Property (1) Short - Gains from Casualties or Thefts (1) Short - Casualty or Theft Desc (2) Short - Trade or Rental Property (2) Short - Income Producing Property (2) Short - Gains from Casualties or Thefts (2) Short - Totals Trade, Business Casualties and Thefts Form Ref. ---22D 23D 24D 25D 26D 27D 28D 29(a) 29(b)(i) 29(b)(ii) Length -----12 12 12 12 12 12 12 25 12 12 Field Description ----------------N N N N N N N AN or "STMbnn" N N +0870 29(b)(c) 12 N 0880 0890 0900 29(a) 29(b)(i) 29(b)(ii) 25 12 12 AN N N 0910 29(c) 12 N 0920 30(b)(i) August 30, 2002 12 N Part II Page 288 Section 4 Publication 1346 FORM 4684 PAGE 2 Field Identification No. ----- -------------0930 Short - Totals Income Producing Property Short - Totals Gains from Casulties or Thefts PAL Indicator Net Gain or (Loss) PAL Indicator Amount on Line 30(b)(ii) Casualty or Theft Gains from F4797 Long - Casualty or Theft Desc (1) Long - Trade Rental Property (1) Long - Income Producing Property (1) Long - Gains from Casualties or Thefts(1) Long - Casualty or Theft Desc (2) Long - Trade Rental Property (2) Long - Income Producing Property (2) Long - Gains from Casualties or Thefts (2) Long - Total Losses Trade, Business Casualties and Thefts Form Ref. ---30(b)(ii) Length -----12 Field Description ----------------N 0940 30(c) 12 N 0948 0950 0958 0960 0970 *0980 +0990 +1000 31(c) 31(c) 32(c) 32(c) 33(c) 34(a) 34(b)(i) 34(b)(ii) 3 12 3 12 12 25 12 12 "PAL" or blank N "PAL" or blank N N AN or "STMbnn" N N +1010 34(c) 12 N 1020 1030 1040 34(a) 34(b)(i) 34(b)(ii) 25 12 12 AN N N 1050 34(c) 12 N 1060 35(b)(i) August 30, 2002 12 N Part II Page 289 Section 4 Publication 1346 FORM 4684 PAGE 2 Field Identification No. ----- -------------1070 Long - Total Losses Income Producing Property Long - Total Gains Long - Line 35 Amounts cols (b)(i) and (b)(ii) PAL Indicator Net Gain or (Loss) PAL Indicator Line 35 Amount Col (b)(ii) Loss equal to or smaller than Gain Casualties and Thefts Form Ref. ---35(b)(ii) Length -----12 Field Description ----------------N 1080 1090 36(c) 37(c) 12 12 N N 1098 1100 1108 1110 1120 38(a) 38(a) 38(b) 38(b) 39 3 12 3 12 12 "PAL" or blank N "PAL" or blank N N Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 290 Section 4 FORM 4797 PAGE 1 Field Identification No. ----- -------------Byte Count Sales of Business Property Form Ref. ---Length -----4 Field Description ----------------"0894" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" "4797bb" "PG01b" N (Primary SSN) Start of Record Sentinel 0000 0001 0002 0003 Record ID Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number Current Year Gross Proceeds Property Desc 1 Date Acquired 1 Date Sold 1 Gross Sales Price 1 Depreciation Allwd 1 Cost/Other Basis 1 Property Gain/Loss 1 Property Desc 2 Date Acquired 2 Date Sold 2 Gross Sales Price 2 Depreciation Allwd 2 Cost/Other Basis 2 1 2a(1) 2b(1) 2c(1) 2d(1) 2e(1) 2f(1) 2g(1) 2a(2) 2b(2) 2c(2) 2d(2) 2e(2) 2f(2) August 30, 2002 4 6 6 5 9 0004 0005 0030 *0040 +0050 +0060 +0070 +0080 +0090 +0095 0120 0130 0140 0150 0160 0170 1 7 12 15 8 8 12 12 12 12 15 8 8 12 12 12 blank N 0000001 N AN or "STMbnn" DT or "INHERIT" or blank DT N or "LIKE-KIND" N N N AN DT or "INHERIT" or blank DT N or "LIKE-KIND" N N Part II Page 291 Section 4 Publication 1346 FORM 4797 PAGE 1 Field Identification No. ----- -------------0175 0200 0210 0220 0230 0240 0250 0255 0280 0290 0300 0310 0320 0330 0335 0440 0450 0456 0461 0482 0500 Property Gain/Loss 2 Property Desc 3 Date Acquired 3 Date Sold 3 Gross Sales Price 3 Depreciation Allwd 3 Cost/Other Basis 3 Property Gain/Loss 3 Property Desc 4 Date Acquired 4 Date Sold 4 Gross Sales Price 4 Depreciation Allwd 4 Cost/Other Basis 4 Property Gain/Loss 4 Gain/Loss (Form 4684 Sec B Gain) Gain/Loss (Form 6252 Sec 1231) Gain/Loss (Form 8824 Sec 1231) Gain from Part III Tot Property Gain/ Loss Nonrecaptured Net Sec 1231 Prior Year Losses Tot Gain/Loss (Sec 1231 Recapture) Sales of Business Property Form Ref. ---2g(2) 2a(3) 2b(3) 2c(3) 2d(3) 2e(3) 2f(3) 2g(3) 2a(4) 2b(4) 2c(4) 2d(4) 2e(4) 2f(4) 2g(4) 3(g) 4(g) 5(g) 6(g) 7(g) 8(g) Length -----12 15 8 8 12 12 12 12 15 8 8 12 12 12 12 12 12 12 12 12 12 Field Description ----------------N AN DT or "INHERIT" or blank DT N or "LIKE-KIND" N N N AN DT or "INHERIT" or blank DT N or "LIKE-KIND" N N N N N N or blank N N N 0511 9(g) August 30, 2002 12 N Part II Page 292 Section 4 Publication 1346 FORM 4797 PAGE 1 Field Identification No. ----- -------------*0520 +0530 +0540 +0550 +0560 +0570 +0575 0600 0610 0620 0630 0640 0650 0655 0680 0690 0700 0710 0720 0730 0735 0760 0770 0780 Property Held Desc 1 Date Acquired 1 Date Sold 1 Gross Sales Price 1 Depreciation Allwd 1 Cost/Other Basis 1 Property Held Gain/ Loss 1 Property Held Desc 2 Date Acquired 2 Date Sold 2 Gross Sales Price 2 Depreciation Allwd 2 Cost/Other Basis 2 Property Held Gain/ Loss 2 Property Held Desc 3 Date Acquired 3 Date Sold 3 Gross Sales Price 3 Depreciation Allwd 3 Cost/Other Basis 3 Property Held Gain/ Loss 3 Property Held Desc 4 Date Acquired 4 Date Sold 4 Sales of Business Property Form Ref. ---10a(1) 10b(1) 10c(1) 10d(1) 10e(1) 10f(1) 10g(1) 10a(2) 10b(2) 10c(2) 10d(2) 10e(2) 10f(2) 10g(2) 10a(3) 10b(3) 10c(3) 10d(3) 10e(3) 10f(3) 10g(3) 10a(4) 10b(4) 10c(4) August 30, 2002 Length -----15 8 8 12 12 12 12 15 8 8 12 12 12 12 15 8 8 12 12 12 12 15 8 8 N N AN DT or "INHERIT" or blank DT Part II Page 293 Section 4 N N AN DT or "INHERIT" or blank DT N N N N AN DT or "INHERIT" or blank DT N N Field Description ----------------AN or "STMbnn" DT or "INHERIT" or blank DT N N Publication 1346 FORM 4797 PAGE 1 Field Identification No. ----- -------------0790 0800 0810 0815 0925 0930 Gross Sales Price 4 Depreciation Allwd 4 Cost/Other Basis 4 Property Held Gain/ Loss 4 Total Ordinary Loss Total Property Gain or Nonrecap Loss Part I Gain from Part III Summary PAL Indicator Net Gain/Loss from Form 4684 Ordinary Gain from Form 6252 Form 8824 Ordinary Gain/Loss for Entire Yr Recapture Sec 179 Net Ordinary Gain/ Loss Form 4684 Loss Redetermined Gain/ Loss Sales of Business Property Form Ref. ---10d(4) 10e(4) 10f(4) 10g(4) 11(g) 12(g) Length -----12 12 12 12 12 12 N N N N Field Description ----------------N N 0940 0948 0955 0970 0974 13(g) 14 14(g) 15(g) 16(g) 12 3 12 12 12 N "PAL" or blank N N N or blank 0980 1010 1020 1030 17(g) 18(g) 18b(1) 18b(2) 12 12 12 12 N N N N Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 294 Section 4 FORM 4797 PAGE 2 Field Identification No. ----- -------------Byte Count Sales of Business Property Form Ref. ---Length -----4 Field Description ----------------"1383" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" "4797bb" "PG02b" N (Primary SSN) Start of Record Sentinel 1040 1041 1042 1043 Record ID Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number Property Description (1) Date Acquired (1) Date Sold (1) Gross Sales Price (1) Cost Or Other Basis Plus Exp of Sale (1) Depreciation Allowed (1) Adjusted Basis (1) Total Gain (1) Property Description (2) Date Acquired (2) Date Sold (2) Gross Sales Price (2) 19(A) 19(A) 19(A) 20(A) 21(A) 22(A) 23(A) 24(A) 19(B) 19(B) 19(B) 20(B) August 30, 2002 4 6 6 5 9 1044 1045 *1050 +1060 +1070 +1080 +1090 *+1100 +1110 +1120 1130 1140 1150 1160 1 7 40 8 8 12 12 12 12 12 40 8 8 12 blank N 0000001 AN or "STMbnn" DT DT N N N or "STMbnn" N N AN DT DT N Part II Page 295 Section 4 Publication 1346 FORM 4797 PAGE 2 Field Identification No. ----- -------------1170 1180 1190 1200 1210 1220 1230 1240 1250 1260 1270 1280 1290 1300 1310 1320 1330 1340 1350 1360 Cost Or Other Basis Plus Exp of Sale (2) Depreciation Allowed (2) Adjusted Basis (2) Total Gain (2) Property Description (3) Date Acquired (3) Date Sold (3) Gross Sales Price (3) Cost Or Other Basis Plus Exp of Sale (3) Depreciation Allowed (3) Adjusted Basis (3) Total Gain (3) Property Description (4) Date Acquired (4) Date Sold (4) Gross Sales Price (4) Cost Or Other Basis Plus Exp of Sale (4) Depreciation Allowed (4) Adjusted Basis (4) Total Gain (4) Sales of Business Property Form Ref. ---21(B) 22(B) 23(B) 24(B) 19(C) 19(C) 19(C) 20(C) 21(C) 22(C) 23(C) 24(C) 19(D) 19(D) 19(D) 20(D) 21(D) 22(D) 23(D) 24(D) August 30, 2002 Length -----12 12 12 12 40 8 8 12 12 12 12 12 40 8 8 12 12 12 12 12 Field Description ----------------N N N N AN DT DT N N N N N AN DT DT N N N N N Part II Page 296 Section 4 Publication 1346 FORM 4797 PAGE 2 Field Identification No. ----- -------------*1370 +1380 Depreciation For Property (1) Section 1245 Property Accepted Amount (1) Depreciation For Property (2) Section 1245 Property Accepted Amount (2) Depreciation For Property (3) Section 1245 Property Accepted Amount (3) Depreciation For Property (4) Section 1245 Property Accepted Amount (4) Additional Depreciation After 12/31/75 (1) Applicable Pcntg Amt (1) Gain Less Depreciation After 12/31/75 (1) Additional Deprec Aft 12/31/69, Bef 1/ 1/76 (1) Applicable Pcntg Amt (1) Section 291 Amount (1) Sales of Business Property Form Ref. ---25a (A) 25b (A) Length -----12 12 Field Description ----------------N or "STMbnn" N 1390 1400 25a (B) 25b (B) 12 12 N N 1410 1420 25a (C) 25b (C) 12 12 N N 1430 1440 25a (D) 25b (D) 12 12 N N *1450 26a (A) 12 N or "STMbnn" +1460 +1470 26b (A) 26c (A) 12 12 N N +1480 26d (A) 12 N *+1490 +1500 26e (A) 26f (A) 12 12 N or "STMbnn" NO ENTRY Publication 1346 August 30, 2002 Part II Page 297 Section 4 FORM 4797 PAGE 2 Field Identification No. ----- -------------+1510 1520 Itemized Depreciation (1) Additional Depreciation After 12/31/75 (2) Applicable Pcntg Amt (2) Gain Less Depreciation After 12/31/75 (2) Additional Deprec Aft 12/31/69, Bef 1/ 1/76 (2) Applicable Pcntg Amt (2) Section 291 Amount (2) Itemized Depreciation (2) Additional Depreciation After 12/31/75 (3) Applicable Pcntg Amt (3) Gain Less Depreciation After 12/31/75 (3) Additional Deprec Aft 12/31/69, Bef 1/ 1/75 (3) Applicable Pcntg Amt (3) Section 291 Amount (3) Itemized Depreciation (3) Sales of Business Property Form Ref. ---26g (A) 26a (B) Length -----12 12 Field Description ----------------N N 1530 1540 26b (B) 26c (B) 12 12 N N 1550 26d (B) 12 N 1560 1570 1580 1590 26e (B) 26f (B) 26g (B) 26a (C) 12 12 12 12 N NO ENTRY N N 1600 1610 26b (C) 26c (C) 12 12 N N 1620 26d (C) 12 N 1630 1640 1650 26e (C) 26f (C) 26g (C) August 30, 2002 12 12 12 N NO ENTRY N Part II Page 298 Section 4 Publication 1346 FORM 4797 PAGE 2 Field Identification No. ----- -------------1660 Additional Depreciation After 12/31/75 (4) Applicable Pcntg Amt (4) Gain Less Depreciation After 12/31/75 (4) Additional Deprec Aft 12/31/69, Bef 1/ 1/75 (4) Applicable Pctng Amt (4) Section 291 Amount (4) Itemized Depreciation (4) Soil Water Land Clearing Exp (1) Applicable Pcntg Amt (1) Smaller of Total Gain or Applicable Pcntg (1) Soil Water Land Clearing Exp (2) Applicable Pcntg Amt (2) Smaller of Total Gain or Applicable Pcntg (2) Soil Water Land Clearing Exp (3) Applicable Pcntg Amt (3) Sales of Business Property Form Ref. ---26a (D) Length -----12 Field Description ----------------N 1670 1680 26b (D) 26c (D) 12 12 N N 1690 26d (D) 12 N 1700 1710 1720 *1730 +1740 +1750 26e (D) 26f (D) 26g (D) 27a (A) 27b (A) 27c (A) 12 12 12 12 12 12 N NO ENTRY N N or "STMbnn" N N 1760 1770 1780 27a (B) 27b (B) 27c (B) 12 12 12 N N N 1790 1800 27a (C) 27b (C) August 30, 2002 12 12 N N Part II Page 299 Section 4 Publication 1346 FORM 4797 PAGE 2 Field Identification No. ----- -------------1810 Smaller of Total Gain or Applicable Pcntg (3) Soil Water Land Clearing Exp (4) Applicable Pcntg Amt (4) Smaller of Total Gain or Applicable Pcntg (4) Intangible Drilling & Devlpmt Costs (1) Smaller of Total Gain or Intangible (1) Intangible Drilling & Devlpmt Costs (2) Smaller of Total Gain or Intangible (2) Intangible Drilling & Devlpmt Cost (3) Smaller of Total Gain or Intangible (3) Intangible Drilling & Devlpmt Costs (4) Smaller of Total Gain or Intangible (4) Applicable Pcntg Excluded From Income (1) Smaller Tot Gain/ Applicable Excluded from Inc (1) Sales of Business Property Form Ref. ---27c (C) Length -----12 Field Description ----------------N 1820 1830 1840 27a (D) 27b (D) 27c (D) 12 12 12 N N N *1850 +1860 28a (A) 28b (A) 12 12 N or "STMbnn" N 1870 1880 28a (B) 28b (B) 12 12 N N 1890 1900 28a (C) 28b (C) 12 12 N N 1910 1920 28a (D) 28b (D) 12 12 N N *1930 29a (A) 12 N or "STMbnn" +1940 29b (A) 12 N Publication 1346 August 30, 2002 Part II Page 300 Section 4 FORM 4797 PAGE 2 Field Identification No. ----- -------------1950 Applicable Pcntg Excluded From Income (2) Smaller Tot Gain/ Applicable Excluded from Inc (2) Applicable Pcntg Excluded From Income (3) Smaller Tot Gain/ Applicable Excluded from Inc (3) Applicable Pcntg Excluded From Income (4) Smaller Tot Gain/ Applicable Excluded from Inc (4) Total Gains For All Properties Part III Exclusions Part III Net Gains Sect 179 Expense Ded Sect 280F Rcvry Ded Sect 179 Depreciation or Recovery Deduction Sect 280F Depreciation or Recovery Deduction Sect 179 Recapture Amount Sect 280F Recapture Amount Sales of Business Property Form Ref. ---29a (B) Length -----12 Field Description ----------------N 1960 29b (B) 12 N 1970 29a (C) 12 N 1980 29b (C) 12 N 1990 29a (D) 12 N 2000 29b (D) 12 N 2010 2020 2030 *2070 +2080 2090 30 31 32 33a 33b 34a 12 12 12 12 12 12 N N N or "NA" N or "STMbnn" N N 2100 34b 12 N 2110 2120 35a 35b 12 12 N N Publication 1346 August 30, 2002 Part II Page 301 Section 4 FORM 4797 PAGE 2 Field Identification No. ----- -------------- Sales of Business Property Form Ref. ---Length -----Field Description ----------------- Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 302 Section 4 FORM 4835 Field Identification No. ----- -------------Byte Count Farm Rental Income and Expenses Form Ref. ---Length -----4 Field Description ----------------"0753" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" "4835bb" "PG01b" N (Primary SSN) Start of Record Sentinel 0000 0001 0002 0003 Record ID Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number EIN Farm ParticipationYes Farm ParticipationNo Income Production of Livestock Total Coop Distribution Taxable Amount Agricultural Program Payments Taxable Amount Commodity Credit Loans Explan Commodity Credit Loans Amt Commodity Credit Loans Forfeited A A 1 2a 2b 3a 3b 4a 4a 4b August 30, 2002 4 6 6 5 9 0004 0005 0010 0030 0035 0050 0060 0075 0090 0095 @0100 0110 0112 1 7 9 1 1 12 12 12 12 12 6 12 12 blank N 0000001 - 0000004 N or blank "X" or blank "X" or blank N N N N N "STMbnn" or blank N N Part II Page 303 Section 4 Publication 1346 FORM 4835 Field Identification No. ----- -------------0115 0120 0122 @0123 0124 0126 0140 0150 0165 0170 0180 0185 0190 Taxable Amount Crop Insur Proceeds Amt Taxable Amount Election to Def Explanation Election to Defer Ind Deferred Amount Other Income, Fed & State Tax Cr Gross Farm Rents Car and Truck Expense Chemicals Conservation Expenses Custom Hire (Machine Work) Depreciation/Sec. 179 Expense Deduction Employee Benefit Program Feed Purchased Fertilizer and lime Freight, Trucking Gasoline, fuel oil Insurance Form 1098 Explanation Farm Rental Income and Expenses Form Ref. ---4c 5a 5b 5c 5c 5d 6 7 8 9 10 11 12 Length -----12 12 12 6 1 12 12 12 12 12 12 12 12 Field Description ----------------N N N "STMbnn" or blank "X" or blank N N N N N N N N 0200 0210 0220 0230 0240 0250 @0255 13 14 15 16 17 18 19a August 30, 2002 12 12 12 12 12 12 6 N N N N N N "STMbnn" or blank Part II Page 304 Section 4 Publication 1346 FORM 4835 Field Identification No. ----- -------------0260 @0265 0270 0280 0320 0330 Mortgage Interest Paid 1098 Name/Address Other Interest Labor Hired Pension/ Profitsharing Plans Rent or Lease Deduction Machinery/ Equipment Rent or Lease Deduction Farm/ Pasture/Animals Repairs, Maintenance Seeds, Plants Purchased Storage, Warehousing Supplies Purchased Taxes Utilities Veterinary Fees Medicine Breeding Other Expenses Desc a Other Expense Amount a Other Expenses Desc b Other Expense Amount b Other Expenses Desc c Farm Rental Income and Expenses Form Ref. ---19a Length -----12 6 19b 20 21 22a 12 12 12 12 Field Description ----------------N "STMbnn" or blank N N N N 0335 22b 12 N 0340 0350 0370 0380 0390 0400 0410 *0420 +0430 0440 0450 0460 23 24 25 26 27 28 29 30a 30a 30b 30b 30c 12 12 12 12 12 12 12 15 12 15 12 15 N N N N N N N AN or "STMbnn" N AN N AN Part II Page 305 Section 4 Publication 1346 August 30, 2002 FORM 4835 Field Identification No. ----- -------------0470 0480 0490 0500 0510 0511 0512 0513 0514 0600 Other Expense Amount c Other Expenses Desc d Other Expense Amount d Other Expenses Desc e Other Expense Amount e Other Expenses Desc f Other Expense Amount f Other Expenses Desc g Other Expense Amount g Deductions from Part II (Total Expenses) PAL Indicator Net Farm Rent Profit All is At Risk Ind Some is Not at Risk Net Farm Rent (Loss) Farm Rental Income and Expenses Form Ref. ---30c 30d 30d 30e 30e 30f 30f 30g 30g 31 Length -----12 15 12 15 12 15 12 15 12 12 Field Description ----------------N AN N AN N AN N AN N N 0605 0610 0615 0620 0630 32 32 33a 33b 33c 3 12 1 1 12 "PAL" or blank N "X" or blank "X" or blank N Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 306 Section 4 FORM 4952 Field Identification No. ----- -------------Byte Count Investment Interest Expense Deduction Form Ref. ---Length -----4 Field Description ----------------"0199" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" "4952bb" "PG01b" N (Primary SSN) Start of Record Sentinel 0000 0001 0002 0003 Record ID Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number Investment Interest Expense Carryover Disallowed Interest Expense Total Investment Interest Investment Property Gross Income Disposed Net Gain Disposed Net Capital Gain Non Capital Disp. Gain Investment Capital Gain Investment Income Investment Expenses 1 2 4 6 6 5 9 0004 0005 0010 0020 1 7 12 12 blank N 0000001 N N 0030 0032 0033 0034 0035 0036 0037 0038 3 4a 4b 4c 4d 4e 4f 5 August 30, 2002 12 12 12 12 12 12 12 12 N N N N N N N N Part II Page 307 Section 4 Publication 1346 FORM 4952 Field Identification No. ----- -------------0040 0050 Net Investment income Carry Forward Disallowed Interest Expense Investment Interest Expense Deduction Investment Interest Expense Deduction Form Ref. ---6 7 Length -----12 12 Field Description ----------------N N 0060 8 12 N Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 308 Section 4 FORM 4970 Field Identification No. ----- -------------Byte Count Tax on Accumulation Distribution of... Form Ref. ---Length -----4 Field Description ----------------"0827" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" "4970bb" "PG01b" N (Primary SSN) Start of Record Sentinel 0000 0001 0002 0003 Record ID Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number Name of Person Subject to Trust Tax SSN of Person Subject to Trust Tax Name of Trust Street Address City/State/Zip Employer Identification Number Domestic Indicator Foreign Indicator Beneficiary Date of Birth Number of Trust Distributions Prior Years Dist. Amt. A B C C C D 4 6 6 5 9 0004 0005 0010 0020 0030 0040 0050 0060 1 7 35 9 35 35 33 9 blank N 0000001 A, hyphen (-), less than (<), or blank N AN AN AN N 0070 0080 0090 0100 0110 E E F G 1 August 30, 2002 1 1 8 2 12 "X" or blank "X" or blank DT N N Part II Page 309 Section 4 Publication 1346 FORM 4970 Field Identification No. ----- -------------0120 0130 0140 0150 0160 0170 0180 0190 0200 0210 0220 0230 Pre-Born/21 Dist. Amt. Net Distribution Amount Net Amount Tax Total Amount Tax Exempt Interest Taxable Amount Number of Dist. Years Annual Average of Dist. Amount Quarter Average of Dist. Amount Number of Accounted Earlier Years Recomputing Average Prior Year PreDist. Taxable Income (a) Prior Year PreDist. Taxable Income (b) Prior Year PreDist. Taxable Income (c) Prior Year PreDist. Taxable Income (d) Prior Year PreDist. Taxable Income (e) Mid Year Digits (a) Tax on Accumulation Distribution of... Form Ref. ---2 3 4 5 6 7 8 9 10 11 12 13a Length -----12 12 12 12 12 12 2 12 12 2 12 12 Field Description ----------------N N N N N N N N N N N N 0240 13b 12 N 0250 13c 12 N 0260 13d 12 N 0270 13e 12 N 0280 Part 2(a)2 August 30, 2002 4 N Part II Page 310 Section 4 Publication 1346 FORM 4970 Field Identification No. ----- -------------0290 0300 0310 0320 0330 0340 0350 0360 0370 0380 0390 0400 0410 0420 0430 0440 0450 0460 0470 0480 0490 Mid Year Pre-Dist. Taxable Income (a) Recomputing Average Repeated (a) Recomputed Income (a) Income Tax (a) Pre-Credit Tax (a) Additional Tax (a) Tax Credit (a) Net Tax (a) Alternative Min. Tax Adjustment (a) Adjusted Net Tax (a) Mid Year Digits (b) Mid Year Pre-Dist. Taxable Income (b) Recomputing Average Repeated (b) Recomputed Income (b) Income Tax (b) Pre-Credit Tax (b) Additional Tax (b) Tax Credit (b) Net Tax (b) Alternative Min. Tax Adjustment (b) Adjusted Net Tax (b) Tax on Accumulation Distribution of... Form Ref. ---14a 15a 16a 17a 18a 19a 20a 21a 22a 23a Part 2(b) 14b 15b 16b 17b 18b 19b 20b 21b 22b 23b Length -----12 12 12 12 12 12 12 12 12 12 4 12 12 12 12 12 12 12 12 12 12 Field Description ----------------N N N N N N N N N N N N N N N N N N N N N Part II Page 311 Section 4 Publication 1346 August 30, 2002 FORM 4970 Field Identification No. ----- -------------0500 0510 0520 0530 0540 0550 0560 0570 0580 0590 0600 0610 0620 0630 0640 0670 Mid Year Digits (c) Mid Year Pre-Dist. Taxable Income (c) Recomputing Average Repeated (c) Recomputed Income (c) Income Tax (c) Pre-Credit Tax (c) Additional Tax (c) Tax Credit (c) Net Tax (c) Alternative Min. Tax Adjustment (c) Adjusted Net Tax (c) Adjusted Tax Average Adjusted Tax Accountable Early Years Total Net Amount Tax Repeated Accumulation Dist. Attributable Tax Tax on Accumulation Distribution of... Form Ref. ---Part 2(c) 14c 15c 16c 17c 18c 19c 20c 21c 22c 23c 24 25 26 27 28 Length -----4 12 12 12 12 12 12 12 12 12 12 12 12 12 12 12 Field Description ----------------N N N N N N N N N N N N N N N N Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 312 Section 4 FORM 4972 Field Identification No. ----- -------------Byte Count Tax on Lump-Sum Distributions Form Ref. ---Length -----4 Field Description ----------------"0426" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" "4972bb" "PG01b" N (Primary SSN) Start of Record Sentinel 0000 0001 0002 0003 Record ID Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number Recipient Name Recipient SSN Distribution of Qualified Plan Yes Box Distribution of Qualified Plan No Box Rollover Yes Box Rollover No Box Beneficiary of Qual Participant Yes Box Beneficiary of Qual Participant No Box Qual Age - Five Yr Member Yes Box Qual Age - Five Yr Member No Box 1 4 6 6 5 9 0004 0005 0010 0020 0024 1 7 35 9 1 blank N 0000001 - 0000002 AN N "X" or blank 0026 1 1 "X" or blank 0030 0040 0042 0044 0084 0086 2 2 3 3 4 4 1 1 1 1 1 1 "X" or blank "X" or blank "X" or blank "X" or blank "X" or blank "X" or blank Publication 1346 August 30, 2002 Part II Page 313 Section 4 FORM 4972 Field Identification No. ----- -------------0190 0200 0201 0202 0204 0206 0210 0220 0230 0235 0240 0250 0260 0270 0280 0290 0300 0310 0320 Prior Yr Distribution Yes Box Prior Yr Distribution No Box Beneficiary Distribution Yes Box Beneficiary Distribution No Box NUA Literal NUA Worksheet Amount Form 1099R Capital Gain Capital Gain Election NUA Literal NUA Included Amt. Ordinary Income Death Benefit Exclusion Total Taxable Amount Actuarial Value Adjusted Total Taxable Amount 50% of Adjusted Taxable Amount Net Adjusted Taxable Amount 20% of Net Adjusted Taxable Amt Minimum Distribution Allowance Tax on Lump-Sum Distributions Form Ref. ---5a 5a 5b 5b 6 6 6 7 8 8 8 9 10 11 12 13 14 15 16 Length -----1 1 1 1 3 12 12 12 3 12 12 12 12 12 12 12 12 12 12 Field Description ----------------"X" or blank "X" or blank "X" or blank "X" or blank "NUA" or blank N N N "NUA" or blank N N N N N N N N N N Publication 1346 August 30, 2002 Part II Page 314 Section 4 FORM 4972 Field Identification No. ----- -------------0330 0340 0350 0351 0352 Allowable Taxable Amount Federal Estate Tax Net Taxable Amount Acturial/Adjusted Taxable Amt Ratio Percentage of Minimum Distribution Allowance Adjusted Actuarial Value 10 Yr Method Taxable Amt 10 Yr Method Lump Sum Tax 10 Yr Method Tentative Average Tax 10 Yr Method Taxable Adj Acturial Amt. 10 Yr Method Adjusted Acturial Tax 10 Yr Method Adjusted Average Tax 10 Yr Method Average Tax Multiple Recipient Distribution Literal Total Tax on LumpSum Distribution Tax on Lump-Sum Distributions Form Ref. ---17 18 19 20 21 Length -----12 12 12 6 12 Field Description ----------------N N N R N 0353 0605 0610 0620 22 23 24 25 12 12 12 12 N N N N 0660 26 12 N 0670 27 12 N 0680 0690 0695 0705 28 29 29 30 12 12 3 12 N N "MRD" or blank N Publication 1346 August 30, 2002 Part II Page 315 Section 4 FORM 4972 Field Identification No. ----- -------------- Tax on Lump-Sum Distributions Form Ref. ---Length -----Field Description ----------------- Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 316 Section 4 FORM 5074 Field Identification No. ----- -------------Byte Count Allocation of Individual Inc Tax to Guam or CNMI Form Ref. ---Length -----4 Field Description ----------------"1018" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" "5074bb" "PG01b" N (Primary SSN) Start of Record Sentinel 0000 0001 0002 0003 Record ID Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number Secondary SSN Primary Name Control 4 6 6 5 9 0004 0005 0020 0030 1 7 9 4 blank N 0000001 N (Spouse's Social Security Number) First 4 significant characters of taxpayer's last name, no leading or embedded spaces; allowable characters are alpha, hyphen (-), or space ( ) (see special instructions) First 4 significant characters of spouse's last name, no leading or embedded spaces; allowable characters are alpha, hyphen (-), or space ( ) (see special instructions) AN Taxpayer's name allowable special characters are: space ( ), less-than (<), hyphen (-), and ampersand (&) Part II Page 317 Section 4 0040 Secondary Name Control 4 0050 Name Line 1 35 Publication 1346 August 30, 2002 FORM 5074 Field Identification No. ----- -------------0060 Name Line 2 Allocation of Individual Inc Tax to Guam or CNMI Form Ref. ---Length -----35 Field Description ----------------AN, in care of addressee or address continuation. Allowable special characters are space ( ), ampersand (&), slash (/), hyphen (-), and percent (%) AN, Allowable special characters are space ( ), slash (/), hyphen (-), and Literal "NONE" A, Allowable special characters is space A (Standard Postal Abbreviations) N (left-justified) AN (must be present if filing status = 3, otherwise blank) N N N N N N N 0070 Taxpayer's Address 35 0080 0090 0100 0110 City State Zip Code Spouse's Name 22 2 12 25 0120 0125 0130 0135 0140 0145 0150 Wages, Salaries, Tips (Guam) Wages, Salaries, Tips (CNMI) Taxable Interest (Guam) Taxable Interest (CNMI) Ordinary Dividends (Guam) Ordinary Dividends (CNMI) Refunds, Credits/ Offsets & Local Inc Taxes (Guam) 1 1 2 2 3 3 4 12 12 12 12 12 12 12 Publication 1346 August 30, 2002 Part II Page 318 Section 4 FORM 5074 Field Identification No. ----- -------------0155 Refunds, Credits/ Offsets & Local Inc Taxes (CNMI) Alimony Received (Guam) Alimony Received (CNMI) Business Income or Loss (Guam) Business Income or Loss (CNMI) Capital Gain or Loss (Guam) Capital Gain or Loss (CNMI) Other Gains or Losses (Guam) Other Gains or Losses (CNMI) IRA Distributions (Taxable Amt) (Guam) IRA Distributions (Taxable Amt) (CNMI) Pensions & Annuities (Taxable Amt) (Guam) Pensions & Annuities (Taxable Amt) (CNMI) Rental Real Estate, Royalties etc. (Guam) Rental Real Estate, Royalties etc. (CNMI) Allocation of Individual Inc Tax to Guam or CNMI Form Ref. ---4 Length -----12 Field Description ----------------N 0160 0165 0170 0175 0180 0185 0190 0195 0200 0205 0210 5 5 6 6 7 7 8 8 9 9 10 12 12 12 12 12 12 12 12 12 12 12 N N N N N N N N N N N 0215 10 12 N 0220 11 12 N 0225 11 12 N Publication 1346 August 30, 2002 Part II Page 319 Section 4 FORM 5074 Field Identification No. ----- -------------0230 0235 0240 0245 0250 Farm Income or Loss (Guam) Farm Income or Loss (CNMI) Unemployment Compensation (Guam) Unemployment Compensation (CNMI) Social Security Benefits (Taxable Amt) (Guam) Social Security Benefits (Taxable Amt) (CNMI) Type of Other Income (Guam) Amount of Other Income (Guam) Type of Other Income (CNMI) Amount of Other Income (CNMI) Total Income (Guam) Total Income (CNMI) IRA Deduction (Guam) IRA Deduction (CNMI) Student Loan Interest Deduction (GUAM) Student Loan Interest Deduction (CNMI) Allocation of Individual Inc Tax to Guam or CNMI Form Ref. ---12 12 13 13 14 Length -----12 12 12 12 12 Field Description ----------------N N N N N 0255 14 12 N *0260 +0263 *0265 +0275 0280 0285 0290 0295 0300 15 15 15 15 16 16 17 17 18 12 12 12 12 12 12 12 12 12 AN or "STMbnn" N AN or "STMbnn" N N N N N N 0305 18 12 N Publication 1346 August 30, 2002 Part II Page 320 Section 4 FORM 5074 Field Identification No. ----- -------------0310 Medical Savings Account Deduction (Guam) Medical Savings Account Deduction (CNMI) Moving Expenses (Guam) Moving Expenses (CNMI) One-Half of SelfEmployment Tax (Guam) One-Half of SelfEmployment Tax (CNMI) Self-Employed Health Insurance Deduction (Guam) Self-Employed Health Insurance Deduction (CNMI) Self-Employed SEP, SIMPLE & Qualified Plans (Guam) Self-Employed SEP, SIMPLE & Qualified Plans (CNMI) Early Withdrawal Penalty (Guam) Early Withdrawal Penalty (CNMI) Alimony Paid (Guam) Alimony Paid (CNMI) Allocation of Individual Inc Tax to Guam or CNMI Form Ref. ---19 Length -----12 Field Description ----------------N 0315 19 12 N 0320 0325 0330 20 20 21 12 12 12 N N N 0335 21 12 N 0340 22 12 N 0345 22 12 N 0350 23 12 N 0355 23 12 N 0360 0365 0370 0375 24 24 25 25 August 30, 2002 12 12 12 12 N N N N Part II Page 321 Section 4 Publication 1346 FORM 5074 Field Identification No. ----- -------------0380 0385 0390 0395 0400 Total Deductions (Guam) Total Deductions (CNMI) Adjusted Gross Income (Guam) Adjusted Gross Income (CNMI) Payments on Estimated Tax Return Filed with Guam Payments on Estimated Tax Return Filed with CNMI Inc Tax Withheld From US Gov Civilian Wages (Guam) Inc Tax Withheld From US Gov Civilian Wages (CNMI) Inc Tax Withheld From US Armed Forces Wages (Guam) Inc Tax Withheld From US Armed Forces Wages (CNMI) Inc Tax Withheld From Wages Earned in Guam Inc Tax Withheld From Wages Earned in CNMI Allocation of Individual Inc Tax to Guam or CNMI Form Ref. ---26 26 27 27 28 Length -----12 12 12 12 12 Field Description ----------------N N N N N 0405 28 12 N 0410 29 12 N 0415 29 12 N 0420 30 12 N 0425 30 12 N 0430 31 12 N 0435 31 12 N Publication 1346 August 30, 2002 Part II Page 322 Section 4 FORM 5074 Field Identification No. ----- -------------0440 0445 Total Payments (Guam) Total Payments (CNMI) Allocation of Individual Inc Tax to Guam or CNMI Form Ref. ---32 32 Length -----12 12 Field Description ----------------N N Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 323 Section 4 INTENTIONAL BLANK PAGE Publication 1346 August 30, 2002 Part II Page 324 Section 4 FORM 5329 PAGE 1 Field Identification No. ----- -------------Byte Count Additional Taxes on Qualified Plans ... Form Ref. ---Length -----4 Field Description ----------------"0362" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" "5329bb" "PG01b" N (Primary SSN) Start of Record Sentinel 0000 0001 0002 0003 Record ID Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number Name of Person Subject to Penalty Tax SSN of Person Subject to Penalty Tax Street Address 4 6 6 5 9 0004 0005 0010 1 7 35 blank N 0000001 - 0000002 A, hyphen (-), less than (<), or blank N 0020 9 0030 35 AN. Allowable special characters are space, ampersand, slash, hyphen, percent and Literal "NONE" AN A (Standard Postal State Abbreviations in the File Specifications) N (left-justified) NO ENTRY N N 01-11 Part II Page 325 Section 4 0040 0050 City State Abbreviation 22 2 0060 0070 0072 0073 Zip Code Amended Return Ind Total Early Distributions Exception Code 1 2 August 30, 2002 9 1 12 2 Publication 1346 FORM 5329 PAGE 1 Field Identification No. ----- -------------0074 Total Amount Excluded from Additional Tax Amount Subject to Additional Tax Total Section 72 Tax on Early Distributions Current TY Taxable Distribution Amount Distributions Excepted From Additional Tax Amount Subject to Additional Tax Tax on Ed IRA Distrib Not Used for Educ Expenses Previous Year Total Excess Contributions Contribution Credit Includible Traditional IRA Distributions Excess Contributions Withdrawn Excess Contributions Adjustment Adjusted Earlier Year Excess Contributions Excess Contributions to Traditional IRA Additional Taxes on Qualified Plans ... Form Ref. ---2 Length -----12 Field Description ----------------N 0076 0078 3 4 12 12 N N 0081 0084 5 6 12 12 N N 0087 0091 7 8 12 12 N N 0094 0100 0110 9 10 11 12 12 12 N N N 0120 12 12 N 0130 13 12 N 0140 14 12 N 0145 15 12 N Publication 1346 August 30, 2002 Part II Page 326 Section 4 FORM 5329 PAGE 1 Field Identification No. ----- -------------0150 0160 Total Excess Contributions Excess Contributions Tax on Traditional IRA Additional Taxes on Qualified Plans ... Form Ref. ---16 17 Length -----12 12 Field Description ----------------N N Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 327 Section 4 FORM 5329 PAGE 2 Field Identification No. ----- -------------Byte Count Additional Taxes on Qualified Plans ... Form Ref. ---Length -----4 Field Description ----------------"0391" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" "5329bb" "PG02b" N (Primary SSN) Start of Record Sentinel 0310 0311 0312 0313 Record ID Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number Excess Contributions to Roth IRA for Current TY Roth IRA Contribution Credit Includible Current Tax Year Roth IRA Distributions Total of Lines 19 and 20 Prev Yr Roth IRA Excess Contributions Withdrawn Roth IRA Current TY Excess Contributions Withdrawn Total Roth IRA Excess Contributions 18 4 6 6 5 9 0314 0315 0400 1 7 12 blank N 0000001 - 0000002 N 0410 0420 19 20 12 12 N N 0430 0440 21 22 12 12 N N 0450 23 12 N 0460 24 12 N Publication 1346 August 30, 2002 Part II Page 328 Section 4 FORM 5329 PAGE 2 Field Identification No. ----- -------------0480 Excess Contributions Tax on Roth IRA Excess Contributions to Ed IRA for Current TY Ed IRA Contribution Credit Includible Current Tax Year Ed IRA Distributions Total of Lines 27 and 28 Previous Yr Ed IRA Excess Contributions Withdrawn Ed IRA Current TY Excess Contributions Withdrawn Total Ed IRA Excess Contributions Excess Contributions Tax on Ed IRA Previous Year Excess Contributions Not Eliminated MSA Contributions Credit Includible MSA Distributions for Current Tax Year Total of Lines 35 and 36 Additional Taxes on Qualified Plans ... Form Ref. ---25 Length -----12 Field Description ----------------N 0490 26 12 N 0500 0510 27 28 12 12 N N 0520 0530 29 30 12 12 N N 0540 31 12 N 0550 0570 32 33 12 12 N N 0580 34 12 N 0590 0600 35 36 12 12 N N 0610 37 August 30, 2002 12 N Part II Page 329 Section 4 Publication 1346 FORM 5329 PAGE 2 Field Identification No. ----- -------------0620 Previous Year MSA Excess Contributions Withdrawn MSA Excess Contributions for Current TY Total MSA Excess Contributions Excess Contributions Tax on MSA Minimum Required Distribution Amount Actually Distributed Excess Accumulation Waiver Waiver Explanation Tax on Excess Accumulations Additional Taxes on Qualified Plans ... Form Ref. ---38 Length -----12 Field Description ----------------N 0630 39 12 N 0640 0660 40 41 12 12 N N 0670 0680 0690 0700 @0710 0720 42 43 44 45 45 45 12 12 12 6 6 12 N N N "WAIVER" or blank "STMbnn" or blank N Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 330 Section 4 FORM 5471 PAGE 1 Field Identification No. ----- -------------Byte Count Information Return of U.S. Persons with Respect... Form Ref. ---Length -----4 Field Description ----------------"1697" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" "5471bb" "PG01b" N (Primary SSN) | Start of Record Sentinel 0000 0001 0002 0003 Record Identification Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number Foreign Tax Year Beginning Foreign Tax Year Ending Change In Taxable Year - No Section 898C(1)(B) Election - Change In Taxable Year 898C(1)(B) Section 898C(1)(B) Election Address of Filer City of Filer State of Filer Zip Code of Filer 4 6 6 5 9 0004 0005 0010 0020 0025 1 7 8 8 1 Blank 0000001 YYYYMMDD YYYYMMDD "X" or Blank | | 0030 1 "X" or Blank 0035 0050 0060 0070 0080 1 35 22 2 12 "X" or Blank AN AN AN N or nnnnnbbbbbbb or nnnnnnnnnbbb Part II Page 331 Section 4 Publication 1346 August 30, 2002 FORM 5471 PAGE 1 Field Identification No. ----- -------------0090 0100 0105 @0107 0110 0120 0130 0135 @0136 0140 0150 0160 0170 Filer's Tax Year Beginning Filer's Tax Year Ending Prior Filer Name Explain Name Change Identifying Number Category of Filer-1 Category of Filer-2 Category of Filer-3 Category 3 Attachment Category of Filer-4 Category of Filer-5 Percent Voting Stock Person This Information Return is Filed For Address of Person City of Person State of Person Zip Code of Person Identifying Number Shareholder Officer Director Information Return of U.S. Persons with Respect... Form Ref. ---Length -----8 8 40 6 9 B(1) B(2) B(3) B(3) B(4) B(5) C D(1) 1 1 1 6 1 1 6 40 Field Description ----------------YYYYMMDD YYYYMMDD AN "STMbnn" or Blank NO ENTRY "X" or Blank "X" or Blank "X" or Blank "STMbnn" or Blank "X" or Blank "X" or Blank R AN or Blank | | | 0180 0182 0184 0186 0190 0200 0210 0220 D(2) D(2) D(2) D(2) D(3) D(4) D(4) D(4) August 30, 2002 35 22 2 12 9 1 1 1 AN AN AN N or nnnnnbbbbbbb or nnnnnnnnnbbb N or Blank "X" or Blank "X" or Blank "X" or Blank Part II Page 332 Section 4 Publication 1346 FORM 5471 PAGE 1 Field Identification No. ----- -------------@0225 0230 First Person's Statement Person This Information Return is Filed For-2 Address of Person-2 City of Person-2 State of Person-2 Zip Code of Person-2 Identifying Number-2 Shareholder-2 Officer-2 Director-2 Second Person's Statement Person This Information Return is Filed For-3 Address of Person-3 City of Person-3 State of Person-3 Zip Code of Person-3 Identifying Number-3 Shareholder-3 Officer-3 Director-3 Information Return of U.S. Persons with Respect... Form Ref. ---D D(1) Length -----6 40 Field Description ----------------"STMbnn" or Blank AN or Blank 0240 0242 0244 0246 0250 0260 0270 0280 @0285 0290 D(2) D(2) D(2) D(2) D(3) D(4) D(4) D(4) D D(1) 35 22 2 12 9 1 1 1 6 40 AN or Blank AN or Blank AN or Blank N or nnnnnbbbbbbb or nnnnnnnnnbbb or Blank N or Blank "X" or Blank "X" or Blank "X" or Blank "STMbnn" or Blank AN or Blank 0300 0302 0304 0306 0310 0320 0330 0340 D(2) D(2) D(2) D(2) D(3) D(4) D(4) D(4) August 30, 2002 35 22 2 12 9 1 1 1 AN or Blank AN or Blank AN or Blank N or nnnnnbbbbbbb or nnnnnnnnnbbb or Blank N or Blank "X" or Blank "X" or Blank "X" or Blank Part II Page 333 Section 4 Publication 1346 FORM 5471 PAGE 1 Field Identification No. ----- -------------@0345 0350 Third Person's Statement Person This Information Return is Filed For-4 Address of Person-4 City of Person-4 State of Person-4 Zip Code of Person-4 Information Return of U.S. Persons with Respect... Form Ref. ---D D(1) Length -----6 40 Field Description ----------------"STMbnn" or Blank AN or Blank 0360 0362 0364 0366 D(2) D(2) D(2) D(2) 35 22 2 12 AN or Blank AN or Blank AN or Blank N or nnnnnbbbbbbb or nnnnnnnnnbbb or Blank N or Blank "X" or Blank "X" or Blank "X" or Blank "STMbnn" or Blank "STMbnn" or blank AN AN AN AN N or nnnnnbbbbbbb or nnnnnnnnnbbb AN or blank | 0370 0380 0390 0400 @0405 @0407 0420 0430 0440 0450 0460 0465 Identifying Number-4 Shareholder-4 Officer-4 Director-4 Fourth Person's Statement Additional Lines of Line D Data Name of Foreign Corporation Address of Foreign Corp. City of Foreign Corp. State of Foreign Corp. Zip Code of Foreign Corp. Country of Foreign Corp. D(3) D(4) D(4) D(4) D D 1a 1a 1a 1a 1a 1a 9 1 1 1 6 6 35 35 22 2 12 35 Publication 1346 August 30, 2002 Part II Page 334 Section 4 FORM 5471 PAGE 1 Field Identification No. ----- -------------0470 Employer Identification Number Country Under Whose Laws Incorporated Date of Incorporation Principal Place of Business (Country Code) Reserved Business Code Principal Business Activity Foreign Corporation Functional Currency Dormant Indicator Name of Branch Office in U.S Address of Branch City of Branch State of Branch Zip Code of Branch Identifying Number of Branch Office Taxable Income (Loss) U.S Income Tax Paid Information Return of U.S. Persons with Respect... Form Ref. ---1b Length -----9 Field Description ----------------N 0480 0490 0500 1c 1d 1e 2 8 2 ALPHA - "US" IS NOT VALID YYYYMMDD ALPHA | 0505 0510 0520 0523 0525 0530 0540 0550 0560 0570 0580 0590 0600 2 1f 1g 1h 6 35 20 1 2a 2a 2a 2a 2a 2a 2b(i) 2b(ii) 35 35 22 2 12 9 12 12 Blank N RANGE: 111000-813000 AN AN "X" or Blank AN AN AN AN N or nnnnnbbbbbbb or nnnnnnnnnbbb N N N Publication 1346 August 30, 2002 Part II Page 335 Section 4 FORM 5471 PAGE 1 Field Identification No. ----- -------------0610 Name of Foreign Corp. Statutory or Resident Agent Address of Foreign Corp. Resident Agent City of Foreign Corp. Resident Agent State of Foreign Corp. Resident Agent Zip Code of Foreign Corp. Resident Agent Country of Foreign Corp. Resident Agent Name of Person with Custody of Corp. Books Address of Person with Custody City of Person with Custody State of Person with Custody Zip Code of Person with Custody Country of Person with Custody Location of Books and Records Description of Class of Stock Information Return of U.S. Persons with Respect... Form Ref. ---2c Length -----35 Field Description ----------------AN 0620 0630 0640 0650 0655 0660 2c 2c 2c 2c 2c 2d 35 22 2 12 35 35 AN AN AN N or nnnnnbbbbbbb or nnnnnnnnnbbb AN or blank AN | 0670 0680 0690 0700 0705 0710 *0720 2d 2d 2d 2d 2d 2d PT I(a) 35 22 2 12 35 71 6 AN AN AN N or nnnnnbbbbbbb or nnnnnnnnnbbb AN or blank AN or Blank ALPHA VALUE: "C" = COMMON, "P" = PREFERRED, "T" = TREASURY or "STMbnn" or Blank N Part II Page 336 Section 4 | +0730 Number of Shares Beginning PT I(b)(i) August 30, 2002 10 Publication 1346 FORM 5471 PAGE 1 Field Identification No. ----- -------------+0740 0750 Number of Shares End Description of Class of Stock-2 Information Return of U.S. Persons with Respect... Form Ref. ---PTI(b)(ii) PT I(a) Length -----10 1 Field Description ----------------N ALPHA "C" = "P" = "T" = N N ALPHA VALUE: C = COMMON P = PREFERRED T = TREASURY or Blank N N ALPHA "C" = "P" = "T" = N N Blank | VALUE: COMMON, PREFERRED, TREASURY or Blank VALUE: COMMON, PREFERRED, TREASURY or Blank 0760 0770 0780 Number of Shares Beginning-2 Number of Shares End-2 Description of Class of Stock-3 PT I(b)(i) PTI(b)(ii) PT I(a) 10 10 1 0790 0800 0810 Number of Shares Beginning-3 Number of Shares End-3 Description of Class of Stock-4 PTI(b)(i) PTI(b)(ii) PT I(a) 10 10 1 0820 0830 0835 *0840 +0850 +0860 +0870 Number of Shares Beginning-4 Number of Shares End-4 Statement Reference - BMF Use Only Description of Preferred Stock Par Value Rate of Dividend Is Stock Cumulative PT I(b)(i) PTI(b)(ii) PT I PT II (a) PT II (b) PT II (c) PT II (d) 10 10 6 20 18 6 1 AN or "STMbnn" or Blank N N "C" = CUMULATIVE "N" = NONCUMULATIVE or Blank Part II Page 337 Section 4 Publication 1346 August 30, 2002 FORM 5471 PAGE 1 Field Identification No. ----- -------------0880 0890 0900 0910 Description of Preferred Stock-2 Par Value-2 Rate of Dividend-2 Is Stock Cumulative2 Description of Preferred Stock-3 Par Value-3 Rate of Dividend-3 Is Stock Cumulative3 Statement Reference - BMF Use Only Information Return of U.S. Persons with Respect... Form Ref. ---PT II (a) PT II (b) PT II (c) PT II (d) Length -----20 18 6 1 Field Description ----------------AN or Blank N or Blank N or Blank "C" = CUMULATIVE "N" = NONCUMULATIVE or Blank AN or Blank N or Blank N or Blank "C" = CUMULATIVE "N" = NONCUMULATIVE or Blank Blank | 0920 0930 0940 0950 PT II (a) PT II (b) PT II (c) PT II (d) 20 18 6 1 0955 PT II 6 Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 338 Section 4 FORM 5471 PAGE 2 Field Identification No. ----- -------------Byte Count Information Return of U.S. Persons With Respect... Form Ref. ---Length -----4 Field Description ----------------"2168" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" "5471bb" "PG02b" N (Primary SSN) Start of Record Sentinel 0970 0971 0972 0973 Record Identification Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number Name of Shareholder1 Address of Shareholder-1 City of Shareholder1 State of Shareholder-1 Zip Code of Shareholder-1 Identifying Number of Shareholder-1 Description of Stock Held by Shareholder 1-1 Number of Shares Beginning of Period 1-1 SCH B (a) SCH B (a) SCH B (a) SCH B (a) SCH B (a) SCH B (a) SCH B (b) 4 6 6 5 9 0974 0975 0980 0990 1000 1010 1020 1030 1040 1 7 35 35 22 2 12 9 20 Blank 0000001 AN AN AN AN N or nnnnnbbbbbbb or nnnnnnnnnbbb N AN 1050 SCH B (c) 10 N Publication 1346 August 30, 2002 Part II Page 339 Section 4 FORM 5471 PAGE 2 Field Identification No. ----- -------------1060 1065 1070 Number of Shares End of Period 1-1 Pro Rata Share of SubPart F Income-1 Description of Stock Held by Shareholder 1-2 Number of Shares Beginning of Period 1-2 Number of Shares End of Period 1-2 Description of Stock Held by Shareholder 1-3 Number of Shares Beginning of Period 1-3 Number of Shares End of Period 1-3 Description of Stock Held by Shareholder 1-4 Number of Shares Beginning of Period 1-4 Number of Shares End of Period 1-4 Name of Shareholder2 Address of Shareholder-2 City of Shareholder2 Information Return of U.S. Persons With Respect... Form Ref. ---SCH B (d) SCH B (e) SCH B (b) Length -----10 6 20 Field Description ----------------N N AN 1080 SCH B (c) 10 N 1090 1100 SCH B (d) SCH B (b) 10 20 N AN 1110 SCH B (c) 10 N 1120 1130 SCH B (d) SCH B (b) 10 20 N AN 1140 SCH B (c) 10 N 1150 1170 1180 1190 SCH B (d) SCH B (a) SCH B (a) SCH B (a) 10 35 35 22 N AN AN AN Publication 1346 August 30, 2002 Part II Page 340 Section 4 FORM 5471 PAGE 2 Field Identification No. ----- -------------1200 1210 1220 1230 State of Shareholder-2 Zip Code of Shareholder-2 Identifying Number of Shareholder-2 Description of Stock Held by Shareholder 2-1 Number of Shares Beginning of Period 2-1 Number of Shares End of Period 2-1 Pro Rata Share of Subpart F Income-2 Description of Stock Held by Shareholder 2-2 Number of Shares Beginning of Period 2-2 Number of Shares End of Period 2-2 Description of Stock Held by Shareholder 2-3 Number of Shares Beginning of Period 2-3 Number of Shares End of Period 2-3 Description of Stock Held by Shareholder 2-4 Information Return of U.S. Persons With Respect... Form Ref. ---SCH B (a) SCH B (a) SCH B (a) SCH B (b) Length -----2 12 9 20 Field Description ----------------AN N or nnnnnbbbbbbb or nnnnnnnnnbbb N AN 1240 SCH B (c) 10 N 1250 1255 1260 SCH B (d) SCH B (e) SCH B (b) 10 6 20 N N AN 1270 SCH B (c) 10 N 1280 1290 SCH B (d) SCH B (b) 10 20 N AN 1300 SCH B (c) 10 N 1310 1320 SCH B (d) SCH B (b) 10 20 N AN Publication 1346 August 30, 2002 Part II Page 341 Section 4 FORM 5471 PAGE 2 Field Identification No. ----- -------------1330 Number of Shares Beginning of Period 2-4 Number of Shares End of Period 2-4 Name of Shareholder3 Address of Shareholder-3 City of Shareholder3 State of Shareholder-3 Zip Code of Shareholder-3 Identifying Number of Shareholder-3 Description of Stock Held by Shareholder 3-1 Number of Shares Beginning of Period 3-1 Number of Shares End of Period 3-1 Pro Rata Share of Subpart F Income-3 Description of Stock Held By Shareholder 3-2 Number of Shares Beginning of Period 3-2 Number of Shares End of Period 3-2 Information Return of U.S. Persons With Respect... Form Ref. ---SCH B (c) Length -----10 Field Description ----------------N 1340 1360 1370 1380 1390 1400 1410 1420 SCH B (d) SCH B (a) SCH B (a) SCH B (a) SCH B (a) SCH B (a) SCH B (a) SCH B (b) 10 35 35 22 2 12 9 20 N AN AN AN AN N or nnnnnbbbbbbb or nnnnnnnnnbbb N AN 1430 SCH B (c) 10 N 1440 1445 1450 SCH B (d) SCH B (e) SCH B (b) 10 6 20 N N AN 1460 SCH B (c) 10 N 1470 SCH B (d) August 30, 2002 10 N Part II Page 342 Section 4 Publication 1346 FORM 5471 PAGE 2 Field Identification No. ----- -------------1480 Description of Stock Held by Shareholder 3-3 Number of Shares Beginning of Period 3-3 Number of Shares End of Period 3-3 Description of Stock Held By Shareholder 3-4 Number of Shares Beginning of Period 3-4 Number of Shares End of Period 3-4 Name of Shareholder4 Address of Shareholder-4 City of Shareholder4 State of Shareholder-4 Zip Code of Shareholder-4 Identifying Number of Shareholder-4 Description of Stock Held By Shareholder 4-1 Number of Shares Beginning of Period 4-1 Information Return of U.S. Persons With Respect... Form Ref. ---SCH B (b) Length -----20 Field Description ----------------AN 1490 SCH B (c) 10 N 1500 1510 SCH B (d) SCH B (b) 10 20 N AN 1520 SCH B (c) 10 N 1530 1550 1560 1570 1580 1590 1600 1610 SCH B (d) SCH B (a) SCH B (a) SCH B (a) SCH B (a) SCH B (a) SCH B (a) SCH B (b) 10 35 35 22 2 12 9 20 N AN AN AN AN N or nnnnnbbbbbbb or nnnnnnnnnbbb N AN 1620 SCH B (c) 10 N Publication 1346 August 30, 2002 Part II Page 343 Section 4 FORM 5471 PAGE 2 Field Identification No. ----- -------------1630 1635 1640 Number of Shares End of Period 4-1 Pro Rata Share of Subpart F Income-4 Description of Stock Held By Shareholder 4-2 Number of Shares Beginning of Period 4-2 Number of Shares End of Period 4-2 Description of Stock Held By Shareholder 4-3 Number of Shares Beginning of Period 4-3 Number of Shares End of Period 4-3 Description of Stock Held By Shareholder 4-4 Number of Shares Beginning of Period 4-4 Number of Shares End of Period 4-4 Name of Shareholder5 Address of Shareholder-5 City of Shareholder5 Information Return of U.S. Persons With Respect... Form Ref. ---SCH B (d) SCH B (e) SCH B (b) Length -----10 6 20 Field Description ----------------N N AN 1650 SCH B (c) 10 N 1660 1670 SCH B (d) SCH B (b) 10 20 N AN 1680 SCH B (c) 10 N 1690 1700 SCH B (d) SCH B (b) 10 20 N AN 1710 SCH B (c) 10 N 1720 1740 1750 1760 SCH B (d) SCH B (a) SCH B (a) SCH B (a) 10 35 35 22 N AN AN AN Publication 1346 August 30, 2002 Part II Page 344 Section 4 FORM 5471 PAGE 2 Field Identification No. ----- -------------1770 1780 1790 1800 State of Shareholder-5 Zip Code of Shareholder-5 Identifying Number of Shareholder-5 Description of Stock Held By Shareholder 5-1 Number of Shares Beginning of Period 5-1 Number of Shares End of Period 5-1 Pro Rata Share of Subpart F Income-5 Description of Stock Held By Shareholder 5-2 Number of Shares Beginning of Period 5-2 Number of Shares End of Period 5-2 Description of Stock Held By Shareholder 5-3 Number of Shares Beginning of Period 5-3 Number of Shares End of Period 5-3 Description of Stock Held By Shareholder 5-4 Information Return of U.S. Persons With Respect... Form Ref. ---SCH B (a) SCH B (a) SCH B (a) SCH B (b) Length -----2 12 9 20 Field Description ----------------AN N or nnnnnbbbbbbb or nnnnnnnnnbbb N AN 1810 SCH B (c) 10 N 1820 1825 1830 SCH B (d) SCH B (e) SCH B (b) 10 6 20 N N AN 1840 SCH B (c) 10 N 1850 1860 SCH B (d) SCH B (b) 10 20 N AN 1870 SCH B (c) 10 N 1880 1890 SCH B (d) SCH B (b) 10 20 N AN Publication 1346 August 30, 2002 Part II Page 345 Section 4 FORM 5471 PAGE 2 Field Identification No. ----- -------------1900 Number of Shares Beginning of Period 5-4 Number of Shares End of Period 5-4 Additional Lines of Schedule B Data Gross Receipts (Functional Currency) Gross Receipts (U.S. Dollars) Returns (Functional Currency) Returns (U.S. Dollars) Subtract Line 1b From 1a (Functional Currency) Subtract Line 1b From 1a (U.S. Dollars) Cost of Goods Sold (Functional Currency) Cost of Goods Sold (U.S. Dollars) Gross Profit (Functional Currency) Gross Profit (U.S. Dollars) Dividends (Functional Currency) Information Return of U.S. Persons With Respect... Form Ref. ---SCH B (c) Length -----10 Field Description ----------------N 1910 @1915 1930 SCH B (d) Sch B SCH C 1a 10 6 18 N "STMbnn" or blank N 1940 1950 1960 1970 SCH C 1a SCH C 1b SCH C 1b SCH C 1c 12 18 12 18 N N N N 1980 SCH C 1c 12 N 1990 SCH C 2 18 N 2000 2010 SCH C 2 SCH C 3 12 18 N N 2020 2030 SCH C 3 SCH C 4 12 18 N N Publication 1346 August 30, 2002 Part II Page 346 Section 4 FORM 5471 PAGE 2 Field Identification No. ----- -------------2040 2050 Dividends (U.S. Dollars) Interest (Income) (Functional Currency) Interest (Income) (U.S. Dollars) Gross Rents, Royalties (Functional Currency) Gross Rents, Royalties (U.S. Dollars) Net Gain (Loss) (Functional Currency) Net Gain (Loss) (U.S. Dollars) Other Income (Functional Currency) Reserved Other Income (U.S. Dollars) Attach Schedule Other Income Total Income (Functional Currency) Total Income (U.S. Dollars) Compensation Not Deducted (Functional Currency) Information Return of U.S. Persons With Respect... Form Ref. ---SCH C 4 SCH C 5 Length -----12 18 Field Description ----------------N N 2060 2070 SCH C 5 SCH C 6 12 18 N N 2080 SCH C 6 12 N 2090 SCH C 7 18 N 2100 2110 SCH C 7 SCH C 8 12 18 N N 2120 2130 @2140 2150 SCH C 8 SCH C 8 SCH C 8 SCH C 9 6 12 6 18 Blank N "STMbnn" or Blank N 2160 2170 SCH C 9 SCH C 10 12 18 N N Publication 1346 August 30, 2002 Part II Page 347 Section 4 FORM 5471 PAGE 2 Field Identification No. ----- -------------2180 Compensation Not Deducted (U.S. Dollars) Rent, Royalties (Functional Currency) Rent, Royalties (U.S. Dollars) Interest (Deductions) (Functional Currency) Interest (Deductions) (U.S. Dollars) Depreciation (Functional Currency) Depreciation (U.S. Dollars) Depletion (Functional Currency) Depletion (U.S Dollars) Taxes (Functional Currency) Taxes (U.S. Dollars) Other Deductions (Functional Currency) Reserved Other Deductions (U.S. Dollars) Information Return of U.S. Persons With Respect... Form Ref. ---SCH C 10 Length -----12 Field Description ----------------N 2190 SCH C 11 18 N 2200 2210 SCH C 11 SCH C 12 12 18 N N 2220 SCH C 12 12 N 2230 SCH C 13 18 N 2240 2250 SCH C 13 SCH C 14 12 18 N N 2260 2270 2280 2290 SCH C 14 SCH C 15 SCH C 15 SCH C 16 12 18 12 18 N N N N 2300 2310 SCH C 16 SCH C 16 6 12 Blank N Publication 1346 August 30, 2002 Part II Page 348 Section 4 FORM 5471 PAGE 2 Field Identification No. ----- -------------@2320 2330 Attach ScheduleOther Deductions Total Deductions (Functional Currency) Total Deductions (U.S. Dollars) Net Income or (Loss) (Functional Currency) Net Income or (Loss) (U.S. Dollars) Extraordinary Items (Functional Currency) Extraordinary Items (U.S. Dollars) Provisions For Income (Functional Currency) Provisions For Income (U.S. Dollars) Net Income (Loss) (Functional Currency) Income (Loss) (U.S. Dollars) Information Return of U.S. Persons With Respect... Form Ref. ---SCH C 16 SCH C 17 Length -----6 18 Field Description ----------------"STMbnn" or Blank N 2340 2350 SCH C 17 SCH C 18 12 18 N N 2360 SCH C 18 12 N 2370 SCH C 19 18 N 2380 2390 SCH C 19 SCH C 20 12 18 N N 2400 SCH C 20 12 N 2410 SCH C 21 18 N 2415 SCH C 21 12 N Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 349 Section 4 FORM 5471 PAGE 3 Field Identification No. ----- -------------Byte Count Information Return of U.S. Persons with Respect... Form Ref. ---Length -----4 Field Description ----------------"1309" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" "5471bb" "PG03b" N (Primary SSN) | Start of Record Sentinel 2420 2421 2422 2423 Record Identification Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number Amount of Tax in U.S. Dollars Name of Country or U.S. Possession-1 Amount of Tax in Foreign Currency-1 Amount of Tax Conversion Rate-1 Amount of Tax in U.S. Dollars-1 Name of Country or U.S. Possession-2 Amount of Tax in Foreign Currency-2 Amount of Tax Conversion Rate-2 Amount of Tax in U.S. Dollars-2 SCH E 1(d) SCH E 2(a) SCH E 2(b) SCH E 2(c) SCH E 2(d) SCH E 3(a) SCH E 3(b) SCH E 3(c) SCH E 3(d) August 30, 2002 4 6 6 5 9 2424 2425 2430 *2440 +2450 +2460 +2470 2480 2490 2500 2510 1 7 12 35 18 11 12 35 18 11 12 Blank 0000001 N AN or "STMbnn" N N (nnnnnnn.nnnn) N AN or Blank N or Blank N (nnnnnnn.nnnn) N or Blank Part II Page 350 Section 4 | | Publication 1346 FORM 5471 PAGE 3 Field Identification No. ----- -------------2520 2530 2540 2550 2560 2570 2580 2590 2600 2610 2620 2630 2640 2650 2660 2670 Name of Country or U.S. Possession-3 Amount of Tax in Foreign Currency-3 Amount of Tax Conversion Rate-3 Amount of Tax in U.S. Dollars-3 Name of Country or U.S. Possession-4 Amount of Tax in Foreign Currency-4 Amount of Tax Conversion Rate-4 Amount of Tax in U.S. Dollars-4 Name of Country or U.S. Possession-5 Amount of Tax in Foreign Currency-5 Amount of Tax Conversion Rate-5 Amount of Tax in U.S. Dollars-5 Name of Country or U.S. Possession-6 Amount of Tax in Foreign Currency-6 Amount of Tax Conversion Rate-6 Amount of Tax in U.S. Dollars-6 Information Return of U.S. Persons with Respect... Form Ref. ---SCH E 4(a) SCH E 4(b) SCH E 4(c) SCH E 4(d) SCH E 5(a) SCH E 5(b) SCH E 5(c) SCH E 5(d) SCH E 6(a) SCH E 6(b) SCH E 6(c) SCH E 6(d) SCH E 7(a) SCH E 7(b) SCH E 7(c) SCH E 7(d) Length -----35 18 11 12 35 18 11 12 35 18 11 12 35 18 11 12 Field Description ----------------AN or Blank N or Blank N (nnnnnnn.nnnn) N or Blank AN or Blank N or Blank N (nnnnnnn.nnnn) N or Blank AN or Blank N or Blank N (nnnnnnn.nnnn) N or Blank AN or blank N or Blank N (nnnnnnn.nnnn) N or Blank | | | | Publication 1346 August 30, 2002 Part II Page 351 Section 4 FORM 5471 PAGE 3 Field Identification No. ----- -------------2675 2680 2690 2700 2710 Statement Reference - BMF Use Only Total Tax in U.S. Dollars Cash - Beginning Cash - End Notes & Accts. Receivable Beginning Notes & Accts. Receivable - End Less Allowance for Bad Debts Beginning Less Allowance for Bad Debts - End Inventories Beginning Inventories - End Other Current Assets - Beginning Reserved Other Current Assets - End Other Current Assets (Attach Schedule) Loans To Stockholders Beginning Loans To Stockholders End Information Return of U.S. Persons with Respect... Form Ref. ---Part I SCH E 8(d) SCH F 1(a) SCH F 1(b) SCH F2a(a) Length -----6 12 12 12 12 Field Description ----------------Blank N N N N | 2720 2730 SCH F2a(b) SCH F2b(a) 12 12 N N 2740 2750 2760 2770 2780 2790 @2800 SCH F2b(b) SCH F 3(a) SCH F 3(b) SCH F 4(a) SCH F 4(a) SCH F 4(b) SCH F 4 12 12 12 12 6 12 6 N N N N Blank N "STMbnn" or Blank 2810 SCH F 5(a) 12 N 2820 SCH F 5(b) 12 N Publication 1346 August 30, 2002 Part II Page 352 Section 4 FORM 5471 PAGE 3 Field Identification No. ----- -------------2830 Investment in Subsidiaries Beginning Reserved Investment in Subsidiaries - End Investment in Subsidiaries (Attach Schedule) Other Investments Beginning Reserved Other Investments End Other Investments (Attach Schedule) Bldgs & Other Depreciables Beginning Bldgs & Other Depreciables - End Less Accumulated Depreciation Beginning Less Accumulated Depreciation - End Depletable Assets Beginning Depletable Assets End Less Accum. Depletion Beginning Information Return of U.S. Persons with Respect... Form Ref. ---SCH F 6(a) Length -----12 Field Description ----------------N 2840 2850 @2860 SCH F 6(a) SCH F 6(b) SCH F 6(b) 6 12 6 Blank N "STMbnn" or Blank 2870 2880 2890 @2900 2910 SCH F 7(a) SCH F 7(a) SCH F 7(b) SCH F 7(b) SCH F8a(a) 12 6 12 6 12 N Blank N "STMbnn" or Blank N 2920 2930 SCH F8a(b) SCH F8b(a) 12 12 N N 2940 2950 2960 2970 SCH F8b(b) SCH F9a(a) SCH F9a(b) SCH F9b(a) 12 12 12 12 N N N N Publication 1346 August 30, 2002 Part II Page 353 Section 4 FORM 5471 PAGE 3 Field Identification No. ----- -------------2980 2990 3000 3010 3020 3030 3040 3050 3060 3070 Less Accum. Depletion - End Land - Beginning Land - End Goodwill - Beginning Goodwill - End Organization Costs Beginning Organization Costs End Patents, Trademarks - Beginning Patents, Trademarks - End Less Accum. Amortization Beginning Less Accum. Amortization - End Other Assets Beginning Reserved Other Assets - End Other Assets (Attach Schedule) Total Assets Beginning Total Assets - End Accounts Payable Beginning Information Return of U.S. Persons with Respect... Form Ref. ---SCH F9b(b) SCH F10(a) SCH F10(b) SCHF11a(a) SCHF11a(b) SCHF11b(a) SCHF11b(b) SCHF11c(a) SCHF11c(b) SCHF11d(a) Length -----12 12 12 12 12 12 12 12 12 12 Field Description ----------------N N N N N N N N N N 3080 3090 3100 3110 @3120 3130 3140 3150 SCHF11d(b) SCH F12(a) SCH F12(a) SCH F12(b) SCH F 12 SCH F13(a) SCH F13(b) SCH F14(a) 12 12 6 12 6 12 12 12 N N Blank N "STMbnn" or Blank N N N Publication 1346 August 30, 2002 Part II Page 354 Section 4 FORM 5471 PAGE 3 Field Identification No. ----- -------------3160 3170 Accounts Payable End Other Current Liabilities Beginning Reserved Other Current Liabilities - End Other Current Liabilities (Attach Schedule) Loans from Stockholders Beginning Loans From Stockholders - End Other Liabilities Beginning Reserved Other Liabilities End Other Liabilities (Attach Schedule) Preferred Stock Beginning Preferred Stock End Common Stock Beginning Common Stock - End Paid-in or Capital Surplus - Beginning Reserved Information Return of U.S. Persons with Respect... Form Ref. ---SCH F14(b) SCH F15(a) Length -----12 12 Field Description ----------------N N 3180 3190 @3200 SCH F15(a) SCH F15(b) SCH F 15 6 12 6 BLANK N "STMbnn" or Blank 3210 SCH F16(a) 12 N 3220 3230 3240 3250 @3260 3270 3280 3290 3300 3305 3310 SCH F16(b) SCH F17(a) SCH F17(a) SCH F17(b) SCH F 17 SCHF18a(a) SCHF18a(b) SCHF18b(a) SCHF18b(b) SCH F19(a) SCH F19(a) August 30, 2002 12 12 6 12 6 12 12 12 12 12 6 N N Blank N "STMbnn" or Blank N N N N N Blank Part II Page 355 Section 4 Publication 1346 FORM 5471 PAGE 3 Field Identification No. ----- -------------3315 @3320 Paid-in or Capital Surplus - End Paid-in or Capital Surplus (Attach Reconcilation) Retained Earnings Beginning Retained Earnings End Less Cost of Treasury Stock Beginning Less Cost of Treasury Stock - End Total Liabilities & Equity - Beginning Total Liabilities & Equity - End Information Return of U.S. Persons with Respect... Form Ref. ---SCH F19(b) SCH F 19 Length -----12 6 Field Description ----------------N "STMbnn" or Blank 3330 3340 3350 SCH F20(a) SCH F20(b) SCH F21(a) 12 12 12 N N N 3360 3370 3380 SCH F21(b) SCH F22(a) SCH F22(b) 12 12 12 N N N Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 356 Section 4 FORM 5471 PAGE 4 Field Identification No. ----- -------------Byte Count Information Return of U.S. Persons with Respect... Form Ref. ---Length -----4 Field Description ----------------"0604" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" "5471bb" "PG04b" N (Primary SSN) | Start of Record Sentinel 3400 3401 3402 3403 Record Identification Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number Own 10% Interest in a Partnership - Yes Own 10% Interest in a Partnership - No Own 10% Yes Attachment Own Interest in a Trust - Yes Own Interest in a Trust - No Own Foreign Entities - Yes Own Foreign Entities - No Own Foreign Entities Yes Attachment SCH G 1 SCH G 1 SCH G 1 SCH G 2 SCH G 2 4 6 6 5 9 3404 3405 3410 3420 @3425 3430 3440 1 7 1 1 6 1 1 Blank 0000001 "X" or Blank "X" or Blank "STMbnn" or Blank "X" or Blank "X" or blank --| 3450 3460 @3465 SCH G 3 SCH G 3 SCH G 3 1 1 6 "X" or Blank "X" or Blank "STMbnn" or Blank Publication 1346 August 30, 2002 Part II Page 357 Section 4 FORM 5471 PAGE 4 Field Identification No. ----- -------------3470 3480 Current Year Income (Loss) Capital Gains or Losses (Net Additions) Capital Gains or Losses (Net Subtractions) Depreciation & Amortization (Net Additions) Depreciation & Amortization (Net Subtractions) Depletion (Net Additions) Depletion (Net Subtractions) Investment Allowance (Net Additions) Investment Allowance (Net Subtractions) Charges To Reserves (Net Additions) Charges To Reserves (Net Subtractions) Inventory Adjustments (Net Additions) Inventory Adjustments (Net Subtractions) Taxes (Net Additions) Information Return of U.S. Persons with Respect... Form Ref. ---SCH H 1 SCH H 2a Length -----18 18 Field Description ----------------N N 3490 SCH H 2a 18 N 3500 SCH H 2b 18 N 3510 SCH H 2b 18 N 3520 3530 3540 SCH H 2c SCH H 2c SCH H 2d 18 18 18 N N N 3550 SCH H 2d 18 N 3560 3570 3580 SCH H 2e SCH H 2e SCH H 2f 18 18 18 N N N 3590 SCH H 2f 18 N 3600 SCH H 2g August 30, 2002 18 N Part II Page 358 Section 4 Publication 1346 FORM 5471 PAGE 4 Field Identification No. ----- -------------3610 3620 3625 3630 @3635 3640 3650 3660 3670 3680 3690 3700 3710 3720 3730 3740 3750 3760 3770 Taxes (Net Subtractions) Other Earnings (Net Additions) Reserved Other Earnings (Net Subtractions) Other Earnings (Attach Schedule) Total Net Additions Total Net Subtractions Current Earnings & Profits Dastm Gain or Loss Combine Lines 5a & 5b Earnings & Profits In U.S. Dollars Exchange Rate Used For Line 5d Subpart F Income Earnings Invested in U.S. Property Subpart F Income Previously Excluded Previously Excluded Export Trade Income Factoring Income Total Lines 1-5 Dividends Received Information Return of U.S. Persons with Respect... Form Ref. ---SCH H 2g SCH H 2h SCH H 2h SCH H 2h SCH H 2h SCH H 3 SCH H 4 SCH H 5a SCH H 5b SCH H 5c SCH H 5d SCH H 5d SCH I 1 SCH I 2 SCH I 3 SCH I 4 SCH I 5 SCH I 6 SCH I 7 August 30, 2002 Length -----18 18 6 18 6 18 18 18 18 18 12 11 12 12 12 12 12 12 12 Field Description ----------------N N Blank N "STMbnn" or Blank N N N N N N N (nnnnnnn.nnnn) N N N N N N N Part II Page 359 Section 4 | Publication 1346 FORM 5471 PAGE 4 Field Identification No. ----- -------------3780 3790 Exchange Gain or Loss Income of Foreign Corporation Blocked (Yes Box) Income of Foreign Corporation Blocked (No Box) Did Any Become Unblocked (Yes Box) Did Any Become Unblocked (No Box) Statement (If Yes, Explain) Additional Schedules I Information Return of U.S. Persons with Respect... Form Ref. ---SCH I 8 Length -----12 1 Field Description ----------------N "X" or Blank 3795 1 "X" or Blank 3800 3805 @3810 @3815 1 1 6 6 "X" or Blank "X" or Blank "STMbnn" or Blank "STMbnn" or Blank Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 360 Section 4 SCHEDULE J (FORM 5471) Field Identification No. ----- -------------Byte Count Accumulated Earnings & Profits of Controlled... Form Ref. ---Length -----4 Field Description ----------------"0645" for Fixed; "nnnn" for variable format Value "****" "SCHbbJ" "5471bb" "PG01b" N (Primary SSN) | Start of Record Sentinel 0000 0001 0002 0003 Record Identification Form Number Page Number Taxpayer Identification Number Filler Schedule Occurrence Number Identifying Number Name of Foreign Corporation Balance BOY Post1986 Current Year E&P Current Year Deficit in E&P Total Current and Accumulated E&P Post-1986 Amounts Included Under Sec. 951(a) Post-1986 Actual Distributions Post1986 Balance of E&P Post1986 1(a) 2a(a) 2b(a) 3(a) 4 6 6 5 9 0004 0005 0010 0020 0030 0040 0050 0060 1 7 9 35 18 18 18 18 Blank 0000001 NO ENTRY AN N N N N | 0070 4(a) 18 N 0080 5b(a) 18 N 0090 6b(a) 18 N Part II Page 361 Section 4 Publication 1346 August 30, 2002 SCHEDULE J (FORM 5471) Field Identification No. ----- -------------0100 0110 0120 Balance At EOY Post1986 Balance BOY Pre-1987 Total Current and Accumulated E&P Pre1987 Amounts Included Under Sec. 951(a) Pre-1987 Actual Distributions Pre1987 Balance of E&P Pre1987 Balance at EOY Pre1987 Balance BOY Property Amounts Included Under Sec. 951(a) Property Actual Distribution or ReclassificationProperty Balance of E&PProperty Balance at EOYProperty Balance BOY-Assets Amounts Included Under Sec. 951(a)Assets Actual Distribution or ReclassificationAssets Accumulated Earnings & Profits of Controlled... Form Ref. ---7(a) 1(b) 3(b) Length -----18 18 18 Field Description ----------------N N N 0130 4(b) 18 N 0140 5b(b) 18 N 0150 0160 0170 0180 6b(b) 7(b) 1(c)(i) 4(c)(i) 18 18 18 18 N N N N 0190 5a(c)(i) 18 N 0200 0210 0220 0230 6a(c)(i) 7(c)(i) 1(c)(ii) 4(c)(ii) 18 18 18 18 N N N N 0240 5a(c)(ii) 18 N Publication 1346 August 30, 2002 Part II Page 362 Section 4 SCHEDULE J (FORM 5471) Field Identification No. ----- -------------0250 0260 0270 0280 Balance of E&P Assets Balance at EOYAssets Balance BOY-Income Amounts Included Under Sec. 951(a)Income Actual Distribution or ReclassificationIncome Balance of E&PIncome Balance at EOYIncome Balance BOY Total Balance at EOY Total Accumulated Earnings & Profits of Controlled... Form Ref. ---6a(c)(ii) 7(c)(ii) 1(c)(iii) 4(c)(iii) Length -----18 18 18 18 Field Description ----------------N N N N 0290 5a(c)(iii) 18 N 0300 0310 0320 0330 6a(c)(iii) 7(c)(iii) 1(d) 7(d) 18 18 18 18 N N N N Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 363 Section 4 INTENTIONAL BLANK PAGE Publication 1346 August 30, 2002 Part II Page 364 Section 4 SCHEDULE M (FORM 5471) Field Identification No. ----- -------------Byte Count Transactions Between Controlled Foreign Corps Form Ref. ---Length -----4 Field Description ----------------"1300" for Fixed; "nnnn" for variable format Value "****" "SCHbbM" "5471bb" "PG01b" N (Primary SSN) | Start of Record Sentinel 0000 0001 0002 0003 Record Identification Form Number Page Number Taxpayer Identification Number Filler Schedule Occurrence Number Identifying Number Name of Foreign Corporation Country Code For Functional Currency Exchange Rate Sales of Stock in Trade - U.S. Person Sales of Property Rights - U.S. Person Compensation Received - U.S. Person Commissions Received - U.S. Person Rents, Royalties Received - U.S. Person 1(b) 2(b) 3(b) 4 6 6 5 9 0004 0005 0010 0020 0022 0024 0030 0040 0050 1 7 9 35 2 11 12 12 12 Blank 0000001-0000005 NO ENTRY AN N N (nnnnnnn.nnnn) N N N | | 0060 4(b) 12 N 0070 5(b) 12 N Publication 1346 August 30, 2002 Part II Page 365 Section 4 SCHEDULE M (FORM 5471) Field Identification No. ----- -------------0080 0090 0100 0110 0120 Dividends Received U.S. Person Interest Received U.S. Person Preminums Received U.S. Person Add Lines 1 - 8 for U.S. Person Purchase of Stock In Trade - U.S. Person Purchase of Tangible Property U.S. Person Purchase of Property Rights U.S. Person Compensation Paid U.S. Person Commissions Paid U.S. Person Rents, Royalties Paid - U.S. Person Dividends Paid U.S. Person Interest Paid U.S. Person Add Lines 10 - 17 for U.S. Person Amounts Borrowed U.S. Person Amounts Loaned U.S. Person Transactions Between Controlled Foreign Corps Form Ref. ---6(b) 7(b) 8(b) 9(b) 10(b) Length -----12 12 12 12 12 Field Description ----------------N N N N N 0130 11(b) 12 N 0140 12(b) 12 N 0150 0160 0170 0180 0190 0200 0210 0220 13(b) 14(b) 15(b) 16(b) 17(b) 18(b) 19(b) 20(b) 12 12 12 12 12 12 12 12 N N N N N N N N Publication 1346 August 30, 2002 Part II Page 366 Section 4 SCHEDULE M (FORM 5471) Field Identification No. ----- -------------0230 Sales of Stock in Trade - Domestic Corp. Sales of Property Rights - Domestic Corp. Compensation Received - Domestic Corp. Commissions Received - Domestic Corp. Rents, Royalties Received - Domestic Corp. Dividends Received Domestic Corp. Interest Received Domestic Corp. Premiums Received Domestic Corp. Add Lines 1 - 8 for Domestic Corp. Purchase of Stock in Trade - Domestic Corp. Purchase of Tangible Property Domestic Corp. Purchase of Property Rights Domestic Corp. Compensation Paid Domestic Corp. Commissions Paid Domestic Corp. Transactions Between Controlled Foreign Corps Form Ref. ---1(c) Length -----12 Field Description ----------------N 0240 2(c) 12 N 0250 3(c) 12 N 0260 4(c) 12 N 0270 5(c) 12 N 0280 0290 0300 0310 0320 6(c) 7(c) 8(c) 9(c) 10(c) 12 12 12 12 12 N N N N N 0330 11(c) 12 N 0340 12(c) 12 N 0350 0360 13(c) 14(c) August 30, 2002 12 12 N N Part II Page 367 Section 4 Publication 1346 SCHEDULE M (FORM 5471) Field Identification No. ----- -------------0370 Rents, Royalties Paid - Domestic Corp. Dividends Paid Domestic Corp. Interest Paid Domestic Corp. Add Lines 10 - 17 for Domestic Corp. Amounts Borrowed Domestic Corp. Amounts Loaned Domestic Corp. Sales of Stock in Trade - Foreign Corp. Sales of Property Rights - Foreign Corp. Compensation Received - Foreign Corp. Commissions Received - Foreign Corp. Rents, Royalties Received - Foreign Corp. Dividends Received Foreign Corp. Interest Received Foreign Corp. Premiums Received Foreign Corp. Transactions Between Controlled Foreign Corps Form Ref. ---15(c) Length -----12 Field Description ----------------N 0380 0390 0400 0410 0420 0430 16(c) 17(c) 18(c) 19(c) 20(c) 1(d) 12 12 12 12 12 12 N N N N N N 0440 2(d) 12 N 0450 3(d) 12 N 0460 4(d) 12 N 0470 5(d) 12 N 0480 0490 0500 6(d) 7(d) 8(d) 12 12 12 N N N Publication 1346 August 30, 2002 Part II Page 368 Section 4 SCHEDULE M (FORM 5471) Field Identification No. ----- -------------0510 0520 Add Lines 1 - 8 for Foreign Corp. Purchase of Stock in Trade - Foreign Corp. Purchase of Tangible Property Foreign Corp. Purchase of Property Rights Foreign Corp. Compensation Paid Foreign Corp. Commissions Paid Foreign Corp. Rents, Royalties Paid - Foreign Corp. Dividends Paid Foreign Corp. Interest Paid Foreign Corp. Add Lines 10 - 17 for Foreign Corp. Amounts Borrowed Foreign Corp. Amounts Loaned Foreign Corp. Sales of Stock in Trade - 10% Foreign Corp. Sales of Property Rights - 10% Foreign Corp. Transactions Between Controlled Foreign Corps Form Ref. ---9(d) 10(d) Length -----12 12 Field Description ----------------N N 0530 11(d) 12 N 0540 12(d) 12 N 0550 0560 0570 0580 0590 0600 0610 0620 0630 13(d) 14(d) 15(d) 16(d) 17(d) 18(d) 19(d) 20(d) 1(e) 12 12 12 12 12 12 12 12 12 N N N N N N N N N 0640 2(e) 12 N Publication 1346 August 30, 2002 Part II Page 369 Section 4 SCHEDULE M (FORM 5471) Field Identification No. ----- -------------0650 Compensation Received - 10% Foreign Corp. Commissions Received - 10% Foreign Corp. Rents, Royalties Received - 10% Foreign Corp. Dividends Received 10% Foreign Corp. Interest Received 10% Foreign Corp. Premiums Received 10% Foreign Corp. Add Lines 1 - 8 for 10% Foreign Corp. Purchase of Stock in Trade - 10% Foreign Corp. Purchase of Tangible Property 10% Foreign Corp. Purchase of Property Rights 10% Foreign Corp. Compensation Paid 10% Foreign Corp. Commissions Paid 10% Foreign Corp. Rents, Royalties Paid - 10% Foreign Corp. Dividends Paid 10% Foreign Corp. Transactions Between Controlled Foreign Corps Form Ref. ---3(e) Length -----12 Field Description ----------------N 0660 4(e) 12 N 0670 5(e) 12 N 0680 0690 0700 0710 0720 6(e) 7(e) 8(e) 9(e) 10(e) 12 12 12 12 12 N N N N N 0730 11(e) 12 N 0740 12(e) 12 N 0750 0760 0770 13(e) 14(e) 15(e) 12 12 12 N N N 0780 16(e) August 30, 2002 12 N Part II Page 370 Section 4 Publication 1346 SCHEDULE M (FORM 5471) Field Identification No. ----- -------------0790 0800 Interest Paid - 10% Foreign Corp. Add Lines 10 - 17 for 10% Foreign Corp. Amounts Borrowed 10% Foreign Corp. Amounts Loaned 10% Foreign Corp. Sales of Stock in Trade - 10% Any Corp. Sales of Property Rights - 10% Any Corp. Compensation Received - 10% Any Corp. Commissions Received - 10% Any Corp. Rents, Royalties Received - 10% Any Corp. Dividends Received 10% Any Corp. Interest Received 10% Any Corp. Premiums Received 10% Any Corp. Add Lines 1 - 8 for 10% Any Corp. Purchase of Stock in Trade - 10% Any Corp. Transactions Between Controlled Foreign Corps Form Ref. ---17(e) 18(e) Length -----12 12 Field Description ----------------N N 0810 0820 0830 19(e) 20(e) 1(f) 12 12 12 N N N 0840 2(f) 12 N 0850 3(f) 12 N 0860 4(f) 12 N 0870 5(f) 12 N 0880 0890 0900 0910 0920 6(f) 7(f) 8(f) 9(f) 10(f) 12 12 12 12 12 N N N N N Publication 1346 August 30, 2002 Part II Page 371 Section 4 SCHEDULE M (FORM 5471) Field Identification No. ----- -------------0930 Purchase of Tangible Property 10% Any Corp. Purchase of Property Rights 10% Any Corp. Compensation Paid 10% Any Corp. Commissions Paid 10% Any Corp. Rents, Royalties Paid - 10% Any Corp. Dividends Paid 10% Any Corp. Interest Paid - 10% Any Corp. Add Lines 10 - 17 for 10% Any Corp. Amounts Borrowed 10% Any Corp. Amounts Loaned 10% Any Corp. Transactions Between Controlled Foreign Corps Form Ref. ---11(f) Length -----12 Field Description ----------------N 0940 12(f) 12 N 0950 0960 0970 0980 0990 1000 1010 1020 13(f) 14(f) 15(f) 16(f) 17(f) 18(f) 19(f) 20(f) 12 12 12 12 12 12 12 12 N N N N N N N N Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 372 Section 4 SCHEDULE N (FORM 5471) Field Identification No. ----- -------------Byte Count Return of Officers, Directors & 10% or .... Form Ref. ---Length -----4 Field Description ----------------"1388" for Fixed; "nnnn" for variable format Value "****" "SCHbbN" "5471bb" "PG01b" N (Primary SSN) | Start of Record Sentinel 0000 0001 0002 0003 Record Identification Form Number Page Number Taxpayer Identification Number Filler Schedule Occurrence Number Identifying Number Name of Foreign Corporation Country Code for Functional Currency Exchange Rate First Time Filer Info Description of Securities Filler Interest Rate Face Value: Beginning of Year Face Value: End of Year PT I SEC A PT I SEC A PT I SEC A PT I SEC A PT I SEC A 4 6 6 5 9 0004 0005 0010 0020 0030 0035 @0036 *0040 +0045 +0050 +0060 +0070 1 7 9 35 2 11 6 20 6 6 12 12 Blank 0000001 NO ENTRY AN N N (nnnnnnn.nnnn) "STMbnn" or Blank AN or "STMbnn" Blank R N N | | Publication 1346 August 30, 2002 Part II Page 373 Section 4 SCHEDULE N (FORM 5471) Field Identification No. ----- -------------0080 0085 0090 0100 0110 0120 0125 0130 0140 0150 0160 0165 0170 0180 0190 0200 0205 0210 0220 0230 Description of Securities-2 Filler Interest Rate-2 Face Value: Beginning of Year-2 Face Value: End of Year-2 Description of Securities-3 Filler Interest Rate-3 Face Value: Beginning of Year-3 Face Value: End of Year-3 Description of Securities-4 Filler Interest Rate-4 Face Value: Beginning of Year-4 Face Value: End of Year-4 Name of Holder Name of Holder Name Line 2 Address of Holder City of Holder State of Holder Return of Officers, Directors & 10% or .... Form Ref. ---PT I SEC A PT I SEC A PT I SEC A PT I SEC A PT I SEC A PT I SEC A PT I SEC A PT I SEC A PT I SEC A PT I SEC A PT I SEC A PT I SEC A PT I SEC A PT I SEC A PT I SEC A PT I SEC B PT I SEC B PT I SEC B PT I SEC B PT I SEC B August 30, 2002 Length -----20 6 6 12 12 20 6 6 12 12 20 6 6 12 12 40 40 35 22 2 Field Description ----------------AN Blank R or Blank N or Blank N or Blank AN Blank R or Blank N or Blank N or Blank AN Blank R or Blank N or Blank N or Blank AN AN AN AN AN Part II Page 374 Section 4 Publication 1346 SCHEDULE N (FORM 5471) Field Identification No. ----- -------------0240 0250 Zip Code of Holder Class of Securities Return of Officers, Directors & 10% or .... Form Ref. ---PT I SEC B PT I SEC B Length -----12 1 Field Description ----------------N or nnnnnbbbbbbb or nnnnnnnnnbbb ALPHA: "C" = COMMON, "P" = PREFERRED, "T" = TREASURY N N N N AN YYYYMMDD AN AN AN AN AN N or nnnnnbbbbbbb or nnnnnnnnnbbb or Blank ALPHA: "C" = COMMON, "P" = PREFERRED, "T" = TREASURY N or Blank | 0260 0270 0280 0290 0300 0305 0310 0315 0320 0330 0340 0350 0360 Number of Securities Held-BOY Face Value of Securities Held-BOY Number of Securities Held-EOY Face Value of Securities Held- EOY Explanation of Change in Holdings Date of Change in Holdings Name of Holder-2 Name of Holder-2Name Line 2 Address of Holder-2 City of Holder-2 State of Holder-2 Zip Code of Holder-2 Class of Securities2 PT I SEC B PT I SEC B PT I SEC B PT I SEC B PT I SEC B PT I SEC B PT I SEC B PT I SEC B PT I SEC B PT I SEC B PT I SEC B PT I SEC B PT I SEC B 10 12 10 12 40 8 40 40 35 22 2 12 1 0370 Number of Securities Held-BOY2 PT I SEC B 10 Publication 1346 August 30, 2002 Part II Page 375 Section 4 SCHEDULE N (FORM 5471) Field Identification No. ----- -------------0380 Face Value of Securities Held-BOY2 Number of Securities Held-EOY2 Face Value of Securities Held-EOY2 Explanation of Change in Holdings-2 Date of Change in Holdings-2 Name of Holder-3 Name of Holder-3Name Line 2 Address of Holder-3 City of Holder-3 State of Holder-3 Zip Code of Holder-3 Class of Securities3 Return of Officers, Directors & 10% or .... Form Ref. ---PT I SEC B Length -----12 Field Description ----------------N or Blank 0390 PT I SEC B 10 N or Blank 0400 PT I SEC B 12 N or Blank 0410 0415 0420 0425 0430 0440 0450 0460 0470 PT I SEC B PT I SEC B PT I SEC B PT I SEC B PT I SEC B PT I SEC B PT I SEC B PT I SEC B PT I SEC B 40 8 40 40 35 22 2 12 1 AN YYYYMMDD or Blank | AN AN AN AN AN N or nnnnnbbbbbbb or nnnnnnnnnbbb or Blank ALPHA: "C" = COMMON, "P" = PREFERRED, "T" = TREASURY N or Blank 0480 Number of Securities Held-BOY3 Face Value of Securities Held BOY3 Number of Securities Held-EOY3 PT I SEC B 10 0490 PT I SEC B 12 N or Blank 0500 PT I SEC B 10 N or Blank Publication 1346 August 30, 2002 Part II Page 376 Section 4 SCHEDULE N (FORM 5471) Field Identification No. ----- -------------0510 Face Value of Securities Held-EOY3 Explanation of Change in Holdings-3 Date of Change in Holdings-3 Gross Income Attach Schedule of Gross Income Deductions Allowed Attach Schedule of Deductions Taxable Income (Loss) Taxes Attach Schedules Per Instructions Charitable Contributions Special Deductions Disallowed Net Operating Loss Expenses and Depreciation Attach Statement for each Property Taxes and Contributions Total Adjustments Combine Line 3 and Line 4g Return of Officers, Directors & 10% or .... Form Ref. ---PT I SEC B Length -----12 Field Description ----------------N or Blank 0520 0525 0530 @0535 0540 @0545 0550 0560 @0565 0570 0580 0590 0600 @0605 0610 0620 0630 PT I SEC B PT I SEC B 1 1 2 2 3 4a 4a 4b 4c 4d 4e 4e 4f 4g 5 40 8 12 6 12 6 12 12 6 12 12 12 12 6 12 12 12 AN YYYYMMDD or Blank | N "STMbnn" or Blank N "STMbnn" or Blank N N "STMbnn" or Blank N N N N "STMbnn" or Blank N N N Part II Page 377 Section 4 Publication 1346 August 30, 2002 SCHEDULE N (FORM 5471) Field Identification No. ----- -------------0640 0650 0660 @0665 0670 Deduction for Dividends Paid Subtract Line 6 from Line 5 Deductions Allowed Attach Designation Required Undistributed Foreign Company Income Taxable Dividends Paid: Cash - Date Paid Taxable Dividends Paid: Cash - Amount Taxable Dividends Paid: Property Date Paid Taxable Dividends Paid: Property Amount Nature of Property Taxable Dividends Paid: Obligations Date Taxable Dividends Paid: Obligations Amount Consent Dividends Attach Schedule of Dividends Deduction for Dividends Paid During Tax Year Return of Officers, Directors & 10% or .... Form Ref. ---6 7 8 8 9 Length -----12 12 12 6 12 Field Description ----------------N N N STMbnn or Blank N 0680 10a 8 YYYYMMDD | 0690 0700 10a 10b 12 8 N YYYYMMDD | 0710 10b 12 N 0715 0720 10b 10c 20 8 AN YYYYMMDD | 0730 10c 12 N 0740 @0745 0750 11 11 12 12 6 12 N "STMbnn" or Blank N Publication 1346 August 30, 2002 Part II Page 378 Section 4 SCHEDULE N (FORM 5471) Field Identification No. ----- -------------@0755 Global Section A and B Attachments Return of Officers, Directors & 10% or .... Form Ref. ---Length -----6 Field Description ----------------"STMbnn" or Blank Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 379 Section 4 INTENTIONAL BLANK PAGE Publication 1346 August 30, 2002 Part II Page 380 Section 4 SCHEDULE O (FORM 5471) PAGE 1 Field Identification No. ----- -------------Byte Count Organization or Reorganization of Foreign Corp. Form Ref. ---Length -----4 Field Description ----------------"2150" for Fixed; "nnnn" for variable format Value "****" "SCHbbO" "5471bb" "PG01b" N (Primary SSN) | Start of Record Sentinel 0000 0001 0002 0003 Record Identification Form Number Page Number Taxpayer Identification Number Filler Schedule Occurrence Number Identifying Number Name of Foreign Corporation Name of Shareholder Name of Shareholder - Name Line 2 Address of Shareholder City of Shareholder State of Shareholder Zip Code of Shareholder Identifying Number of Shareholder Date of Original Acquisition I (a) I (a) I (b) I (b) I (b) I (b) I (c) I (d) 4 6 6 5 9 0004 0005 0010 0020 0030 0035 0040 0050 0060 0070 0080 0090 1 7 9 35 40 40 35 22 2 12 9 8 Blank 0000001 - 0000005 NO ENTRY AN AN AN AN AN AN N or nnnnnbbbbbbb or nnnnnnnnnbbb N YYYYMMDD | | Publication 1346 August 30, 2002 Part II Page 381 Section 4 SCHEDULE O (FORM 5471) PAGE 1 Field Identification No. ----- -------------0100 0110 0115 0120 0130 0140 0150 Date of Additional Acquisition Name of Shareholder2 Name of Shareholder2 - Name Line 2 Address of Shareholder-2 City of Shareholder2 State of Shareholder-2 Zip Code of Shareholder-2 Identifying Number of Shareholder-2 Date of Original Acquisition-2 Date of Additional Acquisition-2 Name of Shareholder3 Name of Shareholder3 - Name Line 2 Address of Shareholder-3 City of Shareholder3 State of Shareholder-3 Zip Code of Shareholder-3 Organization or Reorganization of Foreign Corp. Form Ref. ---I (e) I (a) I (a) I (b) I (b) I (b) I (b) Length -----8 40 40 35 22 2 12 Field Description ----------------YYYYMMDD AN AN AN AN AN N or nnnnnbbbbbbb or nnnnnnnnnbbb or blank N or Blank YYYYMMDD or blank | YYYYMMDD or Blank | AN AN AN AN AN N or nnnnnbbbbbbb or nnnnnnnnnbbb or Blank Part II Page 382 Section 4 | 0160 0170 0180 0190 0195 0200 0210 0220 0230 I (c) I (d) I (e) I (a) I (a) I (b) I (b) I (b) I (b) 9 8 8 40 40 35 22 2 12 Publication 1346 August 30, 2002 SCHEDULE O (FORM 5471) PAGE 1 Field Identification No. ----- -------------0240 0250 0260 0270 0275 0280 0290 0300 0310 Identifying Number of Shareholder-3 Date of Original Acquisition-3 Date of Additional Acquisition-3 Name of Shareholder4 Name of Shareholder4 - Name Line 2 Address of Shareholder-4 City of Shareholder4 State of Shareholder-4 Zip Code of Shareholder-4 Identifying Number of Shareholder-4 Date of Original Acquisition-4 Date of Additional Acquisition-4 Part I Additional Information Name of U.S. Shareholder Name of U.S. Shareholder - N/L 2 Address of U.S Shareholder Organization or Reorganization of Foreign Corp. Form Ref. ---I (c) I (d) I (e) I (a) I (a) I (b) I (b) I (b) I (b) Length -----9 8 8 40 40 35 22 2 12 Field Description ----------------N or Blank YYYYMMDD or Blank | YYYYMMDD or Blank | AN AN AN AN AN N or nnnnnbbbbbbb or nnnnnnnnnbbb or Blank N or Blank YYYYMMDD or Blank | YYYYMMDD or Blank | "STMbnn" or blank | AN AN AN Part II Page 383 Section 4 0320 0330 0340 @0345 0350 0355 0360 I (c) I (d) I (e) Part I II A(a) II A(a) II A(a) August 30, 2002 9 8 8 6 40 40 35 Publication 1346 SCHEDULE O (FORM 5471) PAGE 1 Field Identification No. ----- -------------0370 0380 0390 0395 0400 0410 0420 0430 0440 0445 City of U.S Shareholder State of U.S. Shareholder Zip Code of U.S. Shareholder Identifying Number of U.S. Shareholder Type of Return Date Return Filed IRS Center Where Filed Date Information Return Filed Name of U.S. Shareholder-2 Name of U.S. Shareholder-2 - N/L 2 Address of U.S. Shareholder-2 City of U.S. Shareholder-2 State of U.S. Shareholder-2 Zip Code of U.S. Shareholder-2 Identifying Number of U.S. Shareholder2 Type of Return-2 Date Return Filed-2 Organization or Reorganization of Foreign Corp. Form Ref. ---II A(a) II A(a) II A(a) II A(a) II A(b)(1) II A(b)(2) II A(b)(3) II A(c) II A(a) II A(a) Length -----22 2 12 9 8 8 12 8 40 40 Field Description ----------------AN AN N or nnnnnbbbbbbb or nnnnnnnnnbbb N or Blank AN YYYYMMDD AN YYYYMMDD or Blank | AN AN | 0450 0460 0470 0480 0485 II A(a) II A(a) II A(a) II A(a) II A(a) 35 22 2 12 9 AN AN AN N or nnnnnbbbbbbb or nnnnnnnnnbbb or Blank N or Blank 0490 0500 II A(b)(1) II A(b)(2) August 30, 2002 8 8 AN YYYYMMDD or Blank | Part II Page 384 Section 4 Publication 1346 SCHEDULE O (FORM 5471) PAGE 1 Field Identification No. ----- -------------0510 0520 0530 0535 IRS Center Where Filed-2 Date Information Return Filed-2 Name of U.S. Shareholder-3 Name of U.S. Shareholder-3 - N/L 2 Address of U.S. Shareholder-3 City of U.S. Shareholder-3 State of U.S. Shareholder-3 Zip Code of U.S. Shareholder-3 Identifying Number of U.S. Shareholder3 Type of Return-3 Date Return Filed-3 IRS Center Where Filed-3 Date Information Return Filed-3 Part II Section A Additional Information Attach Statement of U.S. Persons Name of U.S. Officer or Director Organization or Reorganization of Foreign Corp. Form Ref. ---II A(b)(3) II A(c) II A(a) II A(a) Length -----12 8 40 40 Field Description ----------------AN YYYYMMDD or Blank | AN AN 0540 0550 0560 0570 0575 II A(a) II A(a) II A(a) II A(a) II A(a) 35 22 2 12 9 AN AN AN N or nnnnnbbbbbbb or nnnnnnnnnbbb or Blank N or blank 0580 0590 0600 0610 @0615 II A(b)(1) II A(b)(2) II A(b)(3) II A(c) Part II 8 8 12 8 6 AN YYYYMMDD or Blank | AN YYYYMMDD or Blank | "STMbnn" or blank | @0620 0630 II A II B(a) August 30, 2002 6 40 "STMbnn" or Blank AN Part II Page 385 Section 4 Publication 1346 SCHEDULE O (FORM 5471) PAGE 1 Field Identification No. ----- -------------0635 Name of U.S. Officer or Director - N/L 2 Address of U.S. Officer City of U.S. Officer State of U.S. Officer Zip Code of U.S. Officer Social Security Number Officer Director Name of U.S. Officer or Director2 Name of U.S. Officer or Director2 - N/L 2 Address of U.S. Officer-2 City of U.S. Officer-2 State of U.S. Officer-2 Zip Code of U.S. Officer-2 Social Security Number-2 Officer-2 Director-2 Organization or Reorganization of Foreign Corp. Form Ref. ---II B(a) Length -----40 Field Description ----------------AN 0640 0650 0660 0670 0680 0690 0700 0710 II B(b) II B(b) II B(b) II B(b) II B(c) II B(d) II B(d) II B(a) 35 22 2 12 9 1 1 40 AN AN AN N or nnnnnbbbbbbb or nnnnnnnnnbbb N "X" or blank "X" or blank AN 0715 II B(a) 40 AN 0720 0730 0740 0750 0760 0770 0780 II B(b) II B(b) II B(b) II B(b) II B(c) II B(d) II B(d) August 30, 2002 35 22 2 12 9 1 1 AN AN AN N or nnnnnbbbbbbb or nnnnnnnnnbbb or blank N or blank "X" or blank "X" or blank Part II Page 386 Section 4 Publication 1346 SCHEDULE O (FORM 5471) PAGE 1 Field Identification No. ----- -------------0790 Name of U.S. Officer or Director3 Name of U.S. Officer or Director3 - N/L 2 Address of U.S. Officer-3 City of U.S. Officer-3 State of U.S. Officer-3 Zip Code of U.S. Officer-3 Social Security Number-3 Officer-3 Director-3 Part II Section B Additional Information Name of Shareholder Filing Class of Stock Acquired Organization or Reorganization of Foreign Corp. Form Ref. ---II B(a) Length -----40 Field Description ----------------AN 0795 II B(a) 40 AN 0800 0810 0820 0830 0840 0850 0860 @0865 II B(b) II B(b) II B(b) II B(b) II B(c) II B(d) II B(d) Part II 35 22 2 12 9 1 1 6 AN AN AN N or nnnnnbbbbbbb or nnnnnnnnnbbb or blank N or blank X or blank X or blank "STMbnn" or blank | 0870 0880 II C(a) II C(b) 40 1 AN ALPHA: "C" = COMMON, "P" = PREFERRED, "T" = TREASURY or Blank YYYYMMDD or Blank | AN N or Blank N or Blank Part II Page 387 Section 4 0890 0900 0910 0920 Date of Acquisition Method of Acquisition Number of Shares Acquired Directly Number of Shares Acquired Indirectly II C(c) II C(d) II C(e)(1) II C(e)(2) August 30, 2002 8 8 10 10 Publication 1346 SCHEDULE O (FORM 5471) PAGE 1 Field Identification No. ----- -------------0930 Number of Shares Acquired Constructively Name of Shareholder Filing-2 Class of Stock Acquired-2 Organization or Reorganization of Foreign Corp. Form Ref. ---II C(e)(3) Length -----10 Field Description ----------------N or Blank 0940 0950 II C(a) II C(b) 40 1 AN ALPHA: "C" = COMMON, "P" = PREFERRED, "T" = TREASURY or Blank YYYYMMDD or Blank | AN N or Blank N or Blank 0960 0970 0980 0990 Date of Acquisition2 Method of Acquisition-2 Number of Shares Acquired Directly-2 Number of Shares Acquired Indirectly2 Number of Shares Acquired Constructively-2 Name of Shareholder Filing-3 Class of Stock Acquired-3 II C(c) II C(d) II C(e)(1) II C(e)(2) 8 8 10 10 1000 II C(e)(3) 10 N or Blank 1010 1020 II C(a) II C(b) 40 1 AN ALPHA: "C" = COMMON, "P" = PREFERRED, "T" = TREASURY or Blank YYYYMMDD or Blank | AN N or Blank N or Blank 1030 1040 1050 1060 Date of Acquisition3 Method of Acquisition-3 Number of Shares Acquired Directly-3 Number of Shares Acquired Indirectly3 II C(c) II C(d) II C(e)(1) II C(e)(2) 8 8 10 10 Publication 1346 August 30, 2002 Part II Page 388 Section 4 SCHEDULE O (FORM 5471) PAGE 1 Field Identification No. ----- -------------1065 Number of Shares Acquired Constructively-3 Organization or Reorganization of Foreign Corp. Form Ref. ---II C(e)(3) Length -----10 Field Description ----------------N or Blank Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 389 Section 4 SCHEDULE O (FORM 5471) PAGE 2 Field Identification No. ----- -------------Byte Count Organization or Reorganization of Foreign Corp. Form Ref. ---Length -----4 Field Description ----------------"2451" for Fixed; "nnnn" for variable format Value "****" "SCHbbO" "5471bb" "PG02b" N (Primary SSN) | Start of Record Sentinel 1070 1071 1072 1073 Record Identification Form Number Page Number Taxpayer Identification Number Filler Schedule Occurrence Number Amount Paid or Value Given Name From Whom Shares Were Acquired Name From Whom Shares Were Acquired - N/L 2 Address-Person From Whom Shares Acquired City-Person From Whom Shares Acquired State-Person From Whom Shares Acquired Zip Code-Person From Whom Shares Acquired Country-Person from Whom Shares Acquired II C(f) II C(g) II C(g) 4 6 6 5 9 1074 1075 1080 1090 1095 1 7 12 40 40 Blank 0000001 - 0000005 N or Blank AN AN 1100 1110 1120 1130 II C(g) II C(g) II C(g) II C(g) 35 22 2 12 AN AN AN N or nnnnnbbbbbbb or nnnnnnnnnbbb or Blank AN or blank | 1135 II C 35 Publication 1346 August 30, 2002 Part II Page 390 Section 4 SCHEDULE O (FORM 5471) PAGE 2 Field Identification No. ----- -------------1140 1150 Amount Paid or Value Given-2 Name From Whom Shares Were Acquired-2 Name From Whom Shares Were Acquired-2 - N/L 2 Address-Person From Whom Shares Acquired-2 City-Person From Whom Shares Acquired-2 State-Person From Whom Shares Acquired-2 Zip Code-Person From Whom Shares Acquired-2 Country-Person from Whom Shares Acquired-2 Amount Paid or Value Given-3 Name From Whom Shares Were Acquired-3 Name From Whom Shares Were Acquired-3 - N/L 2 Address-Person From Whom Shares Acquired-3 City-Person From Whom Shares Acquired-3 Organization or Reorganization of Foreign Corp. Form Ref. ---II C(f) II C(g) Length -----12 40 Field Description ----------------N or Blank AN 1155 II C(g) 40 AN 1160 II C(g) 35 AN 1170 II C(g) 22 AN 1180 II C(g) 2 AN 1190 II C(g) 12 N or nnnnnbbbbbbb or nnnnnnnnnbbb or Blank AN or blank | 1195 II C 35 1200 1210 II C(f) II C(g) 12 40 N or Blank AN 1215 II C(g) 40 AN 1220 II C(g) 35 AN 1230 II C(g) 22 AN Publication 1346 August 30, 2002 Part II Page 391 Section 4 SCHEDULE O (FORM 5471) PAGE 2 Field Identification No. ----- -------------1240 State-Person From Whom Shares Acquired-3 Zip Code-Person From Whom Shares Acquired-3 Country-Person from Whom Shares Acquired-3 Part II Section C Additional Information Name of Shareholder Disposing of Stock Class of Stock Organization or Reorganization of Foreign Corp. Form Ref. ---II C(g) Length -----2 Field Description ----------------AN 1250 II C(g) 12 N or nnnnnbbbbbbb or nnnnnnnnnbbb or Blank AN or blank | 1253 II C 35 @1255 II 6 "STMbnn" or blank | 1260 1270 II D(a) II D(b) 40 1 AN ALPHA: "C" = COMMON, "P" = PREFERRED, "T" = TREASURY or Blank YYYYMMDD or Blank | AN N or Blank N or Blank N or Blank 1280 1290 1300 1310 1320 Date of Disposition Method of Disposition Number of Shares Disposed Directly Number of Shares Disposed Indirectly Number of Shares Disposed Constructively Name of Shareholder Disposing of Stock-2 Class of Stock-2 II D(c) II D(d) II D(e)(1) II D(e)(2) II D(e)(3) 8 8 10 10 10 1330 1340 II D(a) II D(b) 40 1 AN ALPHA: "C" = COMMON, "P" = PREFERRED, "T" = TREASURY or Blank YYYYMMDD or Blank | Part II Page 392 Section 4 1350 Date of Disposition2 II D(c) 8 Publication 1346 August 30, 2002 SCHEDULE O (FORM 5471) PAGE 2 Field Identification No. ----- -------------1360 1370 1380 Method Of Disposition-2 Number of Shares Disposed Directly-2 Number of Shares Disposed Indirectly2 Number of Shares Disposed Constructively-2 Name of Shareholder Disposing of Stock-3 Class of Stock-3 Organization or Reorganization of Foreign Corp. Form Ref. ---II D(d) II D(e)(1) II D(e)(2) Length -----8 10 10 Field Description ----------------AN N or Blank N or Blank 1390 II D(e)(3) 10 N or Blank 1400 1410 II D(a) II D(b) 40 1 AN ALPHA: "C" = COMMON, "P" = PREFERRED, "T" = TREASURY or Blank YYYYMMDD or Blank | AN N or Blank N or Blank 1420 1430 1440 1450 Date of Disposition3 Method of Disposition-3 Number of Shares Disposed Directly-3 Number of Shares Disposed Indirectly3 Number of Shares Disposed Constructively-3 Amount Received Name To Whom Disposition of Stock Was Made Name To Whom Disposition Made N/L 2 II D(c) II D(d) II D(e)(1) II D(e)(2) 8 8 10 10 1460 II D(e)(3) 10 N or Blank 1470 1480 II D(f) II D(g) 12 40 N or Blank AN 1485 II D(g) 40 AN Publication 1346 August 30, 2002 Part II Page 393 Section 4 SCHEDULE O (FORM 5471) PAGE 2 Field Identification No. ----- -------------1490 1500 1510 1520 1525 1530 1540 Address of Person to Whom Disposition City of Person to Whom Disposition State of Person to Whom Disposition Zip Code of Person to Whom Disposition Country of Person to Whom Disposition Amount Received-2 Name To Whom Disposition of Stock Was Made-2 Name To Whom Disposition Made-2 N/L 2 Address of Person to Whom Disposition2 City of Person to Whom Disposition-2 State of Person to Whom Disposition-2 Zip Code of Person to Whom Disposition2 Country of Person to Whom Disposition2 Amount Received-3 Name To Whom Disposition of Stock Was Made-3 Organization or Reorganization of Foreign Corp. Form Ref. ---II D(g) II D(g) II D(g) II D(g) II D II D(f) II D(g) Length -----35 22 2 12 35 12 40 Field Description ----------------AN AN AN N or nnnnnbbbbbbb or nnnnnnnnnbbb or Blank AN or blank N or Blank AN | 1545 II D(g) 40 AN 1550 II D(g) 35 AN 1560 1570 1580 II D(g) II D(g) II D(g) 22 2 12 AN AN N or nnnnnbbbbbbb or nnnnnnnnnbbb or Blank AN or blank | 1585 II D 35 1590 1600 II D(f) II D(g) 12 40 N or Blank AN Publication 1346 August 30, 2002 Part II Page 394 Section 4 SCHEDULE O (FORM 5471) PAGE 2 Field Identification No. ----- -------------1605 Name To Whom Disposition Made-3 N/L 2 Address of Person to Whom Disposition3 City of Person to Whom Disposition-3 State of Person to Whom Disposition-3 Zip Code of Person to Whom Disposition3 Country of Person to Whom Disposition3 Part II Section D Additional Information Name of Transferor Name of Transferor Name Line 2 Address of Transferor City of Transferor State of Transferor Zip Code of Transferor Country of Transferor Identifying Number of Transferor Date of Transfer Organization or Reorganization of Foreign Corp. Form Ref. ---II D(g) Length -----40 Field Description ----------------AN 1610 II D(g) 35 AN 1620 1630 1640 II D(g) II D(g) II D(g) 22 2 12 AN AN N or nnnnnbbbbbbb or nnnnnnnnnbbb or Blank AN or blank | 1643 II D 35 @1645 II 6 "STMbnn" or blank | 1650 1655 1660 1670 1680 1690 1695 1700 1710 II E(a) II E(a) II E(a) II E(a) II E(a) II E(a) II E II E(b) II E(c) August 30, 2002 40 40 35 22 2 12 35 9 8 AN AN AN AN AN N or nnnnnbbbbbbb or nnnnnnnnnbbb or Blank AN or blank N or Blank YYYYMMDD or Blank | Part II Page 395 Section 4 | Publication 1346 SCHEDULE O (FORM 5471) PAGE 2 Field Identification No. ----- -------------1720 1725 1730 1740 1750 1760 1765 1770 1780 1790 1795 1800 1810 1820 1830 1835 1840 1850 Name of Transferor-2 Name of Transferor2 - Name Line 2 Address of Transferor-2 City of Transferor-2 State of Transferor2 Zip Code of Transferor-2 Country of Transferor-2 Identifying Number of Transferor-2 Date of Transfer-2 Name of Transferor-3 Name of Transferor3 - Name Line 2 Address of Transferor-3 City of Transferor-3 State of Transferor3 Zip Code of Transferor-3 Country of Transferor-3 Identifying Number of Transferor-3 Date of Transfer-3 Organization or Reorganization of Foreign Corp. Form Ref. ---II E(a) II E(a) II E(a) II E(a) II E(a) II E(a) II E II E(b) II E(c) II E(a) II E(a) II E(a) II E(a) II E(a) II E(a) II E II E(b) II E(c) Length -----40 40 35 22 2 12 35 9 8 40 40 35 22 2 12 35 9 8 Field Description ----------------AN AN AN AN AN N or nnnnnbbbbbbb or nnnnnnnnnbbb or Blank AN or blank N or Blank YYYYMMDD or Blank | AN AN AN AN AN N or nnnnnbbbbbbb or nnnnnnnnnbbb or Blank AN or blank N or Blank YYYYMMDD or Blank | Part II Page 396 Section 4 | | Publication 1346 August 30, 2002 SCHEDULE O (FORM 5471) PAGE 2 Field Identification No. ----- -------------1860 1870 1880 1890 1900 1910 1920 1930 1940 1950 1960 1970 @1975 Description of Assets Fair Market Value Adjusted Basis Description of Assets Transferred Description of Assets-2 Fair Market Value-2 Adjusted Basis-2 Description of Assets Transferred-2 Description of Assets-3 Fair Market Value-3 Adjusted Basis-3 Description of Assets Transferred-3 Part II Section E Additional Information Attach Schedule if Filed Tax Return Date of Any Reorganization During Last 4 Years Attach A Chart Organization or Reorganization of Foreign Corp. Form Ref. ---II E(d)(1) II E(d)(2) II E(d)(3) II E(e) II E(d)(1) II E(d)(2) II E(d)(3) II E(e) II E(d)(1) II E(d)(2) II E(d)(3) II E(e) II Length -----40 12 12 40 40 12 12 40 40 12 12 40 6 Field Description ----------------AN N or Blank N or Blank AN AN N or Blank N or blank AN AN N or Blank N or Blank AN "STMbnn" or blank | @1980 1990 II F(a) II F(b) 6 8 "STMbnn" or Blank YYYYMMDD or Blank | @2000 II F(c) 6 "STMbnn" or blank Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 397 Section 4 INTENTIONAL BLANK PAGE Publication 1346 August 30, 2002 Part II Page 398 Section 4 FORM 5713 PAGE 1 Field Identification No. ----- -------------Byte Count International Boycott Report Form Ref. ---Length -----4 Field Description ----------------"0747" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" "5713bb" "PG01b" N (Primary SSN) | Start of Record Sentinel 0000 0001 0002 0003 Record ID Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number Tax Year Beginning Tax Year Ending Identifying Number Address City State Zip Code Service Center Where Return Is Filed Type Of Filer: (individual) Type Of Filer: (partnership) Type Of Filer: (corporation) August 30, 2002 4 6 6 5 9 0004 0005 0010 0020 0040 0050 0060 0070 0080 0090 1 7 8 8 9 35 22 2 12 10 Blank N 0000001 YYYYMMDD YYYYMMDD NO ENTRY AN AN AN N or nnnnnbbbbbbb or nnnnnnnnnbbb AN | | | 0100 0110 0120 1 1 1 "X" or blank NO ENTRY NO ENTRY Publication 1346 Part II Page 399 Section 4 FORM 5713 PAGE 1 Field Identification No. ----- -------------0130 0140 0150 0160 0170 0180 0190 0200 Type Of Filer: (trust) Type Filer: (estate) Type Of Filer: (other) Adjusted Gross Income (Individuals) Partner/Corporation Name Partner/Corporation Identifying Number Partner/Corporation Name - 2 Partner Corporation Identifying Number 2 Partner/Corporation Name - 3 Partner Corporation Identifying Number 3 Partner/Corporation Name - 4 Partner/Corporation Identifying Number 4 Partner/Corporation Name - 5 Partner/Corporation Identifying Number 5 Partner/Corporation Name - 6 International Boycott Report Form Ref. ---Length -----1 1 1 1 2a/b 2a/b 2a/b 2a/b 12 35 9 35 9 Field Description ----------------NO ENTRY NO ENTRY "X" or blank N NO ENTRY NO ENTRY NO ENTRY NO ENTRY | 0210 0220 2a/b 2a/b 35 9 NO ENTRY NO ENTRY 0230 0240 2a/b 2a/b 35 9 NO ENTRY NO ENTRY 0250 0260 2a/b 2a/b 35 9 NO ENTRY NO ENTRY 0270 2a/b 35 NO ENTRY Publication 1346 August 30, 2002 Part II Page 400 Section 4 FORM 5713 PAGE 1 Field Identification No. ----- -------------0280 Partner/Corporation Identifying Number 6 Partner/Corporation Name - 7 Partner/Corporation Identifying Number 7 Attachment Additional Information Additional Information Included Partnership Principal Business Activity Code Principal Business Activity Description Partnership ICDISCs Code IC-DISCs Description Partnership's Total Assets Partnership's Ordinary Income Type Of Form 1120 Series Filed Name Of Corporation Employer Identification Number Taxable Year Beginning Taxable Year Ending International Boycott Report Form Ref. ---2a/b Length -----9 Field Description ----------------NO ENTRY 0290 0300 2a/b 2a/b 35 9 NO ENTRY NO ENTRY 0305 2a/b 6 NO ENTRY 0310 0320 2a/b 2c 1 6 NO ENTRY NO ENTRY 0330 0340 0350 0360 0370 0380 0390 0400 2c 2d 2d 3a 3b 4a 4b(1) 4b(2) 35 3 35 12 12 6 35 9 NO ENTRY NO ENTRY NO ENTRY NO ENTRY NO ENTRY NO ENTRY NO ENTRY NO ENTRY 0410 0420 4b(3) 4b(3) August 30, 2002 8 8 NO ENTRY NO ENTRY Part II Page 401 Section 4 Publication 1346 FORM 5713 PAGE 1 Field Identification No. ----- -------------0430 0440 0450 0460 0470 0480 0490 0500 Total Assets Taxable Income Total Income Of Estates Or Trusts Foreign Tax Credit Deferral Of Earnings Deferral Of IC-DISC Income Exempt FSC Income Excludable ExtraTerritorial Income International Boycott Report Form Ref. ---4c(1) 4c(2) 5 6a 6b 6c 6d 6e Length -----12 12 12 12 12 12 12 12 Field Description ----------------NO ENTRY NO ENTRY NO ENTRY N N NO ENTRY NO ENTRY NO ENTRY Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 402 Section 4 FORM 5713 PAGE 2 Field Identification No. ----- -------------Byte Count International Form Ref. ---- Boycott Report Field Description ----------------"1396" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" "5713bb" "PG02b" N (Primary SSN) | Length -----4 Start of Record Sentinel 0510 0511 0512 0513 Record ID Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number Operations Reportable Under Section 999(a) - Yes Operations Reportable Under Section 999(a) - No Foreign Corporation Controlled - Yes Box Foreign Corporation Controlled - No Box Do You Own Any Stock Of IC-DISC Yes Box Do You Own Any Stock Of IC-DISC No Box Do You Claim Foreign Tax Credit Yes Box Do You Claim Foreign Tax Credit No Box 7a 4 6 6 5 9 0514 0515 0520 1 7 1 blank N 0000001 "X" or blank 0530 7a 1 "X" or blank 0540 0550 0560 7b 7b 7c 1 1 1 "X" or blank "X" or blank "X" or blank 0570 7c 1 "X" or blank 0580 7d 1 "X" or blank 0590 7d 1 "X" or blank Publication 1346 August 30, 2002 Part II Page 403 Section 4 FORM 5713 PAGE 2 Field Identification No. ----- -------------0600 Do You Control Any Corporation - Yes Box Do You Control Any Corporation - No Box If Yes, Did Corporation Participate - Yes Box If Yes, Did Corporation Participate - No Box Are You Controlled Yes Box Are You Controlled No Box If Yes, Did Person Participate - Yes Box If Yes, Did Person Participate - No Box Treated Under Section 671 As Owner - Yes Box Treated Under Section 671 As Owner - No Box Partner In A Partnership - Yes Box Partner In A Partnership - No Box Are You A Foreign Sales Corporation Yes Box International Form Ref. ---7e Boycott Report Field Description ----------------"X" or blank Length -----1 0610 0620 7e 7e 1 1 "X" or blank "X" or blank 0630 7e 1 "X" or blank 0640 0650 0660 7f 7f 7f 1 1 1 "X" or blank "X" or blank "X" or blank 0670 0680 7f 7g 1 1 "X" or blank "X" or blank 0690 7g 1 "X" or blank 0700 7h 1 "X" or blank 0710 0720 7h 7i 1 1 "X" or blank "X" or blank Publication 1346 August 30, 2002 Part II Page 404 Section 4 FORM 5713 PAGE 2 Field Identification No. ----- -------------0730 Are You A Foreign Sales Corporation No Box Are You Excluding Extraterritorial Income - Yes Are You Excluding Extraterritorial Income - No Boycott Of Israel Yes Box Boycott Of Israel No Box Are You Submitting Additional Information Name Of Country Identifying Number Of Person Having Operations Principal Business Activity Code Description Of Principal Business Activity IC-DISCs Product Code Name Of Country - 2 Identifying Number Of Person Having Operations - 2 Principal Business Activity Code - 2 Description Of Principal Business Activity - 2 International Form Ref. ---7i Boycott Report Field Description ----------------"X" or blank Length -----1 0732 7j 1 "X" or blank 0734 7j 1 "X" or blank 0740 0750 0760 8 8 8 1 1 1 "X" or blank "X" or blank "X" or blank *0770 +0780 8a(1) 8a(2) 35 9 AN or "STMbnn" or blank N +0790 *+0800 8a(3) 8a(4) 6 35 N AN or "STMbnn" +0810 0820 0830 8a(5) 8b(1) 8b(2) 3 35 9 NO ENTRY AN or blank N or blank 0840 0850 8b(3) 8b(4) 6 35 N or blank AN or blank Publication 1346 August 30, 2002 Part II Page 405 Section 4 FORM 5713 PAGE 2 Field Identification No. ----- -------------0860 0870 0880 IC-DISCs Product Code - 2 Name Of Country - 3 Identifying Number Of Person Having Operations - 3 Principal Business Activity Code - 3 Description Of Principal Business Activity - 3 IC-DISCs Product Code - 3 Name Of Country - 4 Identifying Number Of Person Having Operations - 4 Principal Business Activity Code - 4 Description Of Principal Business Activity - 4 IC-DISCs Product Code - 4 Name Of Country - 5 Identifying Number Of Person Having Operations - 5 Principal Business Activity Code - 5 Description Of Principal Business Activity - 5 IC-DISCs Product Code - 5 International Form Ref. ---8b(5) 8c(1) 8c(2) Boycott Report Field Description ----------------NO ENTRY AN or blank N or blank Length -----3 35 9 0890 0900 8c(3) 8c(4) 6 35 N or blank AN or blank 0910 0920 0930 8c(5) 8d(1) 8d(2) 3 35 9 NO ENTRY AN or blank N or blank 0940 0950 8d(3) 8d(4) 6 35 N or blank AN or blank 0960 0970 0980 8d(5) 8e(1) 8e(2) 3 35 9 NO ENTRY AN or blank N or blank 0990 1000 8e(3) 8e(4) 6 35 N or blank AN or blank 1010 8e(5) August 30, 2002 3 NO ENTRY Part II Page 406 Section 4 Publication 1346 FORM 5713 PAGE 2 Field Identification No. ----- -------------1020 1030 Name Of Country - 6 Identifying Number Of Person Having Operations - 6 Principal Business Activity Code - 6 Description Of Principal Business Activity - 6 IC-DISCs Product Code - 6 Name Of Country - 7 Identifying Number Of Person Having Operations - 7 Principal Business Activity Code - 7 Description Of Principal Business Activity - 7 IC-DISCs Product Code - 7 Name Of Country - 8 Identifying Number Of Person Having Operations Principal Business Activity Code - 8 Description Of Principal Business Activity - 8 IC-DISCs Product Code - 8 Name Of Country - 9 International Form Ref. ---8f(1) 8f(2) Boycott Report Field Description ----------------AN or blank N or blank Length -----35 9 1040 1050 8f(3) 8f(4) 6 35 N or blank AN or blank 1060 1070 1080 8f(5) 8g(1) 8g(2) 3 35 9 NO ENTRY AN or blank N or blank 1090 1100 8g(3) 8g(4) 6 35 N or blank AN or blank 1110 1120 1130 8g(5) 8h(1) 8h(2) 3 35 9 NO ENTRY AN or blank N OR BLANK 1140 1150 8h(3) 8h(4) 6 35 N or blank AN or blank 1160 1170 8h(5) 8i(1) August 30, 2002 3 35 NO ENTRY AN or blank Part II Page 407 Section 4 Publication 1346 FORM 5713 PAGE 2 Field Identification No. ----- -------------1180 Identifying Number Of Person Having Operations - 9 Principal Business Activity Code - 9 Description Of Principal Business Activity - 9 IC-DISCs Product Code - 9 Name Of Country - 10 Identifying Number Of Person Having Operations-10 Principal Business Activity Code - 10 Description Of Principal Business Activity - 10 IC-DISCs Product Code - 10 Name Of Country - 11 Identifying Number Of Person Having Operations-11 Principal Business Activity Code - 11 Description Of Principal Business Activity - 11 IC-DISCs Product Code - 11 Name Of Country - 12 International Form Ref. ---8i(2) Boycott Report Field Description ----------------N or blank Length -----9 1190 1200 8i(3) 8i(4) 6 35 N or blank AN or blank 1210 1220 1230 8i(5) 8j(1) 8j(2) 3 35 9 NO ENTRY AN or blank N or blank 1240 1250 8j(3) 8j(4) 6 35 N or blank AN or blank 1260 1270 1280 8j(5) 8k(1) 8k(2) 3 35 9 NO ENTRY AN or blank N or blank 1290 1300 8k(3) 8k(4) 6 35 N or blank AN or blank 1310 1320 8k(5) 8l(1) 3 35 NO ENTRY AN or blank Publication 1346 August 30, 2002 Part II Page 408 Section 4 FORM 5713 PAGE 2 Field Identification No. ----- -------------1330 Identifying Number Of Person Having Operations-12 Principal Business Activity Code - 12 Description Of Principal Business Activity - 12 IC-DISCs Product Code - 12 Name Of Country - 13 Identifying Number Of Person Having Operations-13 Principal Business Activity Code - 13 Description Of Principal Business Activity - 13 IC-DISCs Product Code - 13 Name Of Country - 14 Identifying Number Of Person Having Operations-14 Principal Business Activity Code - 14 Description Of Principal Business Activity - 14 IC-DISCs Product Code - 14 Name Of Country - 15 International Form Ref. ---8l(2) Boycott Report Field Description ----------------N or blank Length -----9 1340 1350 8l(3) 8l(4) 6 35 N or blank AN or blank 1360 1370 1380 8l(5) 8m(1) 8m(2) 3 35 9 NO ENTRY AN or blank N or blank 1390 1400 8m(3) 8m(4) 6 35 N or blank AN or blank 1410 1420 1430 8m(5) 8n(1) 8n(2) 3 35 9 NO ENTRY AN or blank N or blank 1440 1450 8n(3) 8n(4) 6 35 N or blank AN or blank 1460 1470 8n(5) 8o(1) 3 35 NO ENTRY AN or blank Publication 1346 August 30, 2002 Part II Page 409 Section 4 FORM 5713 PAGE 2 Field Identification No. ----- -------------1480 Identifying Number Of Person Having Operations-15 Principal Business Activity Code - 15 Desciption Of Principal Business Activity - 15 IC-DISCs Product Code - 15 International Form Ref. ---8o(2) Boycott Report Field Description ----------------N or blank Length -----9 1490 1500 8o(3) 8o(4) 6 35 N or blank AN or blank 1510 8o(5) 3 NO ENTRY --| --| --| --| --| 1565 Reserved 8 6 Blank Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 410 Section 4 FORM 5713 PAGE 3 Field Identification No. ----- -------------Byte Count International Boycott Report Form Ref. ---Length -----4 Field Description ----------------"1485" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" "5713bb" "PG03b" N (Primary SSN) Start of Record Sentinel 1600 1601 1602 1603 Record ID Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number Non-listed Countries Boycotting Israel (Yes Box) Non-listed Countries Boycotting Israel (No Box) Submitting Additional Information Name Of Non-Listed Country Identifying Number Of Person Business Activity Code Description Of Principal Activity IC-DISCs Only Product Code 9 4 6 6 5 9 1604 1605 1610 1 7 1 blank N 0000001 "X" or blank 1620 9 1 "X" or blank 1630 9 1 "X" or blank *1640 +1650 +1660 *+1670 +1680 9a(1) 9a(2) 9a(3) 9a(4) 9a(5) August 30, 2002 35 9 6 35 3 AN or "STMbnn" or blank N N AN or "STMbnn" NO ENTRY Part II Page 411 Section 4 Publication 1346 FORM 5713 PAGE 3 Field Identification No. ----- -------------1690 1700 1710 1720 Name Of Non-Listed Country - 2 Identifying Number Of Person - 2 Business Activity Code - 2 Description Of Principal Activity 2 IC-DISCs Only Product Code - 2 Name Of Non-Listed Country - 3 Identifying Number Of Person - 3 Business Activity Code - 3 Description Of Principal Activity 3 IC-DISCs Only Product Code - 3 Name Of Non-Listed Country - 4 Identifying Number Of Person - 4 Business Activity Code - 4 Description Of Principal Activity 4 IC-DISCs Only Product Code - 4 Name Of Non-Listed Country - 5 International Boycott Report Form Ref. ---9b(1) 9b(2) 9b(3) 9b(4) Length -----35 9 6 35 Field Description ----------------AN or blank N or blank N or blank AN or blank 1730 1740 1750 1760 1770 9b(5) 9c(1) 9c(2) 9c(3) 9c(4) 3 35 9 6 35 NO ENTRY AN or blank N or blank N or blank AN or blank 1780 1790 1800 1810 1820 9c(5) 9d(1) 9d(2) 9d(3) 9d(4) 3 35 9 6 35 NO ENTRY AN or blank N or blank N or blank AN or blank 1830 1840 9d(5) 9e(1) August 30, 2002 3 35 NO ENTRY AN or blank Part II Page 412 Section 4 Publication 1346 FORM 5713 PAGE 3 Field Identification No. ----- -------------1850 1860 1870 Identifying Number Of Person - 5 Business Activity Code - 5 Description Of Principal Activity 5 IC-DISCs Only Product Code - 5 Name Of Non-Listed Country - 6 Identifying Number Of Person - 6 Business Activity Code - 6 Description Of Principal Activity 6 IC-DISCs Only Product Code - 6 Name Of Non-Listed Country - 7 Identifying Number Of Person - 7 Business Activity Code - 7 Description Of Principal Activity 7 IC-DISCs Only Product Code - 7 Name Of Non-Listed Country - 8 Identifying Number Of Person - 8 International Boycott Report Form Ref. ---9e(2) 9e(3) 9e(4) Length -----9 6 35 Field Description ----------------N or blank N or blank AN or blank 1880 1890 1900 1910 1920 9e(5) 9f(1) 9f(2) 9f(3) 9f(4) 3 35 9 6 35 NO ENTRY AN or blank N or blank N or blank AN or blank 1930 1940 1950 1960 1970 9f(5) 9g(1) 9g(2) 9g(3) 9g(4) 3 35 9 6 35 NO ENTRY AN or blank N or blank N or blank AN or blank 1980 1990 2000 9g(5) 9h(1) 9h(2) August 30, 2002 3 35 9 NO ENTRY AN or blank N or blank Part II Page 413 Section 4 Publication 1346 FORM 5713 PAGE 3 Field Identification No. ----- -------------2010 2020 Business Activity Code - 8 Description Of Principal Activity 8 IC-DISCs Only Product Code - 8 Reserved Operations In Any Other Country (Yes Box) Operations In Any Other Country (No Box) Additional Information Relating To Boycotts Name Of Other Country Identifying Number Principal Business Code Description Of Business Activity IC-DISCs - Enter Product Code Name Of Other Country - 2 Identifying Number 2 Principal Business Code - 2 Description Of Business Activity 2 International Boycott Report Form Ref. ---9h(3) 9h(4) Length -----6 35 Field Description ----------------N or blank AN or blank 2030 2035 2040 9h(5) 9 10 3 6 1 NO ENTRY Blank "X" or blank 2050 10 1 "X" or blank 2060 10 1 "X" or blank *2070 +2080 +2090 *+2100 +2110 2120 2130 2140 2150 10a(1) 10a(2) 10a(3) 10a(4) 10a(5) 10b(1) 10b(2) 10b(3) 10b(4) 35 9 6 35 3 35 9 6 35 AN or "STMbnn" or blank N N AN or "STMbnn" NO ENTRY AN or blank N or blank N or blank AN or blank Publication 1346 August 30, 2002 Part II Page 414 Section 4 FORM 5713 PAGE 3 Field Identification No. ----- -------------2160 2170 2180 2190 2200 IC-DISCs - Enter Product Code - 2 Name Of Other Country - 3 Identifying Number 3 Principal Business Code - 3 Description Of Business Activity 3 IC-DISCs - Enter Product Code - 3 Name Of Country - 4 Identifying Number 4 Principal Business Code - 4 Description Of Business Activity 4 IC-DISCs - Enter Product Code - 4 Name Of Other Country - 5 Identifying Number 5 Principal Business Code - 5 Description Of Business Activity 5 IC-DISCs - Enter Product Code - 5 International Boycott Report Form Ref. ---10b(5) 10c(1) 10c(2) 10c(3) 10c(4) Length -----3 35 9 6 35 Field Description ----------------NO ENTRY AN or blank N or blank N or blank AN or blank 2210 2220 2230 2240 2250 10c(5) 10d(1) 10d(2) 10d(3) 10d(4) 3 35 9 6 35 NO ENTRY AN or blank N or blank N or blank AN or blank 2260 2270 2280 2290 2300 10d(5) 10e(1) 10e(2) 10e(3) 10e(4) 3 35 9 6 35 NO ENTRY AN or blank N or blank N or blank AN or blank 2310 10e(5) August 30, 2002 3 NO ENTRY Part II Page 415 Section 4 Publication 1346 FORM 5713 PAGE 3 Field Identification No. ----- -------------2320 2330 2340 2350 Name Of Other Country - 6 Identifying Number 6 Principal Business Code - 6 Description Of Business Activity 6 IC-DISCs - Enter Product Code - 6 Name Of Other Country - 7 Identifying Number 7 Principal Business Code - 7 Description Of Business Activity 7 IC-DISCs - Enter Product Code - 7 Name Of Other Country - 8 Identifying Number 8 Principal Business Code - 8 Description Of Business Activity 8 IC-DISCs - Enter Product Code - 8 Reserved International Boycott Report Form Ref. ---10f(1) 10f(2) 10f(3) 10f(4) Length -----35 9 6 35 Field Description ----------------AN or blank N or blank N or blank AN or blank 2360 2370 2380 2390 2400 10f(5) 10g(1) 10g(2) 10g(3) 10g(4) 3 35 9 6 35 NO ENTRY AN or blank N or blank N or blank AN or blank 2410 2420 2430 2440 2450 10g(5) 10h(1) 10h(2) 10h(3) 10h(4) 3 35 9 6 35 NO ENTRY AN or blank N OR BLANK N OR BLANK AN or blank 2460 2465 10h(5) 10 August 30, 2002 3 6 NO ENTRY Blank Part II Page 416 Section 4 Publication 1346 FORM 5713 PAGE 3 Field Identification No. ----- -------------2470 Requested To Participate (Yes Box) Requested To Participate (No Box) Line 11 Attachments Did You Participate (Yes Box) Did You Participate (No Box) Line 12 Attachments International Boycott Report Form Ref. ---11 Length -----1 Field Description ----------------"X" or blank 2480 @2485 2490 2500 @2505 11 11 12 12 12 1 6 1 1 6 "X" or blank "STMbnn" or blank | "X" or blank "X" or blank "STMbnn" or blank | Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 417 Section 4 FORM 5713 PAGE 4 Field Identification No. ----- -------------Byte Count International Boycott Report Form Ref. ---Length -----4 Field Description ----------------"1926" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" "5713bb" "PG04b" N (Primary SSN) Start of Record Sentinel 2520 2521 2522 2523 Record ID Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number Requests Refrain From Business With Country (Yes) Requests Refrain From Business With Country (No) Agreement Refrain From Business with Country (Yes) Agreement Refrain From Business with Country (No) Requests Refrain From Business With Person (Yes) Requests Refrain From Business With Person (No) Agreement Refrain From Business with Person (Yes) 13a(1)(a) 4 6 6 5 9 2524 2525 2530 1 7 1 Blank N 0000001 "X" or blank 2540 13a(1)(a) 1 "X" or blank 2550 13a(1)(a) 1 "X" or blank 2560 13a(1)(a) 1 "X" or blank 2570 13a(1)(b) 1 "X" or blank 2580 13a(1)(b) 1 "X" or blank 2590 13a(1)(b) 1 "X" or blank Publication 1346 August 30, 2002 Part II Page 418 Section 4 FORM 5713 PAGE 4 Field Identification No. ----- -------------2600 Agreement Refrain From Business with Person (No) Requests Refrain From Business With Company (Yes) Requests Refrain From Business With Company (No) Agreement Refrain From Business with Company (Yes) Agreement Refrain From Business with Company (No) Request To Refrain From Employing (Yes Box) Request To Refrain From Employing (No Box) Agreement To Refrain From Employing (Yes Box) Agreement To Refrain From Employing (No Box) Requests To Refrain From Shipping (Yes Box) Requests To Refrain From Shipping (No Box) Agreement To Refrain From Shipping (Yes Box) International Boycott Report Form Ref. ---13a(1)(b) Length -----1 Field Description ----------------"X" or blank 2610 13a(1)(c) 1 "X" or blank 2620 13a(1)(c) 1 "X" or blank 2630 13a(1)(c) 1 "X" or blank 2640 13a(1)(c) 1 "X" or blank 2650 13a(1)(d) 1 "X" or blank 2660 13a(1)(d) 1 "X" or blank 2670 13a(1)(d) 1 "X" or blank 2680 13a(1)(d) 1 "X" or blank 2690 13a(2) 1 "X" or blank 2700 13a(2) 1 "X" or blank 2710 13a(2) 1 "X" or blank Publication 1346 August 30, 2002 Part II Page 419 Section 4 FORM 5713 PAGE 4 Field Identification No. ----- -------------2720 Agreement To Refrain From Shipping (No Box) Additional Information Requests and Agreements Name Of Resquesting Country Identifying Number Of Person Receiving Business Code Business Activity Description IC-DISCs Code Number Of Requests Total Number Of Requests Code Number Of Agreements - Total Number Of Agreements - Code Name Of Requesting Country - 2 Identifying Number Of Person Receiving - 2 Business Code - 2 Business Activity Description - 2 IC-DISCs Code - 2 Number Of Requests Total - 2 International Boycott Report Form Ref. ---13a(2) Length -----1 Field Description ----------------"X" or blank 2730 13b 1 "X" or blank *2740 +2750 +2760 *+2770 +2780 +2790 +2800 +2810 +2820 2830 2840 13b(1)a 13b(2)a 13b(3)a 13b(4)a 13b(5)a 13b(6)a 13b(7)a 13b(8)a 13b(9)a 13b(1)b 13b(2)b 35 9 6 35 3 12 2 12 2 35 9 AN or "STMbnn" or blank N N AN or "STMbnn" NO ENTRY N N N N AN or blank N or blank 2850 2860 2870 2880 13b(3)b 13b(4)b 13b(5)b 13b(6)b 6 35 3 12 N or blank AN or blank NO ENTRY N or blank Part II Page 420 Section 4 Publication 1346 August 30, 2002 FORM 5713 PAGE 4 Field Identification No. ----- -------------2890 2900 Number Of Requests Code - 2 Number Of Agreements - Total 2 Number Of Agreements - Code 2 Name Of Requesting Country - 3 Identifying Number Of Person Receiving - 3 Business Code - 3 Business Activity Description - 3 IC-DISCs Code - 3 Number Of Requests Total - 3 Number Of Requests Code - 3 Number Of Agreements - Total 3 Number Of Agreements - Code 3 Name Of Requesting Country - 4 Identifying Number Of Person Receiving - 4 Business Code - 4 Business Activity Description - 4 International Boycott Report Form Ref. ---13b(7)b 13b(8)b Length -----2 12 Field Description ----------------N or blank N or blank 2910 13b(9)b 2 N or blank 2920 2930 13b(1)c 13b(2)c 35 9 AN or blank N or blank 2940 2950 2960 2970 2980 2990 13b(3)c 13b(4)c 13b(5)c 13b(6)c 13b(7)c 13b(8)c 6 35 3 12 2 12 N or blank AN or blank NO ENTRY N or blank N or blank N or blank 3000 13b(9)c 2 N or blank 3010 3020 13b(1)d 13b(2)d 35 9 AN or blank N or blank 3030 3040 13b(3)d 13b(4)d August 30, 2002 6 35 N or blank AN or blank Part II Page 421 Section 4 Publication 1346 FORM 5713 PAGE 4 Field Identification No. ----- -------------3050 3060 3070 3080 IC-DISCs Code - 4 Number Of Requests Total - 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8 Identifying Number Of Person Receiving - 8 Business Code - 8 Business Activity Description - 8 IC-DISCs Code-8 Number Of Requests Total - 8 Number Of Requests Code - 8 Number Of Agreements - Total 8 Number Of Agreements - Code 8 Name Of Requesting Country - 9 Identifying Number Of Person Receiving - 9 Business Code - 9 Business Activity Description - 9 IC-DISCs Code - 9 Number Of Requests Total - 9 Number Of Requests Code - 9 International Boycott Report Form Ref. ---13b(1)h 13b(2)h Length -----35 9 Field Description ----------------AN or blank N or blank 3390 3400 3410 3420 3430 3440 13b(3)h 13b(4)h 13b(5)h 13b(6)h 13b(7)h 13b(8)h 6 35 3 12 2 12 N or blank AN or blank NO ENTRY N or blank N or blank N or blank 3450 13b(9)h 2 N or blank 3460 3470 13b(1)i 13b(2)i 35 9 AN or blank N or blank 3480 3490 3500 3510 3520 13b(3)i 13b(4)i 13b(5)i 13b(6)i 13b(7)i 6 35 3 12 2 N or blank AN or blank NO ENTRY N or blank N or blank Publication 1346 August 30, 2002 Part II Page 424 Section 4 FORM 5713 PAGE 4 Field Identification No. ----- -------------3530 Number Of Agreements - Total 9 Number Of Agreements - Code 9 Name Of Requesting Country - 10 Identifying Number Of Person Receiving - 10 Business Code - 10 Business Activity Description - 10 IC-DISCs Code - 10 Number Of Requests Total - 10 Number Of Requests Code - 10 Number Of Agreements - Total 10 Number Of Agreements - Code 10 Name Of Requesting Country - 11 Identifying Number Of Person Receiving - 11 Business Code - 11 Business Activity Description - 11 IC-DISCs Code - 11 International Boycott Report Form Ref. ---13b(8)i Length -----12 Field Description ----------------N or blank 3540 13b(9)i 2 N or blank 3550 3560 13b(1)j 13b(2)j 35 9 AN or blank N or blank 3570 3580 3590 3600 3610 3620 13b(3)j 13b(4)j 13b(5)j 13b(6)j 13b(7)j 13b(8)j 6 35 3 12 2 12 N or blank AN or blank NO ENTRY N or blank N or blank N or blank 3630 13b(9)j 2 N or blank 3640 3650 13b(1)k 13b(2)k 35 9 AN or blank N or blank 3660 3670 3680 13b(3)k 13b(4)k 13b(5)k August 30, 2002 6 35 3 N or blank AN or blank NO ENTRY Part II Page 425 Section 4 Publication 1346 FORM 5713 PAGE 4 Field Identification No. ----- -------------3690 3700 3710 Number Of Requests Total - 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13 IC-DISCs Code - 13 Number Of Requests Total - 13 Number Of Requests Code - 13 Number Of Agreements - Total 13 Number Of Agreements - Code 13 Name Of Requesting Country - 14 Identifying Number Of Person Receiving - 14 Business Code - 14 Business Activity Description - 14 IC-DISCs Code - 14 Number Of Requests Total - 14 Number Of Requests Code - 14 Number Of Agreements - Total 14 Number Of Agreements - Code 14 Name Of Requesting Country - 15 International Boycott Report Form Ref. ---13b(4)m 13b(5)m 13b(6)m 13b(7)m 13b(8)m Length -----35 3 12 2 12 Field Description ----------------AN or blank NO ENTRY N or blank N or blank N or blank 3900 13b(9)m 2 N or blank 3910 3920 13b(1)n 13b(2)n 35 9 AN or blank N or blank 3930 3940 3950 3960 3970 3980 13b(3)n 13b(4)n 13b(5)n 13b(6)n 13b(7)n 13b(8)n 6 35 3 12 2 12 N or blank AN or blank NO ENTRY N or blank N or blank N or blank 3990 13b(9)n 2 N or blank 4000 13b(1)o August 30, 2002 35 AN or blank Part II Page 427 Section 4 Publication 1346 FORM 5713 PAGE 4 Field Identification No. ----- -------------4010 Identifying Number Of Person Receiving - 15 Business Code - 15 Business Activity Description - 15 IC-DISCs Code - 15 Number Of Requests Total - 15 Number Of Requests Code - 15 Number Of Agreements - Total 15 Number Of Agreements - Code 15 Name Of Requesting Country - 16 Identifying Number Of Person Receiving - 16 Business Code - 16 Business Activity Description - 16 IC-DISCs Code - 16 Number Of Requests Total - 16 Number Of Requests Code - 16 Number Of Agreements - Total 16 International Boycott Report Form Ref. ---13b(2)o Length -----9 Field Description ----------------N or blank 4020 4030 4040 4050 4060 4070 13b(3)o 13b(4)o 13b(5)o 13b(6)o 13b(7)o 13b(8)o 6 35 3 12 2 12 N or blank AN or blank NO ENTRY N or blank N or blank N or blank 4080 13b(9)o 2 N or blank 4090 4100 13b(1)p 13b(2)p 35 9 AN or blank N or blank 4110 4120 4130 4140 4150 4160 13b(3)p 13b(4)p 13b(5)p 13b(6)p 13b(7)p 13b(8)p 6 35 3 12 2 12 N or blank AN or blank NO ENTRY N or blank N or blank N or blank Publication 1346 August 30, 2002 Part II Page 428 Section 4 FORM 5713 PAGE 4 Field Identification No. ----- -------------4170 Number Of Agreements - Code 16 Reserved International Boycott Report Form Ref. ---13b(9)p Length -----2 Field Description ----------------N or blank 4175 13 6 Blank Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 429 Section 4 INTENTIONAL BLANK PAGE Publication 1346 August 30, 2002 Part II Page 430 Section 4 SCHEDULE A (FORM 5713) Field Identification No. ----- -------------Byte Count Computation of The International Boycott Factor Form Ref. ---Length -----4 Field Description ----------------"1253" for Fixed; "nnnn" for variable format Value "****" "SCHbbA" "5713bb" "PG01b" N (Primary SSN) Start of Record Sentinel 0000 0001 0002 0003 Record ID Schedule Type Page Number Taxpayer Identification Number Filler Schedule Occurrence Number Boycotting Israel Boycotting Other Identify Other Country Name Of Country Boycott Purchases Boycott Sales Boycott Payroll Name Of Country - 2 Boycott Purchases 2 Boycott Sales - 2 Boycott Payroll - 2 Name Of Country - 3 Boycott Purchases 3 a(1) a(2) a(3) a(4) b(1) b(2) b(3) b(4) c(1) c(2) August 30, 2002 4 6 6 5 9 0004 0005 0020 0030 0040 0050 0060 0070 0080 0090 0100 0110 0120 0130 0140 1 7 1 1 35 35 12 12 12 35 12 12 12 35 12 Blank N 0000001-0000005 "X" or blank "X" or blank AN AN N N N AN or blank N or blank N or blank N or blank AN or blank N or blank Part II Page 431 Section 4 Publication 1346 SCHEDULE A (FORM 5713) Field Identification No. ----- -------------0150 0160 0170 0180 0190 0200 0210 0220 0230 0240 0250 0260 0270 0280 0290 0300 0310 0320 0330 0340 0350 0360 Boycott Sales - 3 Boycott Payroll - 3 Name Of Country - 4 Boycott Purchases 4 Boycott Sales - 4 Boycott Payroll - 4 Name Of Country - 5 Boycott Purchases 5 Boycott Sales - 5 Boycott Payroll - 5 Name Of Country - 6 Boycott Purchases 6 Boycott Sales - 6 Boycott Payroll - 6 Name Of Country - 7 Boycott Purchases 7 Boycott Sales - 7 Boycott Payroll - 7 Name Of Country - 8 Boycott Purchases 8 Boycott Sales - 8 Boycott Payroll - 8 Computation of The International Boycott Factor Form Ref. ---c(3) c(4) d(1) d(2) d(3) d(4) e(1) e(2) e(3) e(4) f(1) f(2) f(3) f(4) g(1) g(2) g(3) g(4) h(1) h(2) h(3) h(4) August 30, 2002 Length -----12 12 35 12 12 12 35 12 12 12 35 12 12 12 35 12 12 12 35 12 12 12 Field Description ----------------N or blank N or blank AN or blank N or blank N or blank N or blank AN or blank N or blank N or blank N or blank AN or blank N or blank N or blank N or blank AN or blank N or blank N or blank N or blank AN or blank N or blank N or blank N or blank Part II Page 432 Section 4 Publication 1346 SCHEDULE A (FORM 5713) Field Identification No. ----- -------------0370 0380 0390 0400 0410 0420 0430 0440 0450 0460 0470 0480 0490 0500 0510 0520 0530 0540 0550 0560 0570 0580 Name Of Country - 9 Boycott Purchases 9 Boycott Sales - 9 Boycott Payroll - 9 Name Of Country - 10 Boycott Purchases 10 Boycott Sales - 10 Boycott Payroll - 10 Name Of Country - 11 Boycott Purchases 11 Boycott Sales - 11 Boycott Payroll - 11 Name Of Country - 12 Boycott Purchases 12 Boycott Sales - 12 Boycott Payroll - 12 Name Of Country - 13 Boycott Purchases 13 Boycott Sales - 13 Boycott Payroll - 13 Name Of Country - 14 Boycott Purchases 14 Computation of The International Boycott Factor Form Ref. ---i(1) i(2) i(3) i(4) j(1) j(2) j(3) j(4) k(1) k(2) k(3) k(4) l(1) l(2) l(3) l(4) m(1) m(2) m(3) m(4) n(1) n(2) August 30, 2002 Length -----35 12 12 12 35 12 12 12 35 12 12 12 35 12 12 12 35 12 12 12 35 12 Field Description ----------------AN or blank N or blank N or blank N or blank AN or blank N or blank N or blank N or blank AN or blank N or blank N or blank N or blank AN or blank N or blank N or blank N or blank AN or blank N or blank N or blank N or blank AN or blank N or blank Part II Page 433 Section 4 Publication 1346 SCHEDULE A (FORM 5713) Field Identification No. ----- -------------0590 0600 0610 0620 0630 0640 0650 0660 0670 0680 0690 Boycott Sales - 14 Boycott Payroll - 14 Name Of Country - 15 Boycott Purchases 15 Boycott Sales - 15 Boycott Payroll - 15 Total - Boycott Purchases Total - Boycott Sales Total - Boycott Payroll Numerator Of Boycott Factor Total Purchases From Countries Other U.S. Total Sales To Or From Countries Other Than U.S. Total Payroll Paid Or Accrued Total Of Lines 2a, b, And c International Boycott Factor Computation of The International Boycott Factor Form Ref. ---n(3) n(4) o(1) o(2) o(3) o(4) (2) (3) (4) 1(4) 2a Length -----12 12 35 12 12 12 12 12 12 12 12 Field Description ----------------N or blank N or blank AN or blank N or blank N or blank N or blank N N N N N 0700 2b 12 N 0710 0720 0730 2c 2d 3 12 12 12 N N N Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 434 Section 4 SCHEDULE B (FORM 5713) Field Identification No. ----- -------------Byte Count Specifically Attributable Taxes & Income ... Form Ref. ---Length -----4 Field Description ----------------"1864" for Fixed; "nnnn" for variable format Value "****" "SCHbbB" "5713bb" "PG01b" N (Primary SSN) Start of Record Sentinel 0000 0001 0002 0003 Record ID Schedule Type Page Number Taxpayer Identification Number Filler Schedule Occurrence Number Boycotting Israel Boycotting Other Identify Other Country Name Of Country Business Code Description Of Business Activity Foreign Taxes Prorated Share IC-DISC Taxable Income FSC Taxable Income Name Of Country - 2 Business Code - 2 a(1) a(2) a(3) a(4) a(5) a(6) a(7) b(1) b(2) August 30, 2002 4 6 6 5 9 0004 0005 0020 0030 0040 0050 0060 0070 0080 0090 0100 0110 0120 0130 1 7 1 1 35 35 6 35 12 12 12 12 35 6 Blank N 0000001 - 0000005 "X" or blank "X" or blank AN AN N AN N N NO ENTRY NO ENTRY AN or blank N or blank Part II Page 435 Section 4 Publication 1346 SCHEDULE B (FORM 5713) Field Identification No. ----- -------------0140 Description Of Business Activity 2 Foreign Taxes - 2 Prorated Share - 2 IC-DISC Taxable Income - 2 FSC Taxable Income 2 Name Of Country - 3 Business Code - 3 Description Of Business Activity 3 Foreign Taxes - 3 Prorated Share - 3 IC-DISC Taxable Income - 3 FSC Taxable Income 3 Name Of Country - 4 Business Code - 4 Description Of Business Activity 4 Foreign Taxes - 4 Prorated Share - 4 IC-DISC Taxable Income - 4 FSC Taxable Income 4 Specifically Attributable Taxes & Income ... Form Ref. ---b(3) Length -----35 Field Description ----------------AN or blank 0150 0160 0170 0180 0190 0200 0210 b(4) b(5) b(6) b(7) c(1) c(2) c(3) 12 12 12 12 35 6 35 N OR BLANK N OR BLANK NO ENTRY NO ENTRY AN or blank N OR BLANK A/N OR BLANK 0220 0230 0240 0250 0260 0270 0280 c(4) c(5) c(6) c(7) d(1) d(2) d(3) 12 12 12 12 35 6 35 N OR BLANK N OR BLANK NO ENTRY NO ENTRY AN or blank N OR BLANK AN or blank 0290 0300 0310 0320 d(4) d(5) d(6) d(7) 12 12 12 12 N OR BLANK N OR BLANK NO ENTRY NO ENTRY Part II Page 436 Section 4 Publication 1346 August 30, 2002 SCHEDULE B (FORM 5713) Field Identification No. ----- -------------0330 0340 0350 Name Of Country - 5 Business Code - 5 Description Of Business Activity 5 Foreign Taxes - 5 Prorated Share - 5 IC-DISC Taxable Income - 5 FSC Taxable Income 5 Name Of Country - 6 Business Code - 6 Description Of Business Activity 6 Foreign Taxes - 6 Prorated Share - 6 IC-DISC Taxable Income - 6 FSC Taxable Income 6 Name Of Country - 7 Business Code - 7 Description Of Business Activity 7 Foreign Taxes - 7 Prorated Share - 7 Specifically Attributable Taxes & Income ... Form Ref. ---e(1) e(2) e(3) Length -----35 6 35 Field Description ----------------AN or blank N OR BLANK AN or blank 0360 0370 0380 0390 0400 0410 0420 e(4) e(5) e(6) e(7) f(1) f(2) f(3) 12 12 12 12 35 6 35 N OR BLANK N OR BLANK NO ENTRY NO ENTRY AN or blank N OR BLANK AN or blank 0430 0440 0450 0460 0470 0480 0490 f(4) f(5) f(6) f(7) g(1) g(2) g(3) 12 12 12 12 35 6 35 N OR BLANK N OR BLANK NO ENTRY NO ENTRY AN or blank N OR BLANK AN or blank 0500 0510 g(4) g(5) August 30, 2002 12 12 N OR BLANK N OR BLANK Part II Page 437 Section 4 Publication 1346 SCHEDULE B (FORM 5713) Field Identification No. ----- -------------0520 0530 0540 0550 0560 IC-DISC Taxable Income - 7 FSC Taxable Income 7 Name Of Country - 8 Business Code - 8 Description Of Business Activity 8 Foreign Taxes - 8 Prorated Share - 8 IC-DISC Taxable Income - 8 FSC Taxable Income 8 Name Of Country - 9 Business Code-9 Description Of Business Activity 9 Foreign Taxes - 9 Prorated Share - 9 IC-DISC Taxable Income - 9 FSC Taxable Income 9 Name Of Country - 10 Business Code - 10 Description Of Business Activity 10 Specifically Attributable Taxes & Income ... Form Ref. ---g(6) g(7) h(1) h(2) h(3) Length -----12 12 35 6 35 Field Description ----------------NO ENTRY NO ENTRY AN or blank N OR BLANK AN or blank 0570 0580 0590 0600 0610 0620 0630 h(4) h(5) h(6) h(7) i(1) i(2) i(3) 12 12 12 12 35 6 35 N OR BLANK N OR BLANK NO ENTRY NO ENTRY AN or blank N OR BLANK AN or blank 0640 0650 0660 0670 0680 0690 0700 i(4) i(5) i(6) i(7) j(1) j(2) j(3) 12 12 12 12 35 6 35 N OR BLANK N or blank NO ENTRY NO ENTRY AN or blank N OR BLANK AN or blank Publication 1346 August 30, 2002 Part II Page 438 Section 4 SCHEDULE B (FORM 5713) Field Identification No. ----- -------------0710 0720 0730 0740 0750 0760 0770 Foreign Taxes - 10 Prorated Share - 10 IC-DISC Taxable Income - 10 FSC Taxable Income 10 Name Of Country - 11 Business Code - 11 Description Of Business Activity 11 Foreign Taxes - 11 Prorated Share - 11 IC-DISC Taxable Income - 11 FSC Taxable Income 11 Name Of Country - 12 Business Code - 12 Description Of Business Activity 12 Foreign Taxes - 12 Prorated Share - 12 IC-DISC Taxable Income - 12 FSC Taxable Income 12 Name Of Country - 13 Business Code - 13 Specifically Attributable Taxes & Income ... Form Ref. ---j(4) j(5) j(6) j(7) k(1) k(2) k(3) Length -----12 12 12 12 35 6 35 Field Description ----------------N OR BLANK N OR BLANK NO ENTRY NO ENTRY AN or blank N OR BLANK AN or blank 0780 0790 0800 0810 0820 0830 0840 k(4) k(5) k(6) k(7) l(1) l(2) l(3) 12 12 12 12 35 6 35 N OR BLANK N OR BLANK NO ENTRY NO ENTRY A N OR BLANK AN or blank 0850 0860 0870 0880 0890 0900 l(4) l(5) l(6) l(7) m(1) m(2) August 30, 2002 12 12 12 12 35 6 N or blank N OR BLANK NO ENTRY NO ENTRY AN or blank N OR BLANK Part II Page 439 Section 4 Publication 1346 SCHEDULE B (FORM 5713) Field Identification No. ----- -------------0910 Description Of Business Activity 13 Foreign Taxes - 13 Prorated Share - 13 IC-DISC Taxable Income - 13 FSC Taxable Income Name Of Country - 14 Business Code -14 Description Of Business Activity 14 Foreign Taxes - 14 Prorated Share - 14 IL-DISC Taxable Income - 14 FSC Taxable Income Total - Foreign Taxes Total - Prorated Share Total - IC-DISC Taxable Income Total - FSC Taxable Income Specifically Attributable Taxes & Income ... Form Ref. ---m(3) Length -----35 Field Description ----------------AN or blank 0920 0930 0940 0950 0960 0970 0980 m(4) m(5) m(6) m(7) n(1) n(2) n(3) 12 12 12 12 35 6 35 N OR BLANK N OR BLANK NO ENTRY NO ENTRY AN or blank N OR BLANK AN or blank 0990 1000 1010 1020 1030 1040 1050 1060 n(4) n(5) n(6) n(7) o(4) o(5) o(6) o(7) 12 12 12 12 12 12 12 12 N or blank N OR BLANK NO ENTRY NO ENTRY N N NO ENTRY NO ENTRY Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 440 Section 4 SCHEDULE C (FORM 5713) Field Identification No. ----- -------------Byte Count Tax Effect of The International Boycott Provisions Form Ref. ---Length -----4 Field Description ----------------"0282" for Fixed; "nnnn" for variable format Value "****" "SCHbbC" "5713bb" "PG01b" N (Primary SSN) | Start of Record Sentinel 0000 0001 0002 0003 Record ID Schedule Type Page Number Taxpayer Identification Number Filler Schedule Occurrence Number Identifying Number International Boycott Factor From Schedule A Attributable Taxes And Income Foreign Tax Credit Before Adjustment International Boycott Factor Line 3, Sch A (F5713) Reduction Of Foreign Tax Credit Adjusted Foreign Tax Credit Amount From Line O, Sch B (Form 5713) Prorated Share Of Total Income 1a 4 6 6 5 9 0004 0005 0010 0020 1 7 9 1 Blank N 0000001 NO ENTRY "X" or blank | 0030 0040 0050 1b 2a(1) 2a(2) 1 12 12 "X" or blank N OR BLANK N OR BLANK 0060 0070 0080 0090 2a(3) 2a(4) 2b 3a(1) August 30, 2002 12 12 12 12 N OR BLANK N OR BLANK N OR BLANK N OR BLANK Part II Page 441 Section 4 Publication 1346 SCHEDULE C (FORM 5713) Field Identification No. ----- -------------0100 0110 0120 Prorated Share Of Income Attributable Subtract Line 3(a)2 From Line 3(a)1 International Boycott Factor Line 3 Prorated Share Of Subpart F Amount From Line O, Sch B Prorated Share Of Section 995 Amount International Boycott Factor Line 4 Prorated Share Of IC-DISc Income Amount From Line O, Sch B Add Amounts From Columns International Boycott Factor Line 5 Exempt Foreign Trade Income Amount From Line O Tax Effect of The International Boycott Provisions Form Ref. ---3a(2) 3a(3) 3a(4) Length -----12 12 12 Field Description ----------------N OR BLANK N OR BLANK N OR BLANK 0130 0140 0150 0160 3a(5) 3b 4a(1) 4a(2) 12 12 12 12 N OR BLANK N OR BLANK N OR BLANK N OR BLANK 0170 0180 0190 0200 4a(3) 4a(4) 5a(1) 5a(2) 12 12 12 12 NO ENTRY NO ENTRY N OR BLANK NO ENTRY 0210 0220 5a(3) 5b 12 12 N OR BLANK N OR Blank Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 442 Section 4 FORM 5884 Field Identification No. ----- -------------Byte Count WORK OPPORTUNITY CREDIT Form Ref. ---Length -----4 Field Description ----------------"0430" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" "5884bb" "PG01b" N (Primary SSN) | Start of Record Sentinel 0000 0001 0002 0003 Record ID Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number Identifying Number Wages Paid Worked At Least 120 But < 400 Hours Total Wages Worked 120-400 Hours Wages Paid Worked At Least 400 Hours Total Wages Worked 400 Hours or More Current Year Credit Attach Exception Statement Work Oppt. Credits From Flow-Through Entities 1041 Portion Total Current Year Work Opportunity Credit 1a 4 6 6 5 9 0004 0005 0010 0040 1 7 9 12 blank N 0000001 NO ENTRY N | 0050 0060 0070 0080 @0085 0090 1a 1b 1b 2 2 3 12 12 12 12 6 12 N N N N "STMbnn" or blank N 0100 0110 4 4 12 12 NO ENTRY N Publication 1346 August 30, 2002 Part II Page 443 Section 4 FORM 5884 Field Identification No. ----- -------------0120 0130 0140 Regular Tax Before Credits Alternative Minimum Tax Regular Tax Plus Alternative Minimum Tax Foreign Tax Credit Credit for Child & Dependent Care Expenses (F2441) Credit for Elderly or Disabled (Sch R) Education Credits (Form 8863) Credit for Qualified Retirement Savings Child Tax Credit Mortgage Interest Credit (Form 8396) Adoption Credit (Form 8839) DC First Time Homebuyer Credit (Form 8859) Possessions Tax Credit (Form 5735) Credit For Fuel From a Nonconventional Source Qualified Electric Vehicle Credit WORK OPPORTUNITY CREDIT Form Ref. ---5 6 7 Length -----12 12 12 Field Description ----------------N N N 0150 0160 8a 8b 12 12 N N 0170 0180 0185 8c 8d 8e 12 12 12 N N N | 0190 0200 0210 0220 8f 8g 8h 8i 12 12 12 12 N N N N 0230 0240 8j 8k 12 12 NO ENTRY N 0250 8l 12 N Publication 1346 August 30, 2002 Part II Page 444 Section 4 FORM 5884 Field Identification No. ----- -------------0260 0270 0290 0300 0305 0310 0320 0330 Add Lines 8a through 8l Net Income Tax Net Regular Tax Enter 25% of Excess Tentative Minimum Tax Greater of Line 11 or Line 12 Subtract Line 13 from Line 9 Work Opportunity Credit Allowed for Current Year WORK OPPORTUNITY CREDIT Form Ref. ---8m 9 10 11 12 13 14 15 Length -----12 12 12 12 12 12 12 12 Field Description ----------------N N N N N N N N --| | | | | Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 445 Section 4 INTENTIONAL BLANK PAGE Publication 1346 August 30, 2002 Part II Page 446 Section 4 FORM 6198 Field Identification No. ----- -------------Byte Count At-Risk Limitations Form Ref. ---Length -----4 Field Description ----------------"0461" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" "6198bb" "PG01b" N (Primary SSN) Start of Record Sentinel 0000 0001 0002 0003 Record ID Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number Description of Activity Activity Profit/Loss Sch D Gain/Loss F4797 Gain/Loss Other Gain/Loss Type Other Gain/Loss Amount Total Other Gain/ Loss Sch K-1 Income/Gain/ Loss Other Deductions Current Year Overall Profit/Loss Adjusted Basis Tax Year Increases 1 2a 2b 2c 2c 2c 3 4 5 6 7 August 30, 2002 4 6 6 5 9 0004 0005 0009 0010 0020 0030 *0033 +0037 0040 0050 0060 0070 0080 0090 1 7 80 12 12 12 20 12 12 12 12 12 12 12 blank N 0000001 - 0000010 AN N N N AN or "STMbnn" N N N N N N N Part II Page 447 Section 4 Publication 1346 FORM 6198 Field Identification No. ----- -------------0100 0110 0120 0130 0140 0150 0160 0170 0180 0190 0200 0210 0220 0230 0240 0250 0260 0270 0280 0290 Line 6 Plus Line 7 Tax Year Decreases Line 8 Minus Line 9 Amount at Risk Investment Increases at Effective Date Line 11 Plus Line 12 Decreases at Effective Date At Risk Effective Date Box Prior Year F6198, Line 19b Box Amount at Risk Increases Effective Date Box Increases End of Prior Year Box Amount of Increases Line 15 Plus Line 16 Decreases Effective Date Box Decreases End of Prior Year Box Amount of Decreases Line 17 Minus Line 18 Amount at Risk At-Risk Limitations Form Ref. ---8 9 10a 10b 11 12 13 14 15a 15b 15 16a 16b 16 17 18a 18b 18 19a 19b August 30, 2002 Length -----12 12 12 12 12 12 12 12 1 1 12 1 1 12 12 1 1 12 12 12 Field Description ----------------N N N N N N N N "X" or blank "X" or blank N "X" or blank "X" or blank N N "X" or blank "X" or blank N N N Part II Page 448 Section 4 Publication 1346 FORM 6198 Field Identification No. ----- -------------0300 0310 Larger of Line 10b or Line 19b Deductible Loss At-Risk Limitations Form Ref. ---20 21 Length -----12 12 Field Description ----------------N N Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 449 Section 4 INTENTIONAL BLANK PAGE Publication 1346 August 30, 2002 Part II Page 450 Section 4 FORM 6251 PAGE 1 Field Identification No. ----- -------------Byte Count Alternative Minimum Tax - Individuals Form Ref. ---Length -----4 Field Description ----------------"0560" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" "6251bb" "PG01b" N (Primary SSN) Start of Record Sentinel 0000 0001 0002 0003 Record ID Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number Standard Deduction Medical/Dental Expense Schedule A Taxes Certain Mortgage Int. Miscellaneous Itemized Deductions Refund of Taxes Investment Int. Expense Depreciation Adjusted Gain or Loss Incentive Stock Options Passive Activity Loss 1 2 3 4 5 6 7 8 9 10 11 August 30, 2002 4 6 6 5 9 0004 0005 0035 0045 0065 0085 0087 0088 0090 0095 0147 0149 0163 1 7 12 12 12 12 12 12 12 12 12 12 12 blank N 0000001 N N N N N N N N N N N Part II Page 451 Section 4 Publication 1346 FORM 6251 PAGE 1 Field Identification No. ----- -------------0165 0175 Beneficiaries of Estates and Trusts Tax Exempt Interest From Private Activity Bond Circulation Expense Depletion Accelerated Depreciation Pre1987 Property Certain Installment Sales Intangible Drilling Large Partnerships Long Term Contracts Certain Loss Limitations Mining Exploration and Development Costs Adjustment for Patron Pollution Control Facilities Research Experimental Expense Section 1202 Exclusion Tax Shelter Farm Loss Related Adjustments Total Other Adjustments Alternative Minimum Tax - Individuals Form Ref. ---12 13 Length -----12 12 Field Description ----------------N N 0178 0180 0184 14a 14b 14c 12 12 12 N N N 0186 0188 0190 0192 0194 0196 14d 14e 14f 14g 14h 14i 12 12 12 12 12 12 N N N N N N 0197 0198 0200 0201 0202 0204 0206 14j 14k 14l 14m 14n 14o 14 August 30, 2002 12 12 12 12 12 12 12 N N N N N N N Part II Page 452 Section 4 Publication 1346 FORM 6251 PAGE 1 Field Identification No. ----- -------------0220 0221 0222 0223 0225 0267 0283 0287 0306 0315 0325 0330 0333 0337 0340 Total Adjustments and Tax Preference Taxable Income Net Operating Loss Worksheet Amount Pre Operating Loss AMT Income Alternative Tax Net Operating Loss Alternative Minimum Taxable Income Exemption Amount Child Exemption Worksheet Literal Adjusted AMT Income Initial Minimum Tax Foreign Tax Credit Tentative Minimum Tax Applicable Return Tax Alternative Minimum Tax Alternative Minimum Tax - Individuals Form Ref. ---15 16 17 18 19 20 21 22 22 23 24 25 26 27 28 Length -----12 12 12 12 12 12 12 12 1 12 12 12 12 12 12 Field Description ----------------N N N N N N N N "C" or blank N N N N N N Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 453 Section 4 FORM 6251 PAGE 2 Field Identification No. ----- -------------Byte Count Alternative Minimum Tax - Individuals Form Ref. ---Length -----4 Field Description ----------------"0355" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" "6251bb" "PG02b" N (Primary SSN) Start of Record Sentinel 0350 0351 0352 0353 Record ID Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number Adjusted AMT Income Amount from Sch D Line 23, or Worksheet Line 9 Unrecaptured Section 1250 Gain Total of Lines 30 and 31 Amount from Sch D Line 23, or Worksheet Line 4 Smaller of Lines 32 or 33 Subtract Lines 34 from 29 Multiply Line 35 by .26 or.28 and Subtract $3,500 Amount from Sch D Line 28, or Worksheet Line 16 29 30 4 6 6 5 9 0354 0355 0360 0370 1 7 12 12 blank N 0000001 N N 0380 0390 0400 31 32 33 12 12 12 N N N 0410 0420 0430 34 35 36 12 12 12 N N N 0480 37 12 N Publication 1346 August 30, 2002 Part II Page 454 Section 4 FORM 6251 PAGE 2 Field Identification No. ----- -------------0490 0505 0510 0515 0530 0532 0533 Smallest of Lines 29, 30 or 37 Qualified 5-Year Gain From Schedule D Smaller of Lines 38 or 39 Multiply Line 40 by .08 Subtract Lines 40 from 38 Multiply Line 42 by .10 Smaller of Adjusted AMT Inc. or Amt from Sch D Amount of Line 38 Subtract Lines 45 from 44 Multiply Line 46 by .20 Adjusted AMT Income Add Lines 35, 38, 46 Net Adjusted AMT Income Net Adjusted AMT Income Multiply by .25 Add Lines 36, 41, 43, 47, and 51 Multiply Line 29 by .26 or.28 and Subtract $3,500 Smaller of Lines 52 or 53 Alternative Minimum Tax - Individuals Form Ref. ---38 39 40 41 42 43 44 Length -----12 12 12 12 12 12 12 Field Description ----------------N N N N N N N 0534 0538 0540 0545 0550 0553 0555 45 46 47 48 49 50 51 12 12 12 12 12 12 12 N N N N N N N 0557 0560 52 53 12 12 N N 0570 54 August 30, 2002 12 N Part II Page 455 Section 4 Publication 1346 FORM 6251 PAGE 2 Field Identification No. ----- -------------- Alternative Minimum Tax - Individuals Form Ref. ---Length -----Field Description ----------------- Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 456 Section 4 FORM 6252 Field Identification No. ----- -------------Byte Count Installment Sale Income Form Ref. ---Length -----4 Field Description ----------------"0623" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" "6252bb" "PG01b" N (Primary SSN) Start of Record Sentinel 0000 0001 0002 0003 Record ID Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number Property Description Date Acquired Date Sold Related Party Yes Related Party No Marketable Security Yes Marketable Security No Selling Price Mortgage / Indebtedness Line 5 Minus Line 6 Cost or Basis Depreciation Allowable Adjusted Basis 1 2a 2b 3 3 4 4 5 6 7 8 9 10 August 30, 2002 4 6 6 5 9 0004 0005 0010 0020 0030 0040 0050 0060 0070 0080 0090 0100 0110 0120 0130 1 7 65 8 8 1 1 1 1 12 12 12 12 12 12 blank N 0000001 - 0000003 AN DT DT "X" or blank "X" or blank "X" or blank "X" or blank N N N N N N Part II Page 457 Section 4 Publication 1346 FORM 6252 Field Identification No. ----- -------------0140 0150 0160 0170 0185 0190 0200 0210 0220 0230 0240 0250 0260 0270 0280 0290 0300 0310 0320 0330 Commission/Other Exp Income Recapture F4797 Sum of Lines 10/11/ 12 Line 5 Minus Line 13 Excluded Gain Amount Gross Profit Line 6 Minus Line 13 Contract Price Gross Profit Ratio Yr of Sale Line 17 Amt Payments Received Sum of Lines 20, 21 Payments Recd Prior Yr Installment Sale Income Ordinary Income Part Line 24 Minus Line 25 Related Party Identity Continuation Data Property Sold Yes Property Sold No Installment Sale Income Form Ref. ---11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 27 28 28 Length -----12 12 12 12 12 12 12 12 6 12 12 12 12 12 12 12 40 80 1 1 Field Description ----------------N N N N N N N N R (Please see Part I, Sect 5.01.2.b) N N N N N N N AN AN "X" or blank "X" or blank Publication 1346 August 30, 2002 Part II Page 458 Section 4 FORM 6252 Field Identification No. ----- -------------0335 2nd Disp more than 2 years after 1st Disp Date of Disposition 1st Disp Sale/ Exchange 2nd Disp Involuntary Conversion 2nd Disp After Death of Orig. Seller/Buyer Disposition Not to Avoid Tax Explanation of Disp Not to Avoid Tax Selling Price Contract Price 1st Yr Smaller Line 30 or 31 Total Payments Received Line 32 Minus Line 33 Line 34 Times 1st Year Gross Profit Ratio Line 35 Ordinary Income Line 35 Minus Line 36 Installment Sale Income Form Ref. ---29a Length -----1 Field Description ----------------"X" or blank 0337 0340 0350 29a 29b 29c 8 1 1 DT "X" or blank "X" or blank 0360 29d 1 "X" or blank 0370 @0380 0390 0400 0410 0420 0430 0440 29e 29e 30 31 32 33 34 35 1 6 12 12 12 12 12 12 "X" or blank "STMbnn" or blank N N N N N N 0450 0460 36 37 12 12 1 N N Value "#" Part II Page 459 Section 4 Record Terminus Character Publication 1346 August 30, 2002 INTENTIONAL BLANK PAGE Publication 1346 August 30, 2002 Part II Page 460 Section 4 FORM 6478 Field Identification No. ----- -------------Byte Count Credit for Alcohol Used as Fuel Form Ref. ---Length -----4 Field Description ----------------"0622" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" "6478bb" "PG01b" N (Primary SSN) | Start of Record Sentinel 0000 0001 0002 0003 Record ID Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number Identifying Number Qualified ethanol fuel production (gallons) Total qualified ethanol fuel 190 proof or greater (in gallons) Total 190 proof or greater Less than 190 proof but at least 150 proof Total less than 190 proof but at least 150 proof Add lines 1, 2a and 2b Total add lines 1, 2a, and 2b 1(a) 4 6 6 5 9 0004 0005 0010 0020 1 7 9 12 blank N 0000001 NO ENTRY N | 0030 0040 0050 0060 1(c) 2a(a) 2a(c) 2b(a) 12 12 12 12 N N N N 0070 2b(c) 12 N 0080 0090 3(a) 3(c) August 30, 2002 12 12 N N Part II Page 461 Section 4 Publication 1346 FORM 6478 Field Identification No. ----- -------------0100 Other fuels blended with alcohol on lines 2a & 2b Total gallons of fuel Total gallons containing less than 5.7% Subtract line 5b from line 5a Aviation fuel for use in noncommercial aviation Total aviation fuel for use in noncommercial Gasohol containing less than 85% alcohol Total gasohol containing less than 85% alcohol Special motor fuel containing 85% or more alcohol Total special motor fuel containing 85% alcohol Add lines 7a through 7c Current year credit less excise tax benefit Flow-through alcohol fuel credits from partnership Credit for Alcohol Used as Fuel Form Ref. ---4(a) Length -----12 Field Description ----------------N 0110 0120 5a(a) 5b(a) 12 12 N N 0130 0140 6(a) 7a(a) 12 12 N N 0150 7a(c) 12 N 0160 7b(a) 12 N 0170 7b(c) 12 N 0180 7c(a) 12 N 0190 7c(c) 12 N 0200 0210 8 9 12 12 N N 0220 10 12 N Publication 1346 August 30, 2002 Part II Page 462 Section 4 FORM 6478 Field Identification No. ----- -------------0225 0230 1041 portion amount Total current year credit for alcohol used as fuel 1041 beneficiaries amount Attach 1041 statement Regular tax before credits Alternative minimum tax Regular Tax Plus Alternative Minimum Tax Foreign tax credit Credit for child & dependent care expenses Credit for elderly or disabled Education credits Credit for Qualified Retirement Savings Child tax credit Mortgage interest credit Adoption credit District of Columbia first time homebuyer credit Possessions tax credit (Form 5735) Credit for Alcohol Used as Fuel Form Ref. ---11 11 Length -----12 12 Field Description ----------------NO ENTRY N 0233 0235 0240 0250 0260 11 11 12 13 14 12 6 12 12 12 NO ENTRY NO ENTRY N N N 0270 0280 15a 15b 12 12 N N 0290 0300 0305 15c 15d 15e 12 12 12 N N N | 0310 0320 0330 0340 15f 15g 15h 15i 12 12 12 12 N N N N 0350 15j August 30, 2002 12 NO ENTRY Part II Page 463 Section 4 Publication 1346 FORM 6478 Field Identification No. ----- -------------0360 Credit for fuel from a nonconventional source Qualified electric vehicle credit Add lines 15a through 15l Net income tax Net Regular Tax Enter 25% of Excess Tentative Minimum Tax Greater of line 18 or line 19 Subtract line 20 from line 16 Credit for alcohol used as fuel Credit for Alcohol Used as Fuel Form Ref. ---15k Length -----12 Field Description ----------------N 0370 0380 0390 0410 0420 0425 0430 0440 0450 15l 15m 16 17 18 19 20 21 22 12 12 12 12 12 12 12 12 12 N N N N N N N N N --| | | | | Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 464 Section 4 FORM 6765 PAGE 1 Field Identification No. ----- -------------Byte Count Credit For Increasing Research Activities Form Ref. ---Length -----4 Field Description ----------------"0578" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" "6765bb" "PG01b" N (Primary SSN) | Start of Record Sentinel 0000 0001 0002 0003 Record ID Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number Identifying Number Payments paid or incurred - Sect. A Organization base period amt. - Sect. A Subtract line 2 from line 1 - Sect. A Wages for qualified services - Sect. A Cost of supplies Sect. A Cost of computers Sect. A Percentage of contract research expenses - Sect. A Total qualified research expenses Sect. A 1 2 4 6 6 5 9 0004 0005 0010 0020 0030 1 7 9 12 12 blank N 0000001 NO ENTRY N N | 0040 3 12 N 0050 0060 0070 0080 4 5 6 7 12 12 12 12 N N N N 0090 8 12 N Publication 1346 August 30, 2002 Part II Page 465 Section 4 FORM 6765 PAGE 1 Field Identification No. ----- -------------0100 0110 0120 Fixed-base percentage Avg. annual gross receipts - Sect. A Multiply line 10 by percent on line 9 (Base amount Subtract line 11 from line 8 Multiply line 8 by 50% Smaller of line 12 or line 13 Add lines 3 and 14 Electing reduced credit literal Regular credit Attach schedule Payments paid or incurred - Sect. B Organization base period amt. - Sect. B Subtract line 18 from line 17 Multiply line 19 by 20% Wages for qualified services - Sect. B Cost of supplies Sect. B Costs of computers Sect. B Credit For Increasing Research Activities Form Ref. ---9 10 11 Length -----6 12 12 Field Description ----------------R N N 0130 0140 0150 0160 0170 0180 @0190 0200 0210 12 13 14 15 16 16 16 17 18 12 12 12 12 8 12 6 12 12 N N N N "SECb280C" or blank N "STMbnn" or blank N N 0220 0230 0240 0250 0260 19 20 21 22 23 12 12 12 12 12 N N N N N Part II Page 466 Section 4 Publication 1346 August 30, 2002 FORM 6765 PAGE 1 Field Identification No. ----- -------------0270 Percentage of contract research expenses - Sect. B Total qualified research expenses Sect. B Avg. annual gross receipts - Sect. B Multiply line 26 by 1% Subtract line 27 from line 25 Multiply line 26 by 1.5% Subtract line 29 from line 25 Subtract line 30 from line 28 Multiply line 26 by 2% Subtract line 32 from line 25 Subtract line 33 from line 30 Multiply line 31 by 2.65% Multiply line 34 by 3.2% Multiply line 33 by 3.75% Add lines 20, 35, 36, and 37 Electing reduced credit literal Credit For Increasing Research Activities Form Ref. ---24 Length -----12 Field Description ----------------N 0280 25 12 N 0290 0300 0310 0320 0330 0340 0350 0360 0370 0380 0390 0400 0410 0420 26 27 28 29 30 31 32 33 34 35 36 37 38 39 August 30, 2002 12 12 12 12 12 12 12 12 12 12 12 12 12 8 N N N N N N N N N N N N N "SECb280C" or blank Part II Page 467 Section 4 Publication 1346 FORM 6765 PAGE 1 Field Identification No. ----- -------------0430 @0440 0450 0455 0460 Alternative incremental credit Attach schedule Flow-through research credits 1041 portion amount Total current year credit for increasing research Credit For Increasing Research Activities Form Ref. ---39 39 40 41 41 Length -----12 6 12 12 12 Field Description ----------------N "STMbnn" or blank N NO ENTRY N Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 468 Section 4 FORM 6765 PAGE 2 Field Identification No. ----- -------------Byte Count Credit For Increasing Research Activities Form Ref. ---Length -----4 Field Description ----------------"0319" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" "6765bb" "PG02b" N (Primary SSN) | Start of Record Sentinel 0480 0481 0482 0483 Record ID Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number 4 6 6 5 9 0484 0485 1 7 Blank N 0000001 --| --| --| | | | 0540 0550 0560 Regular tax before credits Alternative minimum tax Regular Tax Plus Alternative Minimum Tax Foreign tax credit Credit for child/ dependent care expenses Credit for elderly or disabled Education credits Credit for Qualified Retirement Savings Child Tax Credit 42 43 44 12 12 12 N N N 0570 0580 45a 45b 12 12 N N | | 0590 0600 0605 45c 45d 45e 12 12 12 N N N | | | 0610 45f August 30, 2002 12 N | Part II Page 469 Section 4 Publication 1346 FORM 6765 PAGE 2 Field Identification No. ----- -------------0620 0630 0640 Mortgage Interest Credit Adoption Credit District of Columbia First-Time Homebuyer Credit Possessions Tax Credit (Form 5735) Credit for Fuel From A Nonventional Source Qualified Electric Vehicle Credit Add Lines 45a through 45l Net income tax Net Regular Tax Enter 25% of excess Tentative Minimum Tax Greater of line 48 or line 49 Subtract line 50 from line 46 Total Credit Allowed for The Current Year Credit For Increasing Research Activities Form Ref. ---45g 45h 45i Length -----12 12 12 Field Description ----------------N N N | | | 0650 0660 45j 45k 12 12 NO ENTRY N | | 0670 0680 0690 0710 0720 0725 0730 0740 0750 45l 45m 46 47 48 49 50 51 52 12 12 12 12 12 12 12 12 12 N N N N N N N N N | | | --| | | | | | | --| --| Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 470 Section 4 FORM 6781 Field Identification No. ----- -------------Byte Count Gains and Losses from Section 1256, Contracts ... Form Ref. ---Length -----4 Field Description ----------------"1163" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" "6781bb" "PG01b" N (Primary SSN) | Start of Record Sentinel 0000 0001 0002 0003 Record ID Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number Identifying Number Attached List of Foreign Currency Contracts Mixed Straddle Election Box Straddle by Straddle Identification Election Box Mixed Straddle Account Election Box Statement Required by Regulations Net Section 1256 Contracts Loss Election Box Identification of Account - 1 A B 4 6 6 5 9 0004 0005 0009 @0010 1 7 9 6 blank N 0000001 NO ENTRY "STMbnn" or blank | 0020 0030 1 1 "X" or blank "X" or blank 0040 @0050 0060 C C D 1 6 1 "X" or blank "STMbnn" or blank "X" or blank *0070 1a(1) 46 AN, "STMbnn" or blank Publication 1346 August 30, 2002 Part II Page 471 Section 4 FORM 6781 Field Identification No. ----- -------------+0080 +0090 0100 0110 0120 0130 0140 0150 0160 0170 0180 Section 1256 Contracts Loss - 1 Section 1256 Contracts Gain - 1 Identification of Account - 2 Section 1256 Contracts Loss - 2 Section 1256 Contracts Gain - 2 Identification of Account - 3 Section 1256 Contracts Loss - 3 Section 1256 Contracts Gain - 3 Total Section 1256 Contracts Loss Total Section 1256 Contracts Gain Total Section 1256 Contracts Net Gain or Loss Form 1099-B Adjustment Schedule Form 1099-B Adjustments Net Gain or Loss and Form 1099-B Adjustments Net Section 1256 Contracts Loss Subtract Line 6 from Line 5 Gains and Losses from Section 1256, Contracts ... Form Ref. ---1b(1) 1c(1) 1a(2) 1b(2) 1c(2) 1a(3) 1b(3) 1c(3) 2b 2c 3c Length -----12 12 46 12 12 46 12 12 12 12 12 Field Description ----------------N N AN or blank 'See 1st Occ.' 'See 1st Occ.' 'See 2nd Occ.' 'See 1st Occ.' 'See 1st Occ.' N N N @0190 0200 0210 4c 4c 5c 6 12 12 "STMbnn" or blank N N 0220 0230 6c 7c August 30, 2002 12 12 N N Part II Page 472 Section 4 Publication 1346 FORM 6781 Field Identification No. ----- -------------0240 0250 @0260 Short-Term Capital Gain or Loss Long-Term Capital Gain or Loss Attached Schedule of Straddles and Components Description of Property (Losses) 1 Delivery Date (Losses) - 1 Date Close Out or Sold (Losses) - 1 Gross Sales Price (Losses) - 1 Cost or Other Basis Plus Commissions (Losses) - 1 Losses from Straddles - 1 Unrecognized Gain On Offsetting Positions - 1 Recognized Losses 1 28% Rate Loss - 1 Description of Property (Losses) 2 Delivery Date (Losses) - 2 Date Close Out or Sold (Losses) - 2 Gains and Losses from Section 1256, Contracts ... Form Ref. ---8c 9c Part II Length -----12 12 6 Field Description ----------------N N "STMbnn" or blank *0270 10a(1) 35 AN, "STMbnn" or blank +0280 +0290 +0300 +0310 10b(1) 10c(1) 10d(1) 10e(1) 8 8 12 12 YYYYMMDD or blank | YYYYMMDD or blank | N N *+0320 +0330 10f(1) 10g(1) 12 12 N or "STMbnn" N +0340 +0350 0360 10h(1) 10i(1) 10a(2) 12 12 35 N N AN or blank 0370 0380 10b(2) 10c(2) August 30, 2002 8 8 'See 1st Occ.' 'See 1st Occ.' Part II Page 473 Section 4 Publication 1346 FORM 6781 Field Identification No. ----- -------------0390 0400 Gross Sales Price (Losses) - 2 Cost or Other Basis Plus Commissions (Losses) - 2 Losses from Straddles - 2 Unrecognized Gain On Offsetting Positions - 2 Recognized Losses 2 28% Rate Loss - 2 Separate Schedule of Short-Term Losses Short-Term Portion of Recognized Loss Long-Term Portion of Recognized Loss Long-Term Portion of 28% Rate Loss Description of Property (Gains) - 1 Delivery Date (Gains) - 1 Date Close Out or Sold (Gains) - 1 Gross Sales Price (Gains) - 1 Cost or Other Basis Plus Commissions (Gains) - 1 Gains from Straddles - 1 Gains and Losses from Section 1256, Contracts ... Form Ref. ---10d(2) 10e(2) Length -----12 12 Field Description ----------------'See 1st Occ.' 'See 1st Occ.' 0410 0420 10f(2) 10g(2) 12 12 N 'See 1st Occ.' 0430 0440 @0450 0460 0470 0480 *0490 +0500 +0510 +0520 +0530 10h(2) 10i(2) 11 11a(h) 11b(h) 11b(i) 12a(1) 12b(1) 12c(1) 12d(1) 12e(1) 12 12 6 12 12 12 35 8 8 12 12 'See 1st Occ.' 'See 1st Occ.' "STMbnn" or blank N N N AN, "STMbnn" or blank YYYYMMDD or blank | YYYYMMDD or blank | N N *+0540 12f(1) August 30, 2002 12 N or "STMbnn" Part II Page 474 Section 4 Publication 1346 FORM 6781 Field Identification No. ----- -------------+0550 0560 0570 0580 0590 0600 28% Rate Gain - 1 Description of Property (Gains) - 2 Delivery Date (Gains) - 2 Date Close Out or Sold (Gains) - 2 Gross Sales Price (Gains) - 2 Cost or Other Basis Plus Commissions (Gains) - 2 Gains from Straddles - 2 28% Rate Gain - 2 Separate Schedule of Short-Term Gains Short-Term Portion of Gains - 1 Long-Term Portion of Gains - 2 Long-Term Portion of 28% Rate Gain Description of Property (Unrecognized Gains) - 1 Date Acquired (Unrecognized Gains) - 1 Fair Market Value on Last Business Day of TY - 1 Gains and Losses from Section 1256, Contracts ... Form Ref. ---12g(1) 12a(2) 12b(2) 12c(2) 12d(2) 12e(2) Length -----12 35 8 8 12 12 Field Description ----------------N AN or blank 'See 1st Occ.' 'See 1st Occ.' 'See 1st Occ.' 'See 1st Occ.' 0610 0620 @0630 0640 0650 0660 *0670 12f(2) 12g(2) 13 13a(f) 13b(f) 13b(g) 14a(1) 12 12 6 12 12 12 35 N 'See 1st Occ.' "STMbnn" or blank N N N AN, "STMbnn" or blank +0680 14b(1) 8 YYYYMMDD or blank | +0690 14c(1) 12 N Publication 1346 August 30, 2002 Part II Page 475 Section 4 FORM 6781 Field Identification No. ----- -------------+0700 +0710 0720 Cost or Other Basis As Adjusted - 1 Unrecognized Gain 1 Description of Property (Unrecognized Gains) - 2 Date Acquired (Unrecognized Gains) - 2 Fair Market Value on Last Business Day of TY - 2 Cost or Other Basis As Adjusted - 2 Unrecognized Gain 2 Description of Property (Unrecognized Gains) - 3 Date Acquired (Unrecognized Gains) - 3 Fair Market Value on Last Business Day of TY - 3 Cost or Other Basis As Adjusted - 3 Unrecognized Gain 3 Gains and Losses from Section 1256, Contracts ... Form Ref. ---14d(1) 14e(1) 14a(2) Length -----12 12 35 Field Description ----------------N N AN or blank 0730 14b(2) 8 'See 1st Occ.' 0740 14c(2) 12 'See 1st Occ.' 0750 0760 0770 14d(2) 14e(2) 14a(3) 12 12 35 'See 1st Occ.' 'See 1st Occ.' 'See 2nd Occ.' 0780 14b(3) 8 'See 1st Occ.' 0790 14c(3) 12 'See 1st Occ.' 0800 0810 14d(3) 14e(3) 12 12 'See 1st Occ.' 'See 1st Occ.' Record Terminus Character Publication 1346 August 30, 2002 1 Value "#" Part II Page 476 Section 4 FORM 8082 PAGE 1 Field Identification No. ----- -------------Byte Count Notice of Inconsistent Treatment or (AAR) Form Ref. ---Length -----4 Field Description ----------------"1178" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" "8082bb" "PG01b" N (Primary SSN) Start of Record Sentinel 0000 0001 0002 0003 Record ID Form Number Page Number Taxpayer Indentification Number Filler Form Occurrence Number Identifying Number Notice of Inconsistent Treatment Administrative Adjustment Request (AAR) Substituted Return Treatment Yes Box Substituted Return Treatment No Box Pass-Through Entity (Partnership) Pass-Through Entity (Electing Large Partnership) Pass-Through Entity (S Corporation) Pass-Through Entity (Estate) 1a 4 6 6 5 9 0004 0005 0010 0020 1 7 9 1 blank N 0000001 - 0000004 N "X" or blank 0030 1b 1 NO ENTRY 0035 0040 0050 0055 2 2 3a 3b 1 1 1 1 "X" or blank "X" or blank "X" or blank "X" or blank 0060 0065 3c 3d August 30, 2002 1 1 "X" or blank "X" or blank Part II Page 477 Section 4 Publication 1346 FORM 8082 PAGE 1 Field Identification No. ----- -------------0070 0075 0080 Pass-Through Entity (Trust) Pass-Through Entity (REMIC) Identifying Number of Pass-Through Entity Name of PassThrough Entity Notice of Inconsistent Treatment or (AAR) Form Ref. ---3e 3f 4 Length -----1 1 9 Field Description ----------------"X" or blank "X" or blank N 0090 5 35 AN Allowable special characters are: space, less-than (<), hyphen (-) and ampersand (&) AN, Allowable special characters are space, slash, hyphen and Literal "NONE" A, Allowable special character is space A (Standard Postal State Abbreviations) N (left-justified) AN or blank "MSPC " DT 0100 Address of PassThrough Entity 5 35 0110 0120 0130 0140 0150 0160 City of PassThrough Entity State of PassThrough Entity Zip Code of PassThrough Entity Tax Shelter Registration Number IRS Center Where Return is Filed Tax Year of PassThrough Entity (from) Tax Year of PassThrough Entity (to) Your Tax Year (from) Your Tax Year (to) Description of Inconsistent or AAR Items-1 5 5 5 6 7 8 22 2 12 12 5 8 0165 0170 0175 0180 8 8 8 10a 8 8 8 60 DT DT DT AN Publication 1346 August 30, 2002 Part II Page 478 Section 4 FORM 8082 PAGE 1 Field Identification No. ----- -------------0190 0200 0210 Amount of Item Box-1 Treatment of Item Box-1 Amount on Sch K-1, Sch Q, Stmt or Return-1 Amount you are Reporting-1 Difference between C & D-1 Description of Inconsistent or AAR Items-2 Amount of Item Box-2 Treatment of Item Box-2 Amount on Sch K-1, Sch Q, Stmt or Return-2 Amount you are Reporting-2 Difference between C & D-2 Description of Inconsistent or AAR Items-3 Amount of Item Box-3 Treatment of Item Box-3 Amount on Sch K-1, Sch Q, Stmt or Return-3 Amount you are Reporting-3 Notice of Inconsistent Treatment or (AAR) Form Ref. ---10b 10b 10c Length -----1 1 12 Field Description ----------------"X" or blank "X" or blank N 0220 0230 0240 10d 10e 11a 12 12 60 N N AN or blank 0250 0260 0270 11b 11b 11c 1 1 12 "X" or blank "X" or blank N or blank 0280 0290 0300 11d 11e 12a 12 12 60 N or blank N or blank AN or blank 0310 0320 0330 12b 12b 12c 1 1 12 "X" or blank "X" or blank N or blank 0340 12d August 30, 2002 12 N or blank Part II Page 479 Section 4 Publication 1346 FORM 8082 PAGE 1 Field Identification No. ----- -------------0350 0360 Difference between C & D-3 Description of Inconsistent or AAR Items-4 Amount of Item Box-4 Treatment of Item Box-4 Amount on Sch K-1, Sch Q, Stmt, or Return-4 Amount you are Reporting-4 Difference between C & D-4 Explanations-1 Explanations-2 Explanations-3 Explanations-4 Explanations-5 Explanations-6 Explanations-7 Explanations-8 Notice of Inconsistent Treatment or (AAR) Form Ref. ---12e 13a Length -----12 60 Field Description ----------------N or blank AN or blank 0370 0380 0390 13b 13b 13c 1 1 12 "X" or blank "X" or blank N or blank 0400 0410 0420 0430 0440 0450 0460 0470 0480 0490 13d 13e Part III Part III Part III Part III Part III Part III Part III Part III 12 12 70 70 70 70 70 70 70 70 N or blank N or blank AN AN AN AN AN AN AN AN Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 480 Section 4 FORM 8082 PAGE 2 Field Identification No. ----- -------------Byte Count Notice of Inconsistent Treatment or (AAR) Form Ref. ---Length -----4 Field Description ----------------"2073" for Fixed; "nnnn" for variable format Value "****" Value "FRMbbb" "8082bb" "PG02b" N (Primary SSN) Start of Record Sentinel 0520 0521 0522 0523 Record ID Form Number Page Number Taxpayer Indentification Number Filler Form Occurrence Number Explanations-1 Explanations-2 Explanations-3 Explanations-4 Explanations-5 Explanations-6 Explanations-7 Explanations-8 Explanations-9 Explanations-10 Explanations-11 Explanations-12 Explanations-13 Explanations-14 Part III Part III Part III Part III Part III Part III Part III Part III Part III Part III Part III Part III Part III Part III August 30, 2002 4 6 6 5 9 0524 0525 0530 0540 0550 0560 0570 0580 0590 0600 0610 0620 0630 0640 0650 0660 1 7 70 70 70 70 70 70 70 70 70 70 70 70 70 70 blank N 0000001 - 0000004 AN AN AN AN AN AN AN AN AN AN AN AN AN AN Part II Page 481 Section 4 Publication 1346 FORM 8082 PAGE 2 Field Identification No. ----- -------------0670 0680 0690 0700 0710 0720 0730 0740 0750 0760 0770 0780 0790 0800 0810 Explanations-15 Explanations-16 Explanations-17 Explanations-18 Explanations-19 Explanations-20 Explanations-21 Explanations-22 Explanations-23 Explanations-24 Explanations-25 Explanations-26 Explanations-27 Explanations-28 Explanations-29 Notice of Inconsistent Treatment or (AAR) Form Ref. ---Part III Part III Part III Part III Part III Part III Part III Part III Part III Part III Part III Part III Part III Part III Part III Length -----70 70 70 70 70 70 70 70 70 70 70 70 70 70 70 Field Description ----------------AN AN AN AN AN AN AN AN AN AN AN AN AN AN AN Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 482 Section 4 FORM 8271 Field Identification No. ----- -------------Byte Count Investor Reporting of Tax Shelter ... Form Ref. ---Length -----4 Field Description ----------------"0960" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" "8271bb" "PG01b" N (Primary SSN) | Start of Record Sentinel 0000 0001 0002 0003 Record ID Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number Identifying Number Investor's Tax Year Ended Tax Shelter Name - 1 Tax Shelter Registration Number - 1 Name of Person Who Applied for Registration - 1 Tax Shelter Identifying Number 1 Tax Shelter Name - 2 Tax Shelter Registration Number - 2 Name of Person Who Applied for Registration - 2 1a 1b 4 6 6 5 9 0004 0005 0010 0020 0030 0040 1 7 9 8 35 11 blank N 0000001 - 0000002 N or blank YYYYMMDD AN N, "APPLIEDbFOR", or "NObNOTIFICA" AN | | 0050 1b 35 0060 1c 9 N or blank 0070 0080 2a 2b 35 11 'See 1st Occ.' 'See 1st Occ.' 0090 2b 35 'See 1st Occ.' Publication 1346 August 30, 2002 Part II Page 483 Section 4 FORM 8271 Field Identification No. ----- -------------0100 Tax Shelter Identifying Number 2 Tax Shelter Name - 3 Tax Shelter Registration - 3 Name of Person Who Applied for Registration - 3 Tax Shelter Identifying Number 3 Tax Shelter Name - 4 Tax Shelter Registration Number - 4 Name of Person Who Applied for Registration - 4 Tax Shelter Identifying Number 4 Tax Shelter Name - 5 Tax Shelter Registration Number - 5 Name of Person Who Applied for Registration - 5 Tax Shelter Identifying Number 5 Tax Shelter Name - 6 Tax Shelter Registration Number - 6 Investor Reporting of Tax Shelter ... Form Ref. ---2c Length -----9 Field Description ----------------'See 1st Occ.' 0110 0120 0130 3a 3b 3b 35 11 35 'See 1st Occ.' 'See 1st Occ.' 'See 1st Occ.' 0140 3c 9 'See 1st Occ.' 0150 0160 4a 4b 35 11 'See 1st Occ.' 'See 1st Occ.' 0170 4b 35 'See 1st Occ.' 0180 4c 9 'See 1st Occ.' 0190 0200 5a 5b 35 11 'See 1st Occ.' 'See 1st Occ.' 0210 5b 35 'See 1st Occ.' 0220 5c 9 'See 1st Occ.' 0230 0240 6a 6b 35 11 'See 1st Occ.' 'See 1st Occ.' Publication 1346 August 30, 2002 Part II Page 484 Section 4 FORM 8271 Field Identification No. ----- -------------0250 Name of Person Who Applied for Registration - 6 Tax Shelter Identifying Number 6 Tax Shelter Name - 7 Tax Shelter Registration Number - 7 Name of Person Who Applied for Registration - 7 Tax Shelter Identifying Number 7 Tax Shelter Name - 8 Tax Shelter Registration Number - 8 Name of Person Who Applied for Registration - 8 Tax Shelter Identifying Number 8 Tax Shelter Name - 9 Tax Shelter Registration Number - 9 Name of Person Who Applied for Registration - 9 Tax Shelter Identifying Number 9 Investor Reporting of Tax Shelter ... Form Ref. ---6b Length -----35 Field Description ----------------'See 1st Occ.' 0260 6c 9 'See 1st Occ.' 0270 0280 7a 7b 35 11 'See 1st Occ.' 'See 1st Occ.' 0290 7b 35 'See 1st Occ.' 0300 7c 9 'See 1st Occ.' 0310 0320 8a 8b 35 11 'See 1st Occ.' 'See 1st Occ.' 0330 8b 35 'See 1st Occ.' 0340 8c 9 'See 1st Occ.' 0350 0360 9a 9b 35 11 'See 1st Occ.' 'See 1st Occ.' 0370 9b 35 'See 1st Occ.' 0380 9c 9 'See 1st Occ.' Publication 1346 August 30, 2002 Part II Page 485 Section 4 FORM 8271 Field Identification No. ----- -------------0390 0400 Tax Shelter Name 10 Tax Shelter Registration Number - 10 Name of Person Who Applied for Registration - 10 Tax Shelter Identifying Number 10 Investor Reporting of Tax Shelter ... Form Ref. ---10a 10b Length -----35 11 Field Description ----------------'See 1st Occ.' 'See 1st Occ.' 0410 10b 35 'See 1st Occ.' 0420 10c 9 'See 1st Occ.' Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 486 Section 4 FORM 8275 PAGE 1 Field Identification No. ----- -------------Byte Count Disclosure Statement Form Ref. ---Length -----4 Field Description ----------------"1487" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" "8275bb" "PG01b" N (Primary SSN) | Start of Record Sentinel 0000 0001 0002 0003 Record ID Form Number Page Number Taxpayer Indentification Number Filler Form Occurrence Number Identifying Number Rev Rul, Rev Proc, etc-1 Item or Group of Items-1 Detailed Description of Items 1-1 Detailed Description of Items 2-1 Form or Schedule-1 Line Number-1 Amount-1 Rev Rul, Rev Proc, etc-2 Item or Group of Items-2 I 1(a) I 1(b) I 1(c) 4 6 6 5 9 0004 0005 0010 0020 0030 0040 1 7 9 35 50 50 blank N 0000001 NO ENTRY AN AN AN | 0050 I 1(c) 50 AN 0060 0070 0080 0090 0100 I 1(d) I 1(e) I 1(f) I 2(a) I 2(b) 21 5 12 35 50 AN AN N AN or blank AN or blank Publication 1346 August 30, 2002 Part II Page 487 Section 4 FORM 8275 PAGE 1 Field Identification No. ----- -------------0110 Detailed Description of Items 1-2 Detailed Description of Items 2-2 Form or Schedule-2 Line Number-2 Amount-2 Rev Rul, Rev Proc, etc-3 Item or Group of Items-3 Detailed Description of Items 1-3 Detailed Description of Items 2-3 Form or Schedule-3 Line Number-3 Amount-3 Detailed Explanation 1-1 Detailed Explanation 1-2 Detailed Explanation 1-3 Detailed Explanation 2-1 Detailed Explanation 2-2 Disclosure Statement Form Ref. ---I 2(c) Length -----50 Field Description ----------------AN or blank 0120 I 2(c) 50 AN or blank 0130 0140 0150 0160 0170 0180 I 2(d) I 2(e) I 2(f) I 3(a) I 3(b) I 3(c) 21 5 12 35 50 50 AN or blank AN or blank N or blank AN or blank AN or blank AN or blank 0190 I 3(c) 50 AN or blank 0200 0210 0220 0230 0240 0250 0260 0270 I 3(d) I 3(e) I 3(f) II II II II II 1 1 1 2 2 21 5 12 70 70 70 70 70 AN or blank AN or blank N or blank AN AN AN AN or blank AN or blank Publication 1346 August 30, 2002 Part II Page 488 Section 4 FORM 8275 PAGE 1 Field Identification No. ----- -------------0280 0290 0300 0310 0320 Detailed Explanation 2-3 Detailed Explanation 3-1 Detailed Explanation 3-2 Detailed Explanation 3-3 Name of PassThrough Entity Disclosure Statement Form Ref. ---II II II II III 2 3 3 3 1 Length -----70 70 70 70 35 Field Description ----------------AN or blank AN or blank AN or blank AN or blank AN Allowable special characters are: space, less-than (<), hyphen (-), and ampersand (&) AN, Allowable special characters are space, slash, hyphen and Literal "NONE" A, Allowable special character is space A (Standard Postal State Abbreviations) N (left-justified) N 0330 Address of PassThrough Entity III 1 35 0340 0350 0360 0370 City of PassThrough Entity State of PassThrough Entity Zip Code of PassThrough Entity Identifying Number of Pass-Through Entity Tax Year of PassThrough Entity (from) Tax Year of PassThrough Entity (to) IRS Center where Return is Filed III III III III 1 1 1 2 22 2 12 9 0380 III 3 8 YYYYMMDD | 0390 0400 III III 3 4 8 5 YYYYMMDD | "MSPC ","AUSPC","ANSPC", "CSPC ","OSPC ","BSPC ", "ATSPC","KCSPC","PSPC ", "FSPC " Value "#" Part II Page 489 Section 4 Record Terminus Character Publication 1346 August 30, 2002 1 FORM 8275 PAGE 2 Field Identification No. ----- -------------Byte Count Disclosure Statement Form Ref. ---Length -----4 Field Description ----------------"2073" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" "8275bb" "PG02b" N (Primary SSN) Start of Record Sentinel 0420 0421 0422 0423 Record ID Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number Explanations-1 Explanations-2 Explanations-3 Explanations-4 Explanations-5 Explanations-6 Explanations-7 Explanations-8 Explanations-9 Explanations-10 Explanations-11 Explanations-12 Explanations-13 Explanations-14 Explanations-15 IV IV IV IV IV IV IV IV IV IV IV IV IV IV IV August 30, 2002 4 6 6 5 9 0424 0425 0430 0440 0450 0460 0470 0480 0490 0500 0510 0520 0530 0540 0550 0560 0570 1 7 70 70 70 70 70 70 70 70 70 70 70 70 70 70 70 blank N 0000001 AN AN AN AN AN AN AN AN AN AN AN AN AN AN AN Part II Page 490 Section 4 Publication 1346 FORM 8275 PAGE 2 Field Identification No. ----- -------------0580 0590 0600 0610 0620 0630 0640 0650 0660 0670 0680 0690 0700 0710 Explanations-16 Explanations-17 Explanations-18 Explanations-19 Explanations-20 Explanations-21 Explanations-22 Explanations-23 Explanations-24 Explanations-25 Explanations-26 Explanations-27 Explanations-28 Explanations-29 Disclosure Statement Form Ref. ---IV IV IV IV IV IV IV IV IV IV IV IV IV IV Length -----70 70 70 70 70 70 70 70 70 70 70 70 70 70 Field Description ----------------AN AN AN AN AN AN AN AN AN AN AN AN AN AN Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 491 Section 4 INTENTIONAL BLANK PAGE Publication 1346 August 30, 2002 Part II Page 492 Section 4 FORM 8275-R PAGE 1 Field Identification No. ----- -------------Byte Count Regulation Disclosure Statement Form Ref. ---Length -----4 Field Description ----------------"1487" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" "8275Rb" "PG01b" N (Primary SSN) | Start of Record Sentinel 0000 0001 0002 0003 Record ID Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number Identifying Number Regulation Section-1 Item or Group of Items-1 Detailed Description of Items 1-1 Detailed Description of Items 2-1 Form or Schedule-1 Line Number-1 Amount-1 Regulation Section-2 Item or Group of Items-2 Detailed Description of Items 1-2 I I I 1(a) 1(b) 1(c) 4 6 6 5 9 0004 0005 0010 0020 0030 0040 1 7 9 35 50 50 blank N 0000001 NO ENTRY AN AN AN | 0050 I 1(c) 50 AN 0060 0070 0080 0090 0100 0110 I I I I I I 1(d) 1(e) 1(f) 2(a) 2(b) 2(c) 21 5 12 35 50 50 AN AN N AN or blank AN or blank AN or blank Publication 1346 August 30, 2002 Part II Page 493 Section 4 FORM 8275-R PAGE 1 Field Identification No. ----- -------------0120 Detailed Description of Items 2-2 Form or Schedule-2 Line Number-2 Amount-2 Regulation Section-3 Item or Group of Items-2 Detailed Description of Items 1-3 Detailed Description of Items 2-3 Form or Schedule-3 Line Number-3 Amount-3 Detailed Explanation 1-1 Detailed Explanation 2-1 Detailed Explanation 3-1 Detailed Explanation 1-2 Detailed Explanation 2-2 Detailed Explanation 3-2 Detailed Explanation 1-3 Regulation Disclosure Statement Form Ref. ---I 2 (c) Length -----50 Field Description ----------------AN or blank 0130 0140 0150 0160 0170 0180 I I I I I I 2(d) 2(e) 2(f) 3(a) 3(b) 3(c) 21 5 12 35 50 50 AN or blank AN or blank N or blank AN or blank AN or blank AN or blank 0190 I 3(c) 50 AN or blank 0200 0210 0220 0230 0240 0250 0260 0270 0280 0290 I I I II II II II II II II 3(d) 3(e) 3(f) 1 1 1 2 2 2 3 21 5 12 70 70 70 70 70 70 70 AN or blank AN or blank N or blank AN AN AN AN or blank AN or blank AN or blank AN or blank Part II Page 494 Section 4 Publication 1346 August 30, 2002 FORM 8275-R PAGE 1 Field Identification No. ----- -------------0300 0310 0320 Detailed Explanation 2-3 Detailed Explanation 3-3 Name of PassThrough Entity Regulation Disclosure Statement Form Ref. ---II II 3 3 Length -----70 70 35 Field Description ----------------AN or blank AN or blank AN Allowable special characters are: space, less-than (<), hyphen (-) and ampersand (&) AN, Allowable special characters are space, slash, hyphen and Literal "NONE" A, Allowable special character is space A (Standard Postal State Abbreviations) N (left Justified) N III 1 0330 Address of PassThrough Entity III 1 35 0340 0350 0360 0370 City of PassThrough Entity State of PassThrough Entity Zip Code of PassThrough Entity Identifying Number of Pass-Through Entity Tax Year of PassThrough Entity (from) Tax Year of PassThrough Entity (to) IRS Center where Return is Filed III 1 III 1 III 1 III 2 22 2 12 9 0380 III 3 8 YYYYMMDD | 0390 0400 III 3 III 4 8 5 YYYYMMDD | "MSPC ","AUSPC","ANSPC", "CSPC ","OSCP ","BSCP ", "ATSPC","KCSPC","PSPC ", "FSPC " Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 495 Section 4 FORM 8275-R PAGE 2 Field Identification No. ----- -------------Byte Count Disclosure Statement Form Ref. ---Length -----4 Field Description ----------------"2003" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" "8275Rb" "PG02b" N (Primary SSN) Start of Record Sentinel 0410 0411 0412 0413 Record ID Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number Explanations-1 Explanations-2 Explanations-3 Explanations-4 Explanations-5 Explanations-6 Explanations-7 Explanations-8 Explanations-9 Explanations-10 Explanations-11 Explanations-12 Explanations-13 Explanations-14 Explanations-15 IV IV IV IV IV IV IV IV IV IV IV IV IV IV IV August 30, 2002 4 6 6 5 9 0414 0415 0430 0440 0450 0460 0470 0480 0490 0500 0510 0520 0530 0540 0550 0560 0570 1 7 70 70 70 70 70 70 70 70 70 70 70 70 70 70 70 blank N 0000001 AN AN AN AN AN AN AN AN AN AN AN AN AN AN AN Part II Page 496 Section 4 Publication 1346 FORM 8275-R PAGE 2 Field Identification No. ----- -------------0580 0590 0600 0610 0620 0630 0640 0650 0660 0670 0680 0690 0700 Explanations-16 Explanations-17 Explanations-18 Explanations-19 Explanations-20 Explanations-21 Explanations-22 Explanations-23 Explanations-24 Explanations-25 Explanations-26 Explanations-27 Explanations-28 Disclosure Statement Form Ref. ---IV IV IV IV IV IV IV IV IV IV IV IV IV Length -----70 70 70 70 70 70 70 70 70 70 70 70 70 Field Description ----------------AN AN AN AN AN AN AN AN AN AN AN AN AN Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 497 Section 4 INTENTIONAL BLANK PAGE Publication 1346 August 30, 2002 Part II Page 498 Section 4 FORM 8283 PAGE 1 Field Identification No. ----- -------------Byte Count Noncash Charitable Contributions Form Ref. ---Length -----4 Field Description ----------------"0939" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" "8283bb" "PG01b" N (Primary SSN) Start of Record Sentinel 0000 0001 0002 0003 Record ID Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number Donee Organization A Donee Address A Descrip of Prop A Donee Organization B Donee Address B Descrip of Prop B Donee Organization C Donee Address C Descrip of Prop C Donee Organization D Donee Address D Descrip of Prop D Donee Organization E Donee Address E Descrip of Prop E 1A(a) 1A(a) 1A(b) 1B(a) 1B(a) 1B(b) 1C(a) 1C(a) 1C(b) 1D(a) 1D(a) 1D(b) 1E(a) 1E(a) 1E(b) August 30, 2002 4 6 6 5 9 0004 0005 *0010 +0020 +0030 0050 0060 0070 0090 0100 0110 0130 0140 0150 0170 0180 0190 1 7 25 30 25 25 30 25 25 30 25 25 30 25 25 30 25 blank N 0000001 - 0000002 AN or "STMbnn" AN AN AN AN AN AN AN AN AN AN AN AN AN AN Part II Page 499 Section 4 Publication 1346 FORM 8283 PAGE 1 Field Identification No. ----- -------------*+0210 +0220 +0230 +0240 +0250 +0255 0260 0270 0280 0290 0300 0305 0310 0320 0330 0340 0350 0355 0360 0370 0380 0390 0400 0405 0410 Contribution Date A Date Acquired A How Acquired A Cost or Basis A Fair Market Value A Method Used A Contribution Date B Date Acquired B How Acquired B Cost or Basis B Fair Market Value B Method Used B Contribution Date C Date Acquired C How Acquired C Cost or Basis C Fair Market Value C Method Used C Contribution Date D Date Acquired D How Acquired D Cost or Basis D Fair Market Value D Method Used D Contribution Date E Noncash Charitable Contributions Form Ref. ---1A(c) 1A(d) 1A(e) 1A(f) 1A(g) 1A(h) 1B(c) 1B(d) 1B(e) 1B(f) 1B(g) 1B(h) 1C(c) 1C(d) 1C(e) 1C(f) 1C(g) 1C(h) 1D(c) 1D(d) 1D(e) 1D(f) 1D(g) 1D(h) 1E(c) August 30, 2002 Length -----8 6 9 12 12 20 8 6 9 12 12 20 8 6 9 12 12 20 8 6 9 12 12 20 8 Field Description ----------------DT or "STMbnn" DT AN N N AN DT DT AN N N AN DT DT AN N N AN DT DT AN N N AN DT Part II Page 500 Section 4 Publication 1346 FORM 8283 PAGE 1 Field Identification No. ----- -------------0420 0430 0440 0450 0455 *0457 +0460 +0470 +0480 +0490 *+0500 +0510 +0520 0530 0540 0550 0560 0570 0580 Date Acquired E How Acquired E Cost or Basis E Fair Market Value E Method Used E Property ID Letter Amount This Year Amount Prior Year Name Donee Number & Street City, State, Zip Place Kept Name of Person Restriction YES Restriction NO Give Rights YES Give Rights NO Restriction on Use YES Restriction on Use NO Noncash Charitable Contributions Form Ref. ---1E(d) 1E(e) 1E(f) 1E(g) 1E(h) 2a 2b(1) 2b(2) 2c 2c 2c 2d 2e 3a 3a 3b 3b 3c 3c Length -----6 9 12 12 20 6 12 12 25 25 25 25 25 1 1 1 1 1 1 Field Description ----------------DT AN N N AN AN (Values "A, B, C, D, E" or "STMbnn") N N AN AN AN or "STMbnn" AN AN "X" or blank "X" or blank "X" or blank "X" or blank "X" or blank "X" or blank Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 501 Section 4 FORM 8283 PAGE 2 Field Identification No. ----- -------------Byte Count Noncash Charitable Contributions Form Ref. ---Length -----4 Field Description ----------------"0712" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" "8283bb" "PG02b" N (Primary SSN) Start of Record Sentinel 0590 0591 0592 0593 Record ID Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number Property Type-Art $20,000 or More Property Type Real Estate Property Type - Gem/ Jewelry Property Type Stamps Property Type - Art Less Than $20,000 Property Type Coins Property Type Books Property Type Other Descrip of Prop (A) Summary Condition (A) 4 4 4 4 4 4 4 4 5A(a) 5A(b) August 30, 2002 4 6 6 5 9 0594 0595 0641 0642 0643 0644 0645 0646 0647 0648 *0650 +0652 1 7 1 1 1 1 1 1 1 1 25 30 blank N 0000001 - 0000002 NO ENTRY "X" or blank "X" or blank "X" or blank "X" or blank "X" or blank "X" or blank "X" or blank AN or "STMbnn" AN Part II Page 502 Section 4 Publication 1346 FORM 8283 PAGE 2 Field Identification No. ----- -------------+0654 +0660 *+0670 +0680 +0690 +0700 +0710 0720 0722 0724 0730 0740 0750 0760 0770 0780 0790 0792 0794 0800 0810 0820 0830 Fair Market value (A) Date Acquired (A) How Acquired (A) Cost or Basis (A) Bargain Sale (A) Amt of Deductions (A) Ave.Trdg.Price(A) Descrip of Prop (B) Summary Condition (B) Fair Market value(B) Date Acquired (B) How Acquired (B) Cost or Basis (B) Bargain Sale (B) Amt of Deductions (B) Ave. Trdg. Price(B) Descrip of Prop (C) Summary Condition (C) Fair Market value(C) Date Acquired (C) How Acquired (C) Cost or Basis (C) Bargain Sale (C) Noncash Charitable Contributions Form Ref. ---5A(c) 5A(d) 5A(e) 5A(f) 5A(g) 5A(h) 5A(i) 5B(a) 5B(b) 5B(c) 5B(d) 5B(e) 5B(f) 5B(g) 5B(h) 5B(i) 5C(a) 5C(b) 5C(c) 5C(d) 5C(e) 5C(f) 5C(g) August 30, 2002 Length -----12 6 11 12 12 12 12 25 30 12 6 11 12 12 12 12 25 30 12 6 11 12 12 Field Description ----------------N DT AN or "STMbnn" N N N N AN AN N DT AN N N N N AN AN N DT AN N N Part II Page 503 Section 4 Publication 1346 FORM 8283 PAGE 2 Field Identification No. ----- -------------0840 0850 0860 0870 0880 0890 0900 0910 0920 0930 0940 0950 Amt of Deductions (C) Ave. Trdg.Price (C) Descrip of Prop (D) Summary Condition (D) Fair Market value (D) Date Acquired (D) How Acquired (D) Cost or Basis (D) Bargain Sale (D) Amt of Deductions (D) Ave. Trdg. Price(D) Identifying Letters of Items $500 or Less Description of Items Date Received Use of The Property for An Unrelated Use Box - Yes Use of The Property for An Unrelated Use Box - No Donee Name Employer ID Number & Street City, State, Zip Noncash Charitable Contributions Form Ref. ---5C(h) 5C(i) 5D(a) 5D(b) 5D(c) 5D(d) 5D(e) 5D(f) 5D(g) 5D(h) 5D(i) II Length -----12 12 25 30 12 6 11 12 12 12 12 4 Field Description ----------------N N AN AN N DT AN N N N N A - Value: A, B, C and/or D AN DT "X" or blank 0960 0970 0973 II IV IV 25 8 1 0976 IV 1 "X" or blank 0980 0990 1000 1010 IV IV IV IV August 30, 2002 35 9 25 25 AN N AN AN Part II Page 504 Section 4 Publication 1346 FORM 8283 PAGE 2 Field Identification No. ----- -------------- Noncash Charitable Contributions Form Ref. ---Length -----Field Description ----------------- Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 505 Section 4 INTENTIONAL BLANK PAGE Publication 1346 August 30, 2002 Part II Page 506 Section 4 FORM 8379 PAGE 1 Field Identification No. ----- -------------Byte Count Injured Spouse Claim and Allocation Form Ref. ---Length -----4 Field Description ----------------"0231" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" "8379bb" "PG01b" N (Primary SSN) Start of Record Sentinel 0000 0001 0002 0003 Record ID Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number Name Shown First on Return First Social Security Number First Injured Spouse Box Name Shown Second on Return Second Social Security Number Second Injured Spouse Box Tax Year for Claim Street Address 1 4 6 6 5 9 0004 0005 0010 1 7 35 blank N 0000001 AN, Allowable special characters are: space, and hyphen (-) N "X" or blank AN, Allowable special characters are: space, and hyphen (-) N "X" or blank DT or blank AN, Allowable special characters are: space, slash and hyphen or blank 0020 0030 0040 1 1 1 9 1 35 0050 0060 0070 0080 1 1 2 3 9 1 4 35 Publication 1346 August 30, 2002 Part II Page 507 Section 4 FORM 8379 PAGE 1 Field Identification No. ----- -------------0090 City Injured Spouse Claim and Allocation Form Ref. ---3 Length -----22 Field Description ----------------AN, Allowable special characters are: space, slash and hyphen or blank A (Standard Postal State Abbreviations) or blank N or blank "X" or blank "X" or blank "X" or blank "X" or blank "X" or blank "AZ" or blank (More than one state may apply on Line 6) "CA" or blank (More than one state may apply on Line 6) "ID" or blank (More than one state may apply on Line 6) "LA" or blank (More than one state may apply on Line 6) "NV" or blank (More than one state may apply on Line 6) "NM" or blank (More than one state may apply on Line 6) "TX" or blank (More than one state may apply on Line 6) Part II Page 508 Section 4 0100 0110 0120 0130 0140 0150 0160 0161 State Abbreviation Zip Code Address - Yes Box Address - No Box Divorced/Separated Box Community Property State - Yes Box Community Property State - No Box Community Property State Abbreviation for Arizona Community Prop. State Abbreviation for California Community Property State Abbreviation for Idaho Community Prop. State Abbreviation for Louisiana Community Property State Abbreviation for Nevada Community Prop. State Abbreviation for New Mexico Community Property State Abbreviation for Texas 3 3 4 4 5 6 6 6 2 12 1 1 1 1 1 2 0162 6 2 0163 6 2 0164 6 2 0165 6 2 0166 6 2 0167 6 2 Publication 1346 August 30, 2002 FORM 8379 PAGE 1 Field Identification No. ----- -------------0168 Community Prop. State Abbreviation for Washington Community Prop. State Abbreviation for Wisconsin Injured Spouse Claim and Allocation Form Ref. ---6 Length -----2 Field Description ----------------"WA" or blank (More than one state may apply on Line 6) "WI"or blank (More than one state may apply on Line 6) 0169 6 2 Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 509 Section 4 FORM 8379 PAGE 2 Field Identification No. ----- -------------Byte Count Injured Spouse Claim and Allocation Form Ref. ---Length -----4 Field Description ----------------"0769" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" "8379bb" "PG02b" N (Primary SSN) Start of Record Sentinel 0171 0172 0173 0174 Record ID Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number Wages - Joint Return Wages - Injured Spouse Wages - Other Spouse Total Other Income Joint Return Total Other Income Injured Spouse Total Other Income Other Spouse Other Income Type 1 Other Income Type 1 Amount - Joint Return Other Income Type 1 Amount - Injured Spouse Other Income Type 1 Amount - Other Spouse 7aa 7ab 7ac 7ba 7bb 7bc 7b 7ba 4 6 6 5 9 0175 0176 0180 0190 0200 0210 0220 0230 *0240 +0250 1 7 12 12 12 12 12 12 30 12 blank N 0000001 N N N N N N AN, "STMbnn" or blank N +0260 7bb 12 N +0270 7bc 12 N Publication 1346 August 30, 2002 Part II Page 510 Section 4 FORM 8379 PAGE 2 Field Identification No. ----- -------------0280 0290 Other Income Type 2 Other Income Type 2 Amount - Joint Return Other Income Type 2 Amount - Injured Spouse Other Income Type 2 Amount - Other Spouse Other Income Type 3 Other Income Type 3 Amount - Joint Return Other Income Type 3 Amount - Injured Spouse Other Income Type 3 Amount - Other Spouse Other Income Type 4 Other Income Type 4 Amount - Joint Return Other Income Type 4 Amount - Injured Spouse Other Income Type 4 Amount - Other Spouse Other Income Type 5 Other Income Type 5 Amount - Joint Return Injured Spouse Claim and Allocation Form Ref. ---7b 7ba Length -----30 12 Field Description ----------------AN or blank N 0300 7bb 12 N 0310 7bc 12 N 0320 0330 7b 7ba 30 12 AN or blank N 0340 7bb 12 N 0350 7bc 12 N 0360 0370 7b 7ba 30 12 AN or blank N 0380 7bb 12 N 0390 7bc 12 N 0400 0410 7b 7ba 30 12 AN or blank N Publication 1346 August 30, 2002 Part II Page 511 Section 4 FORM 8379 PAGE 2 Field Identification No. ----- -------------0420 Other Income Type 5 Amount - Injured Spouse Other Income Type 5 Amount - Other Spouse Other Income Type 6 Other Income Type 6 Amount - Joint Return Other Income Type 6 Amount - Injured Spouse Other Income Type 6 Amount - Other Spouse Adjustments to Income - Joint Return Adjustments to Income - Injured Spouse Adjustments to Income - Other Spouse Standard Deduction Joint Return Standard Deduction Injured Spouse Standard Deduction Other Spouse Itemized Deduction Joint Return Itemized Deduction Injured Spouse Injured Spouse Claim and Allocation Form Ref. ---7bb Length -----12 Field Description ----------------N 0430 7bc 12 N 0440 0450 7b 7ba 30 12 AN or blank N 0460 7bb 12 N 0470 7bc 12 N 0480 8a 12 N 0490 8b 12 N 0500 8c 12 N 0510 0520 0530 0540 0550 9a 9b 9c 10a 10b 12 12 12 12 12 N N N N N Publication 1346 August 30, 2002 Part II Page 512 Section 4 FORM 8379 PAGE 2 Field Identification No. ----- -------------0560 0570 0580 0590 0600 0610 0620 0630 0640 0650 0660 Itemized Deduction Other Spouse Exemptions - Joint Return Exemptions Injured Spouse Exemptions - Other Spouse Credits - Joint Return Credits - Injured Spouse Credits - Other Spouse Other Taxes - Joint Return Other Taxes Injured Spouse Other Taxes - Other Spouse Federal Income Tax Withheld - Joint Return Federal Income Tax Withheld - Injured Spouse Federal Income Tax Withheld - Other Spouse Estimated Tax Payments - Joint Return Estimated Tax Payments - Injured Spouse Injured Spouse Claim and Allocation Form Ref. ---10c 11a 11b 11c 12a 12b 12c 13a 13b 13c 14a Length -----12 2 2 2 12 12 12 12 12 12 12 Field Description ----------------N N N N N N N N N N N 0670 14b 12 N 0680 14c 12 N 0690 15a 12 N 0700 15b 12 N Publication 1346 August 30, 2002 Part II Page 513 Section 4 FORM 8379 PAGE 2 Field Identification No. ----- -------------0710 Estimated Tax Payments - Other Spouse Injured Spouse Claim and Allocation Form Ref. ---15c Length -----12 Field Description ----------------N Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 514 Section 4 FORM 8396 Field Identification No. ----- -------------Byte Count Mortgage Interest Credit Form Ref. ---Length -----4 Field Description ----------------"0380" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" "8396bb" "PG01b" N (Primary SSN) Start of Record Sentinel 0000 0001 0002 0003 Record ID Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number Name Line 4 6 6 5 9 0004 0005 0010 1 7 35 blank N 0000001 AN Taxpayer's name allowable special characters are: space, less-than (<), hyphen (-) and ampersand (&). N AN Allowable special characters are space, slash, hyphen and Literal "NONE" A Allowable special character is space. A (Standard Postal State Abbreviations) N (Left-justified) N R N Part II Page 515 Section 4 0020 0030 SSN Street Address 9 35 0040 0050 0060 0070 0080 0090 City State Abbreviation Zip Code Certified Mortgage Interest Paid Certificate Credit Rate Mortgage Interest Offset 1 2 3 August 30, 2002 22 2 12 12 6 12 Publication 1346 FORM 8396 Field Identification No. ----- -------------0100 0110 0120 0130 Three-Year Previous Carryforward Credit Two-Year Previous Carryforward Credit Prior Year Carryforward Credit Total Previous Carryforward Credit I Total Taxes Before Credit Child/Dep/Elderly/ Disabled/Edu/Rate Credit Tot Tax Less Credits Mortgage Interest Credit Interest Offset/ Oldest Carryforward Credit Combine Total Previous Carryforward Credit II Previous Carryforward Credit Offset Tentative Two-Year Carryforward Credit Next Year's TwoYear Carryforward Credit Tentative ThreeYear Carryforward Credit Mortgage Interest Credit Form Ref. ---4 5 6 7 Length -----12 12 12 12 Field Description ----------------N N N N 0140 0151 8 9 12 12 N N 0160 0170 0180 10 11 12 12 12 12 N N N 0190 13 12 N 0200 14 12 N 0210 0220 15 16 12 12 N N 0230 17 12 N Publication 1346 August 30, 2002 Part II Page 516 Section 4 FORM 8396 Field Identification No. ----- -------------0240 Next Year's ThreeYear Carryforward Credit Next Year's Prior Year Carryforward Credit Mortgage Interest Credit Form Ref. ---18 Length -----12 Field Description ----------------N 0250 19 12 N Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 517 Section 4 INTENTIONAL BLANK PAGE Publication 1346 August 30, 2002 Part II Page 518 Section 4 FORM 8582 PAGE 1 Field Identification No. ----- -------------Byte Count Form Ref. ---Length -----4 Field Description ----------------"0247" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" "8582bb" "PG01b" N (Primary SSN) Start of Record Sentinel 0000 0001 0002 0003 Record ID Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number Rental Real Estate Net Income Rental Real Estate Net Loss Unallowed Prior Year Rental Losses Net Rental Activity Loss Other Net Income Other Net Loss Unallowed Prior Year Other Losses Net Other Activity Loss Passive Activity Income/Loss Loss Limit Special Allowance Exclusion 1a 1b 1c 1d 2a 2b 2c 2d 3 4 5 August 30, 2002 4 6 6 5 9 0004 0005 0010 0020 0031 0032 0033 0037 0065 0070 0080 0090 0095 1 7 12 12 12 12 12 12 12 12 12 12 12 blank N 0000001 N N N N N N N N N N N Part II Page 519 Section 4 Publication 1346 FORM 8582 PAGE 1 Field Identification No. ----- -------------0105 0115 0125 0135 0145 0235 Modified Adjusted Gross Income Special Allowance Base Special Allowance Limit Special Allowance for Rental Activity Total Net Income Total Losses Allowed Form Ref. ---6 7 8 9 10 11 Length -----12 12 12 12 12 12 Field Description ----------------N N N N N N Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 520 Section 4 FORM 8582 PAGE 2 Field Identification No. ----- -------------Byte Count Form Ref. ---Length -----4 Field Description ----------------"2001" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" "8582bb" "PG02b" N (Primary SSN) Start of Record Sentinel 0240 0241 0242 0243 Record ID Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number Name of Activity 1 Net Income 1 Net Loss 1 Unallowed Loss 1 Overall Gain 1 Overall Loss 1 Name of Activity 2 Net Income 2 Net Loss 2 Unallowed Loss 2 Overall Gain 2 Overall Loss 2 Name of Activity 3 Net Income 3 Net Loss 3 W1 W1-(a) W1-(b) W1-(c) W1-(d) W1-(e) W1 W1-(a) W1-(b) W1-(c) W1-(d) W1-(e) W1 W1-(a) W1-(b) August 30, 2002 4 6 6 5 9 0244 0245 *0250 +0260 +0270 +0280 +0290 +0300 0310 0320 0330 0340 0350 0360 0370 0380 0390 1 7 20 12 12 12 12 12 20 12 12 12 12 12 20 12 12 blank N 0000001 AN or "STMbnn" N N N N N AN N N N N N AN N N Part II Page 521 Section 4 Publication 1346 FORM 8582 PAGE 2 Field Identification No. ----- -------------0400 0410 0420 0430 0440 0450 0460 0470 0480 0490 0500 0510 0520 0530 0540 0550 0560 0890 *0900 +0910 +0920 +0930 +0940 +0950 0960 Unallowed Loss 3 Overall Gain 3 Overall Loss 3 Name of Activity 4 Net Income 4 Net Loss 4 Unallowed Loss 4 Overall Gain 4 Overall Loss 4 Name of Activity 5 Net Income 5 Net Loss 5 Unallowed Loss 5 Overall Gain 5 Overall Loss 5 Total Net Income Total Net Loss Total Unallowed Name of Activity 1 Net Income 1 Net Loss 1 Unallowed Loss 1 Overall Gain 1 Overall Loss 1 Name of Activity 2 Form Ref. ---W1-(c) W1-(d) W1-(e) W1 W1-(a) W1-(b) W1-(c) W1-(d) W1-(e) W1 W1-(a) W1-(b) W1-(c) W1-(d) W1-(e) W1-(a) W1-(b) W1-(c) W2 W2-(a) W2-(b) W2-(c) W2-(d) W2-(e) W2 August 30, 2002 Length -----12 12 12 20 12 12 12 12 12 20 12 12 12 12 12 12 12 12 20 12 12 12 12 12 20 Field Description ----------------N N N AN N N N N N AN N N N N N N N N AN or "STMbnn" N N N N N AN Part II Page 522 Section 4 Publication 1346 FORM 8582 PAGE 2 Field Identification No. ----- -------------0970 0980 1000 1010 1020 1030 1040 1050 1060 1070 1080 1090 1100 1110 1120 1130 1140 1150 1160 1170 1180 1190 1200 1210 1220 Net Income 2 Net Loss 2 Unallowed Loss 2 Overall Gain 2 Overall Loss 2 Name of Activity 3 Net Income 3 Net Loss 3 Unallowed Loss 3 Overall Gain 3 Overall Loss 3 Name of Activity 4 Net Income 4 Net Loss 4 Unallowed Loss 4 Overall Gain 4 Overall Loss 4 Name of Activity 5 Net Income 5 Net Loss 5 Unallowed Loss 5 Overall Gain 5 Overall Loss 5 Total Net Income Total Net Loss Form Ref. ---W2-(a) W2-(b) W2-(c) W2-(d) W2-(e) W2 W2-(a) W2-(b) W2-(c) W2-(d) W2-(e) W2 W2-(a) W2-(b) W2-(c) W2-(d) W2-(e) W2 W2-(a) W2-(b) W2-(c) W2-(d) W2-(e) W2-(a) W2-(b) August 30, 2002 Length -----12 12 12 12 12 20 12 12 12 12 12 20 12 12 12 12 12 20 12 12 12 12 12 12 12 Field Description ----------------N N N N N AN N N N N N AN N N N N N AN N N N N N N N Part II Page 523 Section 4 Publication 1346 FORM 8582 PAGE 2 Field Identification No. ----- -------------1550 *1560 +1570 +1580 +1590 +1600 +1610 1620 1630 1640 1650 1660 1670 1680 1690 1700 1710 1720 1730 1740 1750 1760 Total Unallowed Loss Name of Activity 1 Form or Schedule Reported on 1 Loss 1 Ratio 1 Income and Special Allowance 1 Loss Minus Income 1 Name of Activity 2 Form or Schedule Reported on 2 Loss 2 Ratio 2 Income and Special Allowance 2 Loss Minus Income 2 Name of Activity 3 Form or Schedule Reported on 3 Loss 3 Ratio 3 Income and Special Allowance 3 Loss Minus Income 3 Name of Activity 4 Form or Schedule Reported on 4 Loss 4 Form Ref. ---W2-(c) W3 W3 W3(a) W3(b) W3(c) W3(d) W3 W3 W3(a) W3(b) W3(c) W3(d) W3 W3 W3(a) W3(b) W3(c) W3(d) W3 W3 W3(a) August 30, 2002 Length -----12 20 10 12 6 12 12 20 10 12 6 12 12 20 10 12 6 12 12 20 10 12 Field Description ----------------N AN or "STMbnn" AN N R N N AN AN N R N N AN AN N R N N AN AN N Part II Page 524 Section 4 Publication 1346 FORM 8582 PAGE 2 Field Identification No. ----- -------------1770 1780 1790 1800 1810 1820 1830 1840 1850 1860 1870 1880 *1900 +1910 +1920 +1930 +1940 1950 1960 1970 1980 1990 Ratio 4 Income and Special Allowance 4 Loss Minus Income 4 Name of Activity 5 Form or Schedule Reported on 5 Loss 5 Ratio 5 Income and Special Allowance 5 Loss Minus Income 5 Total Loss Total Income and Special Allowance Total Loss Minus Income Name of Activity 1 Form or Schedule Reported on 1 Loss 1 Ratio 1 Unallowed Loss 1 Name of Activity 2 Form or Schedule Reported on 2 Loss 2 Ratio 2 Unallowed Loss 2 Form Ref. ---W3(b) W3(c) W3(d) W3 W3 W3(a) W3(b) W3(c) W3(d) W3(a) W3(c) W3(d) W4 W4 W4(a) W4(b) W4(c) W4 W4 W4(a) W4(b) W4(c) August 30, 2002 Length -----6 12 12 20 10 12 6 12 12 12 12 12 20 10 12 6 12 20 10 12 6 12 Field Description ----------------R N N AN AN N R N N N N N AN or "STMbnn" AN N R N AN AN N R N Part II Page 525 Section 4 Publication 1346 FORM 8582 PAGE 2 Field Identification No. ----- -------------2000 2010 2020 2030 2040 2050 2060 2070 2080 2090 2100 2110 2120 2130 2140 2150 2160 *2170 +2180 +2190 +2200 +2210 2220 Name of Activity 3 Form or Schedule Reported on 3 Loss 3 Ratio 3 Unallowed Loss 3 Name of Activity 4 Form or Schedule Reported on 4 Loss 4 Ratio 4 Unallowed Loss 4 Name of Activity 5 Form or Schedule Reported on 5 Loss 5 Ratio 5 Unallowed Loss 5 Total Loss Total Unallowed Loss Name of Activity 1 Form or Schedule Reported on 1 Loss 1 Unallowed Loss 1 Allowed Loss 1 Name of Activity 2 Form Ref. ---W4 W4 W4(a) W4(b) W4(c) W4 W4 W4(a) W4(b) W4(c) W4 W4 W4(a) W4(b) W4(c) W4(a) W4(c) W5 W5 W5(a) W5(b) W5(c) W5 August 30, 2002 Length -----20 10 12 6 12 20 10 12 6 12 20 10 12 6 12 12 12 20 10 12 12 12 20 Field Description ----------------AN AN N R N AN AN N R N AN AN N R N N N AN or "STMbnn" AN N N N AN Part II Page 526 Section 4 Publication 1346 FORM 8582 PAGE 2 Field Identification No. ----- -------------2230 2240 2250 2260 2270 2280 2290 2300 2310 2320 2330 2340 2350 2360 2370 2380 2390 2400 2410 2420 2430 2440 Form or Schedule Reported on 2 Loss 2 Unallowed Loss 2 Allowed Loss 2 Name of Activity 3 Form or Schedule Reported on 3 Loss 3 Unallowed Loss 3 Allowed Loss 3 Name of Activity 4 Form or Schedule Reported on 4 Loss 4 Unallowed Loss 4 Allowed Loss 4 Name of Activity 5 Form or Schedule Reported on 5 Loss 5 Unallowed Loss 5 Allowed Loss 5 Total Loss Total Unallowed Loss Total Allowed Loss Form Ref. ---W5 W5(a) W5(b) W5(c) W5 W5 W5(a) W5(b) W5(c) W5 W5 W5(a) W5(b) W5(c) W5 W5 W5(a) W5(b) W5(c) W5(a) W5(b) W5(c) Length -----10 12 12 12 20 10 12 12 12 20 10 12 12 12 20 10 12 12 12 12 12 12 Field Description ----------------AN N N N AN AN N N N AN AN N N N AN AN N N N N N N Publication 1346 August 30, 2002 Part II Page 527 Section 4 FORM 8582 PAGE 2 Field Identification No. ----- -------------Form Ref. ---Length -----Field Description ----------------- Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 528 Section 4 FORM 8582 PAGE 3 Field Identification No. ----- -------------Byte Count Passive Activity Loss Limitations Form Ref. ---Length -----4 Field Description ----------------"0327" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" "8582bb" "PG03b" N (Primary SSN) Start of Record Sentinel 2450 2451 2452 2453 Record ID Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number Name of Activity Form or Schedule Name 1 Net Loss from Form or Schedule 1 Net Income from Form or Schedule 1 Net Loss minus Net Income 1 Ratio 1 Unallowed Loss 1 Allowed Loss Net Loss/Allowed Loss 1 Form or Schedule Name 2 Net Loss from Form or Schedule 2 Net Income from Form or Schedule 2 W6 W6-1 W6-1a(a) W6-1b(a) W6-1c(b) W6-1c(c) W6-1c(d) W6-1c(e) W6-2 W6-1a(a) W6-1b(a) August 30, 2002 4 6 6 5 9 2454 2455 2458 *2461 +2470 +2490 +2500 +2510 +2520 +2530 2541 2550 2570 1 7 20 10 12 12 12 6 12 12 10 12 12 blank N 0000001 AN AN or "STMbnn" N N N R N N AN N N Part II Page 529 Section 4 Publication 1346 FORM 8582 PAGE 3 Field Identification No. ----- -------------2580 2590 2600 2610 2620 2630 2650 2660 2670 2680 2690 2700 2710 2720 Net Loss minus Net Income 2 Ratio 2 Unallowed Loss 2 Allowed Loss Net Loss/Allowed Loss 2 Form or Schedule Name 3 Net Loss from Form or Schedule 3 Net Income from Form or Schedule 3 Net Loss minus Net Income 3 Ratio 3 Unallowed Loss 3 Allowed Loss 3 Total Net Loss Minus Net Income Total Unallowed Loss Total Allowed Loss Passive Activity Loss Limitations Form Ref. ---W6-1c(b) W6-1c(c) W6-1c(d) W6-1c(e) W6-3 W6-1a(a) W6-1b(a) W6-1c(b) W6-1c(c) W6-1c(d) W6-1c(e) W6(b) W6(d) W6(e) Length -----12 6 12 12 10 12 12 12 6 12 12 12 12 12 Field Description ----------------N R N N AN N N N R N N N N N Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 530 Section 4 FORM 8582-CR PAGE 1 Field Identification No. ----- -------------Byte Count Passive Activity Credit Limitations Form Ref. ---Length -----4 Field Description ----------------"0331" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" "8582CR" "PG01b" N (Primary SSN) Start of Record Sentinel 0000 0001 0002 0003 Record ID Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number Rental Real Estate Credits from Worksheet 1, Col a PY Unallowed Credits from Worksheet 1, Col b Total Rental Real Estate Credits Rehabilitation Credits from Worksheet 2, Col a Rehabilitation PY Credits from Worksheet 2, Col b Total Rehabilitation Credits Low-Income Housing Credits from Worksheet 3, Col a 1a 4 6 6 5 9 0004 0005 0010 1 7 12 blank N 0000001 N 0020 1b 12 N 0030 0040 1c 2a 12 12 N N 0050 2b 12 N 0060 2c 12 N 0070 3a 12 N Publication 1346 August 30, 2002 Part II Page 531 Section 4 FORM 8582-CR PAGE 1 Field Identification No. ----- -------------0080 Low-Income Housing PY Credits, Worksheet 3, Col b Total Low-Income Housing Credits All Passive Activity Credits, Worksheet 4, Col a Passive Activity PY Credits, Worksheet 4, Col b Total All Passive Activity Credits Total Credits Tax Attributable to Net Passive Income Total Net Credits Smaller of Real Estate or Total Net Credits Enter $150,000 Modified Adjusted Gross Income Subtract Line 10 from Line 9 Multiply Line 11 by 50% Special Allowance for Rental Activity Subtract Line 13 from Line 12 Tax Attributable to the Amount on Line 14 Passive Activity Credit Limitations Form Ref. ---3b Length -----12 Field Description ----------------N 0090 0100 3c 4a 12 12 N N 0110 4b 12 N 0120 0130 0140 0150 0160 4c 5 6 7 8 12 12 12 12 12 N N N N N 0170 0180 0190 0200 0210 0220 0230 9 10 11 12 13 14 15 12 12 12 12 12 12 12 N N N N N N N Publication 1346 August 30, 2002 Part II Page 532 Section 4 FORM 8582-CR PAGE 1 Field Identification No. ----- -------------0240 Smaller of Line 8 or Line 15 Passive Activity Credit Limitations Form Ref. ---16 Length -----12 Field Description ----------------N Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 533 Section 4 FORM 8582-CR PAGE 2 Field Identification No. ----- -------------Byte Count Passive Activity Credit Limitations Form Ref. ---Length -----4 Field Description ----------------"0423" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" "8582CR" "PG02b" N (Primary SSN) Start of Record Sentinel 0250 0251 0252 0253 Record ID Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number Total Net Credits Smaller of Line 8 or Line 15 Subtract Line 18 from Line 17 Smaller of Line 2c or Line 19 Enter $250,000 Modified Adjusted Gross Income Subtract Line 22 from Line 21 Multiply Line 23 by 50% Special Allowance for Rental Activity Subtract Line 25 from Line 24 17 18 19 20 21 22 23 24 25 26 4 6 6 5 9 0254 0255 0260 0270 0280 0290 0300 0310 0320 0330 0340 0350 1 7 12 12 12 12 12 12 12 12 12 12 blank N 0000001 N N N N N N N N N N Publication 1346 August 30, 2002 Part II Page 534 Section 4 FORM 8582-CR PAGE 2 Field Identification No. ----- -------------0360 Tax Attributable to the Amount on Line 26 Amount, if any, from Line 18 Subtract Line 28 from Line 27 Smaller of Line 20 or Line 29 Amt on Line 19 or Subtract Line 16 from Line 7 Amount from Line 30 Subtract Line 32 from Line 31 Smaller of Line 3c or Line 33 Tax Attributable to Remaining Special Allowance Smaller of Line 34 or Line 35 Passive Activity Credit Allowed Election to Increase Basis of Credit Property Box Name of Passive Activity Disposed of Description of the Credit Property Amount of Unallowed Credit Passive Activity Credit Limitations Form Ref. ---27 Length -----12 Field Description ----------------N 0370 0380 0390 0400 28 29 30 31 12 12 12 12 N N N N 0410 0420 0430 0440 32 33 34 35 12 12 12 12 N N N N 0450 0460 0470 36 37 38 12 12 1 N N "X" or blank 0480 0490 0500 39 40 41 35 80 12 AN or blank AN or blank N Publication 1346 August 30, 2002 Part II Page 535 Section 4 FORM 8582-CR PAGE 2 Field Identification No. ----- -------------- Passive Activity Credit Limitations Form Ref. ---Length -----Field Description ----------------- Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 536 Section 4 FORM 8586 Field Identification No. ----- -------------Byte Count Low-Income Housing Credit Form Ref. ---Length -----4 Field Description ----------------"0477" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" "8586bb" "PG01b" N (Primary SSN) | Start of Record Sentinel 0000 0001 0002 0003 Record ID Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number Identifying Number Number of Forms 8609 Attached Multiple Building Project Schedule Eligible Basis of Building(s) Qualified Basis of Low-Income Building(s) Decrease in the Qualified Basis BoxYes Decrease in the Qualified Basis BoxNo Building Identification Number - BIN1 1 1 2 3a 4 6 6 5 9 0004 0005 0010 0020 @0025 0030 0040 1 7 9 12 6 12 12 blank N 0000001 NO ENTRY N "STMbnn" or blank N N | 0050 3b 1 "X" or blank 0060 3b 1 "X" or blank *0070 3b(i) 9 AN or "STMbnn" Publication 1346 August 30, 2002 Part II Page 537 Section 4 FORM 8586 Field Identification No. ----- -------------+0080 Building Identification Number - BIN2 Building Identification Number - BIN3 Building Identification Number - BIN4 Credit Attributable to more than one Building Sch Current Year Credit Flow-through Entity EIN Total Credits from Flow-through Entities Credits from more than One Flowthrough Entity Total Current Year & Flow-through Entities Credits Passive Activity or Total Current Year Credits Regular Tax Before Credits Alternative Minimum Tax Regular Tax Plus Alternative Minimum Tax Foreign Tax Credit Low-Income Housing Credit Form Ref. ---3b(ii) Length -----9 Field Description ----------------AN +0090 3b(iii) 9 AN +0100 3b(iv) 9 AN @0105 4 6 "STMbnn" or blank 0110 0115 0120 4 5 5 12 9 12 N N N @0125 5 6 "STMbnn" or blank 0130 6 12 N 0140 7 12 N 0150 0160 0170 8 9 10 12 12 12 N N N 0180 11a August 30, 2002 12 N Part II Page 538 Section 4 Publication 1346 FORM 8586 Field Identification No. ----- -------------0190 Credit for Child and Dependent Care Exp (F2441) Credit for the Elderly or the Disabled (Sch R) Education Credits (F8863) Credit for Qualified Retirement Savings Child Tax Credit (F1040) Mortgage Interest Credit (F8396) Adoption Credit (F8839) DC First-Time Homebuyer Credit (F8859) Possessions Tax Credit (F5735) Credit for Fuel from a Nonconventional Source Qualified Electric Vehicle Credit (F8834) Total Credits Net Income Tax Net Regular Tax 25% of the Excess of $25,000 of Net Regular Tax Low-Income Housing Credit Form Ref. ---11b Length -----12 Field Description ----------------N 0200 11c 12 N 0210 0215 11d 11e 12 12 N N | 0220 0230 0240 0250 11f 11g 11h 11i 12 12 12 12 N N N N 0260 0270 11j 11k 12 12 NO ENTRY N 0280 11l 12 N 0290 0300 0320 0330 11m 12 13 14 12 12 12 12 N N N N --| | | Publication 1346 August 30, 2002 Part II Page 539 Section 4 FORM 8586 Field Identification No. ----- -------------0335 0340 0350 0360 Tentative Minimum Tax Greater of Line 14 or Line 15 Subtract Line 16 from Line 12 Low-Income Housing Credit Allowed for CY Low-Income Housing Credit Form Ref. ---15 16 17 18 Length -----12 12 12 12 Field Description ----------------N N N N | | Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 540 Section 4 FORM 8594 PAGE 1 Field Identification No. ----- -------------Byte Count Asset Acquisition Statement Form Ref. ---Length -----4 Field Description ----------------"0369" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" "8594bb" "PG01b" N (Primary SSN) Start of Record Sentinel 0000 0001 0002 0003 Record ID Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number Identifying Number Buyer Seller Name of Other Party to Transaction Other Party's Identification Number Address City State Zip Code Sale Date Total Sales Price Assets Transferred Market Value Class I I 1 I 1 4 6 6 5 9 0004 0005 0010 0020 0030 0040 0050 1 7 9 1 1 35 9 blank N 0000001 N "X" or blank "X" or blank AN N 0060 0070 0080 0090 0100 0110 0120 I 1 I 1 I 1 I 1 I 2 I 3 II 4 35 22 2 12 8 12 12 AN AN AN N YYYYMMDD N N Publication 1346 August 30, 2002 Part II Page 541 Section 4 FORM 8594 PAGE 1 Field Identification No. ----- -------------0130 0140 Assets Transferred Sales Price Class I Assets Transferred Market Value Class II Assets Transferred Sales Price Class II Assets Transferred Market Value Class III Assets Transferred Sales Price Class III Assets Transferred Market Value Class IV Assets Transferred Sales Price Class IV Assets Transferred Market Value Class V Assets Transferred Sales Price Class V Assets Transferred Market Value Class VI & VII Assets Transferred Sales Price Class VI & VII Total Assets Transferred Market Value Total Assets Transferred Sales Price Purchaser/Seller Provide for an Allocation - Yes Asset Acquisition Statement Form Ref. ---II 4 II 4 Length -----12 12 Field Description ----------------N N 0150 0160 II 4 II 4 12 12 N N 0170 II 4 12 N 0180 II 4 12 N 0190 0200 0210 0220 II 4 II 4 II 4 II 4 12 12 12 12 N N N N 0230 II 4 12 N 0240 II 4 12 N 0250 II 4 12 N 0260 II 5 1 "X" or blank Publication 1346 August 30, 2002 Part II Page 542 Section 4 FORM 8594 PAGE 1 Field Identification No. ----- -------------0270 Purchaser/Seller Provide for an Allocation - No Are Aggregate Fair Market Values Listed - Yes Are Aggregate Fair Market Values Listed - No In Connection with a Purchase - Yes In Connection with a Purchase - No Attach a Schedule of Agreement Asset Acquisition Statement Form Ref. ---II 5 Length -----1 Field Description ----------------"X" or blank 0280 II 5 1 "X" or blank 0290 II 5 1 "X" or blank 0300 0310 @0315 II 6 II 6 II 6 1 1 6 "X" or blank "X" or blank "STMbnn" or blank Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 543 Section 4 FORM 8594 PAGE 2 Field Identification No. ----- -------------Byte Count Asset Acquisition Statement Form Ref. ---Length -----4 Field Description ----------------"0505" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" "8594bb" "PG02b" N (Primary SSN) Start of Record Sentinel 0320 0321 0322 0323 Record ID Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number Supplemental Stmt Tax Year and Return Form Number Supplemental Stmt Allocation Sales Price Class I Supplemental Stmt Increase/Decrease Class I Supplemental Stmt Redetermined Allocation Class I Supplemental Stmt Allocation Sales Price Class II Supplemental Stmt Increase/Decrease Class II Supplemental Stmt Redetermined Allocation Class II III 7 4 6 6 5 9 0324 0325 *0330 1 7 12 blank N 0000001 AN, "STMbnn" or blank 0340 III 8 12 AN 0350 III 8 12 AN 0360 III 8 12 AN 0370 III 8 12 AN 0380 III 8 12 AN 0390 III 8 12 AN Publication 1346 August 30, 2002 Part II Page 544 Section 4 FORM 8594 PAGE 2 Field Identification No. ----- -------------0400 Supplemental Stmt Allocation Sales Price Class III Supplemental Stmt Increase/Decrease Class III Supplemental Stmt Redetermined Class III Supplemental Stmt Allocation Sales Price Class IV Supplemental Stmt Increase/Decrease Class IV Supplemental Stmt Redetermined Allocation Class IV Supplemental Stmt Allocation Sales Price Class V Supplemental Stmt Increase/Decrease Class V Supplemental Stmt Redetermined Allocation Class V Supplemental Stmt Sales Price Class VI & VII Supplemental Stmt Incr/Decrease Class VI & VII Supplemental Stmt Redetermined Class VI & VII Asset Acquisition Statement Form Ref. ---III 8 Length -----12 Field Description ----------------AN 0410 III 8 12 AN 0420 III 8 12 AN 0430 III 8 12 AN 0440 III 8 12 AN 0450 III 8 12 AN 0460 III 8 12 AN 0470 III 8 12 AN 0480 III 8 12 AN 0490 III 8 12 AN 0500 III 8 12 AN 0510 III 8 12 AN Publication 1346 August 30, 2002 Part II Page 545 Section 4 FORM 8594 PAGE 2 Field Identification No. ----- -------------0520 Total Assets Allocation of Sales Price Total Assets Redetermined Allocation Reason(s) for Increase Reason(s) for Increase Reason(s) for Increase Asset Acquisition Statement Form Ref. ---III 8 Length -----12 Field Description ----------------AN 0530 III 8 12 AN *0540 *0550 *0560 IV 12 IV 12 IV 12 70 70 70 AN, "STMbnn" or blank AN AN Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 546 Section 4 FORM 8606 PAGE 1 Field Identification No. ----- -------------Byte Count Nondeductible IRAs Form Ref. ---Length -----4 Field Description ----------------"0261" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" "8606bb" "PG01b" N (Primary SSN) Start of Record Sentinel 0000 0001 0002 0003 Record ID Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number Nondeductible IRA Name 4 6 6 5 9 0004 0005 0009 1 7 35 blank N 0000001 - 0000002 AN, Taxpayer's name allowable special characters are: space, less-than (<) and hyphen (-) N N 0010 0100 SSN of Taxpayer with IRAs Current Tax Year Nondeductible Contrib. IRA Basis for Prior Years Total IRA Value Post Tax Year Contributions Tax Year Net Basis Current Tax Year IRAs plus Rollovers Current TY IRA Withdrawals Less Pre-Jan Rollover 1 9 12 0105 0162 0164 0166 0170 0180 2 3 4 5 6 7 12 12 12 12 12 12 N N N N N N Publication 1346 August 30, 2002 Part II Page 547 Section 4 FORM 8606 PAGE 1 Field Identification No. ----- -------------0185 0190 Tax Year Combined IRA Value Tot IRAs, Rollovers, Withdrawals And IRA Value Tax Year Basis Ratio Nontaxable Portion of Amt Converted to Roth IRA Non Taxable Portion of Withdrawals Not Converted Total Non Taxable Portion of Withdrawals Total IRA Basis Taxable Withdrawals From Traditional, SEP & IRAs Nondeductible IRAs Form Ref. ---8 9 Length -----12 12 Field Description ----------------N N 0225 0235 10 11 6 12 R N 0245 12 12 N 0250 13 12 N 0260 0265 14 15 12 12 N N Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 548 Section 4 FORM 8606 PAGE 2 Field Identification No. ----- -------------Byte Count Nondeductible IRAs Form Ref. ---Length -----4 Field Description ----------------"0227" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" "8606bb" "PG02b" N (Primary SSN) Start of Record Sentinel 0330 0331 0332 0333 Record ID Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number Total IRA Conversion Amount IRA Basis Taxable IRA Conversion Amount TY Roth IRA Withdrawals Not including Rollovers Roth IRA Contribution Basis Current TY Net Roth IRA Withdrawals Basis in Roth IRA Contributions Net Roth IRA Withdrawals Not Including Basis Amount From 1998 Form 8606, Line 17 16 17 18 19 4 6 6 5 9 0334 0335 0338 0342 0344 0351 1 7 12 12 12 12 blank N 0000001 - 0000002 N N N N 0354 0358 0361 0376 20 21 22 23 12 12 12 12 N N N N 0380 24 12 N Publication 1346 August 30, 2002 Part II Page 549 Section 4 FORM 8606 PAGE 2 Field Identification No. ----- -------------0384 0400 0430 0435 Tot Amt from F8606: TY 1998, 1999, 2000 Subtract Line 25 from 24 Taxable IRA Amount Current TY Education IRAs Withdrawals Exclusion for Education IRA Withdrawals - Yes Box Exclusion for Education IRA Withdrawals - No Box TY Qualified Higher Education Exp Amt Non-Taxable Education IRA Withdrawals - Yes Box Non-Taxable Education IRA Withdrawals - No Box Current TY Taxable Withdrawal Amount Nondeductible IRAs Form Ref. ---25 26 27 28 Length -----12 12 12 12 Field Description ----------------N N N N 0452 29 1 "X" or blank 0456 29 1 "X" or blank 0470 0476 29 30 12 1 N "X" or blank 0486 30 1 "X" or blank 0489 30 12 N Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 550 Section 4 FORM 8609 Field Identification No. ----- -------------Byte Count LOW-INCOME HOUSING CREDIT ALLOCATION CERTIFICATION Form Ref. ---Length -----4 Field Description ----------------"0525" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" "8609bb" "PG01b" N (Primary SSN) Start of Record Sentinel 0000 0001 0002 0003 Record ID Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number Addition to Qualified Basis Amended Form Address of Building City of Building State of Building Zip Code of Building Name of Housing Credit Agency Address of Housing Credit Agency City of Housing Credit Agency State of Housing Credit Agency Zip Code of Housing Credit Agency A A A A B B B B B August 30, 2002 4 6 6 5 9 0004 0005 0010 0020 0030 0040 0050 0060 0070 0080 0090 0100 0110 1 7 1 1 35 22 2 12 35 35 22 2 12 blank N 0000001 - 0000010 "X" or blank NO ENTRY AN AN AN N or nnnnnbbbbbbb or nnnnnnnnnbbb AN AN AN AN N or nnnnnbbbbbbb or nnnnnnnnnbbb Part II Page 551 Section 4 Publication 1346 FORM 8609 Field Identification No. ----- -------------0120 0130 0140 0150 0160 0165 0170 Name of Building Owner Address of Building Owner City of Building Owner State of Building Owner Zip Code of Building Owner TIN of Building Owner Employer Identification Number of Agency Building Identification Number (BIN) Date of Allocation Maximum Housing Credit Dollar Amount Maximum Credit Percentage Maximum Qualified Basis Eligibility Basis Increased under 42(d)(5)(C) Percentage of Eligibility Basis Increase Percentage Aggregate Basis Financed LOW-INCOME HOUSING CREDIT ALLOCATION CERTIFICATION Form Ref. ---C C C C C C D Length -----35 35 22 2 12 9 9 Field Description ----------------AN AN AN AN N or nnnnnbbbbbbb or nnnnnnnnnbbb N N 0180 E 9 AN 0190 0200 0210 0220 0230 1a 1b 2 3a 3b 8 12 6 12 1 DT N R N "X" or blank 0240 3b 6 R 0250 4 6 R Publication 1346 August 30, 2002 Part II Page 552 Section 4 FORM 8609 Field Identification No. ----- -------------0260 0270 Building in Service Date Newly Constructed and Federally Subsidized Newly Constructed and NOT Federally Subsidized Existing Building Sec 42e Rehab Expenditures Fed Subsidized Sec 42e Rehab Expenditures NOT Fed Subsidized Date Building Placed in Service Eligible Basis of Building Original Qualified Basis of Building Multiple Building Project-Sec 42-Yes Multiple Building Project-Sec 42-No Elect to reduce Eligible Basis-Sec 42(i)(2)(B)-Yes Elect to reduce Eligible Basis-Sec 42(i)(2)(B)-No Elect to reduce Eligible basis-Sec 42(d)(3)-Yes LOW-INCOME HOUSING CREDIT ALLOCATION CERTIFICATION Form Ref. ---5 6a Length -----8 1 Field Description ----------------DT "X" or blank 0280 6b 1 "X" or blank 0290 0300 6c 6d 1 1 "X" or blank "X" or blank 0310 6e 1 "X" or blank 0320 0330 0340 0350 0355 0360 7a 7b 8a 8b 8b 9a 8 12 12 1 1 1 DT N N "X" or blank "X" or blank "X" or blank 0365 9a 1 "X" or blank 0370 9b 1 "X" or blank Publication 1346 August 30, 2002 Part II Page 553 Section 4 FORM 8609 Field Identification No. ----- -------------0375 Elect to reduce Eligible basis-Sec 42(d)(3)-No Elect to begin Credit Period-Sec 42(f)(1)-Yes Elect to begin Credit Period-Sec 42(f)(1)-No Elect Not to treat Large Partnerships as Taxpayer Elect Minimum SetAside Requirement range 20-50 Elect Minimum SetAside Requirement range 40-60 Elect Minimum SetAside Requirement range 25-60 Elect Deep-RentSkewed Project Qualified Basis of Building has Decreased Qualified Basis of Building has NOT Decreased Attachments Taxpayer Identification Number First Year Certification Date Taxpayer Name LOW-INCOME HOUSING CREDIT ALLOCATION CERTIFICATION Form Ref. ---9b Length -----1 Field Description ----------------"X" or blank 0380 10a 1 "X" or blank 0385 10a 1 "X" or blank 0390 10b 1 "X" or blank 0400 10c 1 "X" or blank 0410 10c 1 "X" or blank 0420 10c 1 "X" or blank 0430 0440 10d 1 1 "X" or blank "X" or blank 0450 1 "X" or blank @0455 0460 6 9 "STMbnn" or blank N (Primary SSN) 0470 0475 8 35 August 30, 2002 DT AN Part II Page 554 Section 4 Publication 1346 FORM 8609 Field Identification No. ----- -------------0480 Reserved LOW-INCOME HOUSING CREDIT ALLOCATION CERTIFICATION Form Ref. ---Length -----1 Field Description ----------------Blank Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 555 Section 4 INTENTIONAL BLANK PAGE Publication 1346 August 30, 2002 Part II Page 556 Section 4 SCHEDULE A (FORM 8609) Field Identification No. ----- -------------Byte Count ANNUAL STATEMENT Form Ref. ---Length -----4 Field Description ----------------"0294" for Fixed; "nnnn" for variable format Value "****" "SCHbbA" "8609bb" "PG01b" N (Primary SSN) Start of Record Sentinel 0000 0001 0002 0003 Record ID Schedule Type Page Number Taxpayer Identification Number Filler Schedule Occurrence Number Building Owner's Name Identifying Number Building Identification Number Eligible Basis of Building Low Income Portion Qualified Basis of Low Income Building Part Year AdjustmentDisposition/ Acquisition-1 Credit Percentage Multiply Line 3 or 4 by Percentage on Line 5 A B C 4 6 6 5 9 0004 0005 0010 0020 0030 1 7 35 9 9 blank N 0000001 - 0000010 AN N AN 0040 0050 0060 0070 1 2 3 4 12 6 12 12 N R N N 0080 0090 5 6 6 12 R N Publication 1346 August 30, 2002 Part II Page 557 Section 4 SCHEDULE A (FORM 8609) Field Identification No. ----- -------------0100 0110 Additions to Qualified Basis Part Year AdjustmentDisposition/ Acquisition-2 Credit PercentageOne-Third of Line 5 Multiply Line 7 or Line 8 by Percentage on Line 9 Sec 42(f)(3)(B) Modification Add Lines 10 and 11 Credit for Building before Line 14 Reduction Disallowed Credit due to Federal Grants Credit Allowed for Building for Tax Year Taxpayer Proportionate Share of Credit for Tax Yr Adjustments Taxpayer's Credit ANNUAL STATEMENT Form Ref. ---7 8 Length -----12 12 Field Description ----------------N N 0120 0130 9 10 6 12 R N 0140 0150 0160 11 12 13 12 12 12 N N N 0170 14 12 N 0180 15 12 N 0190 16 12 N 0200 0210 17 18 12 12 N N Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 558 Section 4 FORM 8611 Field Identification No. ----- -------------Byte Count RECAPTURE OF LOW-INCOME HOUSING CREDIT Form Ref. ---Length -----4 Field Description ----------------"0399" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" "8611bb" "PG01b" N (Primary SSN) blank N 0000001 - 0000005 NO ENTRY AN AN AN N or nnnnnbbbbbbb or nnnnnnnnnbbb N | | Start of Record Sentinel 0000 0001 0002 0003 Record ID Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number Identifying Number Address of Building City of Building State of Building Zip Code of Building Building Identification Number Date Placed in Service Issuer's Name Date of Issue Name of Issue CUSIP Number C C C C D 4 6 6 5 9 0004 0005 0010 0020 0030 0040 0050 0060 1 7 9 35 22 2 12 9 0070 0080 0090 0100 0110 E F(1) F(2) F(3) F(4) 8 35 8 35 9 YYYYMMDD AN | YYYYMMDD or blank | AN Values: A-Z and/or 0-9 or all blank cannot be all zeros Part II Page 559 Section 4 Publication 1346 August 30, 2002 FORM 8611 Field Identification No. ----- -------------0120 Total Credits Reported on Form 8586 in Prior Yrs Credits included on Line 1 Credits Subject to Recapture Credit Recapture Percentage Accelerated Portion of Credit Percentage Decreased in Qualified Basis Amount of Accelerated Portion Recaptured Recapture Amount from Flow Through Entity Accelerated Portion of the Unused Credit Net Recapture Line 11 Literal Interest on Line 10 Recapture Amount Total Recapture-Add Line 10 and Line 11 Interest on Line 7 Recapture Amount Total Recapture Add Line 7 and Line 13 RECAPTURE OF LOW-INCOME HOUSING CREDIT Form Ref. ---1 Length -----12 Field Description ----------------N 0130 0140 0150 0160 0170 2 3 4 5 6 12 12 6 12 6 N N R N R 0180 7 12 N 0190 8 12 N 0200 0210 0215 0220 0230 0240 0250 9 10 11 11 12 13 14 12 12 16 12 12 12 12 N N "SECTIONb42(J)(5)" N N NO ENTRY NO ENTRY Publication 1346 August 30, 2002 Part II Page 560 Section 4 FORM 8611 Field Identification No. ----- -------------- RECAPTURE OF LOW-INCOME HOUSING CREDIT Form Ref. ---Length -----Field Description ----------------- Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 561 Section 4 INTENTIONAL BLANK PAGE Publication 1346 August 30, 2002 Part II Page 562 Section 4 FORM 8615 Field Identification No. ----- -------------Byte Count Tax for Children Under Age 14 Who Have... Form Ref. ---Length -----4 Field Description ----------------"0436" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" "8615bb" "PG01b" N (Primary SSN) Start of Record Sentinel 0000 0001 0002 0003 Record ID Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number Child Name 4 6 6 5 9 0004 0005 0010 1 7 35 blank N 0000001 AN Child's name allowable special characters are: space, less-than (<), hyphen (-) and ampersand (&) N A First 4 significant characters of parent's last name, no leading or embedded spaces; allowable characters are alpha, hyphen or space (see special instructions) N "ESTIMATED" or blank Values 1 to 5 N Part II Page 563 Section 4 0020 0040 0045 Child SSN Parent Name Parent Name Control A A 9 35 4 0050 0055 0060 0070 Parent SSN FSC Estimated Literal Parent Filing Status Gross Unearned Income B C C 1 August 30, 2002 9 9 1 12 Publication 1346 FORM 8615 Field Identification No. ----- -------------0080 0090 0100 0110 0115 Deductions Child Unearned Income Adjusted Child Taxable Income Child Net Investment Income Parent Taxable Income Estimated Literal Parent Taxable Income Sect. 644 Literal 1 Sect. 644 Amount Other Unearned Income Estimated Literal Other Children Unearned Income Combined Income Parent Schedule D Ind. Tax at Parent Tax Rate Parent Schedule D Ind. Form 8814 Tax Form 8814 Literal Parent Tax Sect. 644 Literal 2 Adjusted Tax Tax for Children Under Age 14 Who Have... Form Ref. ---2 3 4 5 6 Length -----12 12 12 12 9 Field Description ----------------N N N N "ESTIMATED" or blank 0120 0122 0124 0128 6 6 6 7 12 7 12 9 N "SECb644" or blank N "ESTIMATED" or blank 0130 0140 0143 0160 0163 0166 0168 0180 0185 0190 7 8 9 9 10 10 10 10 10 11 August 30, 2002 12 12 1 12 1 12 9 12 7 12 N N "X" or blank N "X" or blank N "FORMb8814" or blank N "SECb644" or blank N Part II Page 564 Section 4 Publication 1346 FORM 8615 Field Identification No. ----- -------------0200 0210 0220 0230 0233 0250 0260 0270 0280 0290 Combined Children Investment Income Child Tentative Tax Pct. Child Tentative Tax Child Taxable Unearned Income Child Schedule D Ind. Unearned Income Tax at Child Rate Child Tentative Investment Tax Child Schedule D Ind. Child Income Tax Form 8615 Tax Tax for Children Under Age 14 Who Have... Form Ref. ---12a 12b 13 14 15 15 16 17 17 18 Length -----12 6 12 12 1 12 12 1 12 12 Field Description ----------------N R N N "X" or blank N N "X" or blank N N Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 565 Section 4 INTENTIONAL BLANK PAGE Publication 1346 August 30, 2002 Part II Page 566 Section 4 FORM 8621 PAGE 1 Field Identification No. ----- -------------Byte Count Return by a Shareholder of a Passive Investment... Form Ref. ---Length -----4 Field Description ----------------"0567" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" "8621bb" "PG01b" N (Primary SSN) Start of Record Sentinel 0000 0001 0002 0003 Record ID Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number Name of Shareholder Identifying Number Address City State Zip Code Country Shareholder's Tax Year Beginning Shareholder's Tax Year Ending Type Of Shareholder (Individual) Type Of Shareholder (Corporation) Type Of Shareholder (Partnership) August 30, 2002 4 6 6 5 9 0004 0005 0010 0020 0030 0040 0050 0060 0065 0070 0080 0090 0100 0110 1 7 35 9 35 22 2 12 35 8 8 1 1 1 Blank N 0000001 - 0000005 AN N AN AN AN N (Left-Justified) AN N (YYYYMMDD) N (YYYYMMDD) "X" or blank "X" or blank "X" or blank Part II Page 567 Section 4 Publication 1346 FORM 8621 PAGE 1 Field Identification No. ----- -------------0120 0130 0140 0150 0160 0170 0180 0190 0195 0200 Type Of Shareholder (S Corporation) Type Of Shareholder (Nongrantor Trust) Type Of Shareholder (Estate) Name Of PFIC Or QEF Address City State Zip Code Country Employer Identification Number, If Any Tax Year Of Company Or Fund: Tax Year Beginning Tax Year Of Company Or Fund: Tax Year Ending Election To Treat PFIC As QEF Elect to Recognize Gain on Sale Interest in PFIC Elect to Treat Post 1986 Earnings & Profits Attach Statement For Post 1986 Earnings & Profits Return by a Shareholder of a Passive Investment... Form Ref. ---Length -----1 1 1 35 35 22 2 12 35 9 Field Description ----------------"X" or blank "X" or blank "X" or blank AN AN AN AN N (Left-Justified) AN N or blank 0210 8 YYYYMMDD 0220 8 YYYYMMDD 0230 0240 I A I B 1 1 "X" or blank "X" or blank 0250 I C 1 "X" or blank @0255 I 6 "STMbnn" or blank Publication 1346 August 30, 2002 Part II Page 568 Section 4 FORM 8621 PAGE 1 Field Identification No. ----- -------------0260 Election To Extend Time For Payment Of Tax Election To Recognize Gain On Sale Of Pfic Election To Mark-tomarket PFIC Stock Pro Rata Share Of The Ordinary Earnings Of The QEF Portion Of Line 1a Subtract Line 1b From Line 1a Pro Rata Share Of Total Net Capital Gain Of QEF Portion Of Line 2a Subtract Line 2b From Line 2a Add Lines 1c And 2c Tot Amt Of Cash & FMV Of Other Property Distrib. Attach Attachment Enter Portion Of Line 3a Add Lines 3b And 3c Subtract Line 3d From Line 3a Total Taxable Income For The Tax Year Return by a Shareholder of a Passive Investment... Form Ref. ---I D Length -----1 Field Description ----------------"X" or blank 0270 I E 1 "X" or blank 0280 0290 I F II1a 1 12 "X" or blank N 0300 0310 0320 II1b II 1c II2a 12 12 12 N N N 0330 0340 0350 0360 II 2b II2c II3a II3 12 12 12 12 N N N N @0365 0370 0380 0390 0400 II II3c II3d II3e II4a 6 12 12 12 12 "STMbnn" or blank N N N N Publication 1346 August 30, 2002 Part II Page 569 Section 4 FORM 8621 PAGE 1 Field Identification No. ----- -------------0410 Tot Tax Without Regard To Amount On Line 3e Subtract Line 4b From Line 4a Return by a Shareholder of a Passive Investment... Form Ref. ---II4b Length -----12 Field Description ----------------N 0420 II4c 12 N Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 570 Section 4 FORM 8621 PAGE 2 Field Identification No. ----- -------------Byte Count Return by A Shareholder of A Passive Investment Form Ref. ---Length -----4 Field Description ----------------"1087" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" "8621bb" "PG02b" N (Primary SSN) Start of Record Sentinel 0440 0441 0442 0443 Record ID Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number Fair Market Value Of PFIC Stock At End Of Tax Year Adjusted Basis In Stock At End Of Tax Year Excess - Subtract Line 6 From Line 5 Any Unreversed Inclusions Smaller Of Line 7 Or Line 8 Tot Distributions From PFIC During Current TY Total Distributions, Reduced Divide Line 10b By 3 III5 4 6 6 5 9 0444 0445 0450 1 7 12 Blank N 0000001 - 0000005 N 0460 III6 12 N 0470 0480 0490 0500 III7 III8 III9 IV10a 12 12 12 12 N or blank N or blank N or blank N 0510 IV10b 12 N 0520 IV10c 12 N Part II Page 571 Section 4 Publication 1346 August 30, 2002 FORM 8621 PAGE 2 Field Identification No. ----- -------------0530 0540 0550 Multiply Line 10c By 125% Subtract Line 10d From Line 10a Enter Gain (Loss) Of Stock Of A Sec. 1291 Fund Attach Statement For Each Distribution/ Disposition Amounts In Line 12a Allocable To The Current TY Aggregate Increases In Tax Foreign Tax Credit Subtract Line 11d From Line 11c Interest On Each Net Increase Attach Statement For Each Excess Distribution Tax Year Of Outstanding Election Undistributed Earnings Deferred Tax Interest Accrued On Deferred Tax Event Terminating Election Earnings Distributed Return by A Shareholder of A Passive Investment Form Ref. ---IV10d IV10e IV10f Length -----12 12 12 Field Description ----------------N N N @0555 IV11a 6 "STMbnn" or blank 0560 IV11b 12 N 0570 0580 0590 0600 @0605 IV11c IV11d IV11e IV11f IV 12 12 12 12 6 N N N N "STMbnn" or blank 0610 0620 0630 0640 0650 0660 V1(i) V2(I) V3(i) V4(i) V5(i) V6(i) 8 12 12 12 35 12 YYYYMMDD N N N AN N Part II Page 572 Section 4 Publication 1346 August 30, 2002 FORM 8621 PAGE 2 Field Identification No. ----- -------------0670 0680 0690 0700 Deferred Tax Due Accrued Interest Due Portion Of Deferred Tax Outstanding Interest Accrued After Partial Termination Tax Year Of Outstanding Election Undistributed Earnings Deferred Tax Interest Accrued On Deferred Tax Event Terminating Election Earnings Distributed Deferred Tax Due Accrued Interest Due Portion Of Deferred Tax Outstanding Interest Accrued After Partial Termination Tax Year Of Outstanding Election Undistributed Earnings Deferred Tax Interest Accrued On Deferred Tax Return by A Shareholder of A Passive Investment Form Ref. ---V7(i) V8(i) V9(i) V10(i) Length -----12 12 12 12 Field Description ----------------N N N or blank N or blank 0710 0720 0730 0740 0750 0760 0770 0780 0790 0800 V1(ii) V2(ii) V3(ii) V4(ii) 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---V5(iii) V6(iii) V7(iii) V8(iii) V9(iii) V10(iii) Length -----35 12 12 12 12 12 Field Description ----------------AN or blank N or blank N or blank N or blank N or blank N or blank 0910 0920 0930 0940 0950 0960 0970 0980 0990 1000 V1(iv) V2(iv) V3(iv) V4(iv) V5(iv) V6(iv) V7(iv) V8(iv) V9(iv) V10(iv) 8 12 12 12 35 12 12 12 12 12 YYYYMMDD or blank N or blank N or blank N or blank AN or blank N or blank N or blank N or blank N or blank N or blank 1010 1020 V1(v) V2(v) 8 12 YYYYMMDD or blank N or blank Part II Page 574 Section 4 Publication 1346 August 30, 2002 FORM 8621 PAGE 2 Field Identification No. ----- -------------1030 1040 1050 1060 1070 1080 1090 1100 Deferred Tax Interest Accrued On Deferred Tax Event Terminating Election Earnings Distributed Deferred Tax Due Accrued Interest Due Portion Of Deferred Tax Outstanding Interest Accrued After Partial Termination Tax Year Of Outstanding Election Undistributed Earnings Deferred Tax Interest Accrued On Deferred Tax Event Terminating 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Publication 1346 August 30, 2002 Part II Page 576 Section 4 FORM 8689 Field Identification No. ----- -------------Byte Count Allocation of Individual Income Tax to the VI Form Ref. ---Length -----4 Field Description ----------------"0724" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" "8689bb" "PG01b" N (Primary SSN) Start of Record Sentinel 0000 0001 0002 0003 Record ID Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number Secondary SSN Primary Name Control 4 6 6 5 9 0004 0005 0020 0030 1 7 9 4 blank N 0000001 N (Spouse's Social Security Number) First 4 significant characters of taxpayer's last name, no leading or embedded spaces; allowable characters are alpha, hyphen (-), or space ( ) (see special instructions) First 4 significant characters of spouse's last name, no leading or embedded spaces; allowable characters are alpha, hyphen (-), or space ( ) (see special instructions) 0040 Secondary Name Control 4 Publication 1346 August 30, 2002 Part II Page 577 Section 4 FORM 8689 Field Identification No. ----- -------------0050 Name Line 1 Allocation of Individual Income Tax to the VI Form Ref. ---Length -----35 Field Description ----------------AN, Taxpayer's name allowable special characters are: space ( ), less-than (<), hyphen (-), and ampersand (&) AN, in care of addressee or address continuation. Allowable special characters are space ( ), ampersand (&), slash (/), hyphen (-), and percent (%) AN, Allowable special characters are space ( ), slash (/), hyphen (-) and literal "NONE" A, Allowable special character is space A (Standard Postal Abbreviations) N (Left-Justified) AN (must be present if filing status = 3, otherwise blank) N N N N 0060 Name Line 2 35 0070 Taxpayer's Address 35 0080 0090 0100 0110 City State Zip Spouse's Name 22 2 12 25 0120 0130 0140 0150 Wages, Salaries, Tips Taxable Interest Ordinary Dividends Taxable Refunds, Credits, or Offsets of Local Tx Alimony Received Business Income or Loss 1 2 3 4 12 12 12 12 0160 0170 5 6 August 30, 2002 12 12 N N Part II Page 578 Section 4 Publication 1346 FORM 8689 Field Identification No. ----- -------------0180 0190 0200 0210 Capital Gain or Loss Other Gains or Losses IRA Distributions (Taxable Amount) Pensions And Annuities (Taxable Amount) Rental Real Estate, Royalties , Partnerships, etc. Farm Income or Loss Unemployment Compensation Social Security Benefits (Taxable Amount) Type of Other Income Amount of Other Income Total Other Income Total Income IRA Deduction Student Loan Interest Deduction Medical Savings Account Deduction Moving Expenses One-Half of SelfEmployment Tax Allocation of Individual Income Tax to the VI Form Ref. ---7 8 9 10 Length -----12 12 12 12 Field Description ----------------N N N N 0220 11 12 N 0230 0240 0250 12 13 14 12 12 12 N N N *0260 +0270 0275 0280 0290 0300 0310 0320 0330 15 15 15 16 17 18 19 20 21 12 12 12 12 12 12 12 12 12 AN or "STMbnn" N N N N N N N N Publication 1346 August 30, 2002 Part II Page 579 Section 4 FORM 8689 Field Identification No. ----- -------------0340 Self-Employed Health Insurance Deduction Self-Employed SEP/ SIMPLE, and Qualified Plans Penalty on Early Withdrawal of Savings Total Other Adjustments Adjusted Gross Income Total Tax From Form 1040 Adjustment to Total Tax Amount Adjusted Total Tax Amount Adjusted Gross Income from Form 1040 Divide Line 26 by Line 30 Tax Allocated to The Virgin Islands VI Tax Withheld ES Payments Form 4868 Amount Total Payments Overpaid to Virgin Islands Refund Allocation of Individual Income Tax to the VI Form Ref. ---22 Length -----12 Field Description ----------------N 0350 23 12 N 0360 24 12 N 0370 0380 0390 0400 0410 0420 25 26 27 28 29 30 12 12 12 12 12 12 N N N N N N 0430 0440 0450 0460 0470 0480 0490 0500 31 32 33 34 35 36 37 38 August 30, 2002 6 12 12 12 12 12 12 12 R N N N N N N N Part II Page 580 Section 4 Publication 1346 FORM 8689 Field Identification No. ----- -------------0510 0520 Applied to ES Tax Amount Owed to Virgin Islands Allocation of Individual Income Tax to the VI Form Ref. ---39 40 Length -----12 12 Field Description ----------------N N Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 581 Section 4 INTENTIONAL BLANK PAGE Publication 1346 August 30, 2002 Part II Page 582 Section 4 FORM 8697 PAGE 1 Field Identification No. ----- -------------Byte Count Interest Computation Under the Look-Back Method Form Ref. ---Length -----4 Field Description ----------------"0499" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" "8697bb" "PG01b" N (Primary SSN) blank N 0000001 - 0000004 DT or blank DT or blank N "X" or blank "X" or blank "X" or blank "X" OR BLANK "X" or blank AN "STMbnn" or blank Start of Record Sentinel 0000 0001 0002 0003 Record ID Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number Filing Year Beginning Filing Year Ending Identifying Number Type of Taxpayer: Corporation Type of Taxpayer: Individual Type of Taxpayer: Estate or Trust Type of Taxpayer:S Corporation Type of Taxpayer: Partnership Name of Entity Schedule of Additional Entity(s) A B B B B B C C 4 6 6 5 9 0004 0005 0010 0020 0080 0090 0100 0110 0120 0130 0140 @0145 1 7 8 8 9 1 1 1 1 1 35 6 Publication 1346 August 30, 2002 Part II Page 583 Section 4 FORM 8697 PAGE 1 Field Identification No. ----- -------------0150 Employer Identification Number of Entity Employer Name Control Interest Computation Under the Look-Back Method Form Ref. ---C Length -----9 Field Description ----------------N 0155 C 4 First 4 significant characters of employer's name, no leading or embedded spaces, allowable characters are alpha, numeric, hyphen, ampersand, spaces may be present only as last two positions DT N N "STMbnn" or blank N 0160 0170 0180 @0185 0190 REG-Year Ended-1 Taxable Income/Loss for Prior Year(s)-1 Adjustment to Income-1 REG-Schedule of Separate Contracts-1 Adjusted Taxable Income for LookBack Purposes-1 Income Tax Liability on Line 3a Amount-1 Income Tax Liability on Prior Year(s) Return-1 REG-Increase/ Decrease in Prior Year(s) Tax-1 REG-Interest Due on Increase-1 REG-Interest to be Refunded on Decrease-1 REG-Year Ended-2 Part I Part I Part I Part I Part I a 1a 2a 2a 3a 6 12 12 6 12 0200 Part I 4a 12 N 0210 Part I 5a 12 N 0220 Part I 6a 12 N 0230 0240 Part I Part I 7a 8a 12 12 N or blank N or blank 0250 Part I b 6 DT or blank Part II Page 584 Section 4 Publication 1346 August 30, 2002 FORM 8697 PAGE 1 Field Identification No. ----- -------------0260 0270 @0275 0280 Taxable Income/Loss for Prior Year(s)-2 Adjustment to Income-2 REG-Schedule of Separate Contracts-2 Adjusted Taxable Income for LookBack Purposes-2 Income Tax Liability on Line 3b Amount-2 Income Tax Liability on Prior Year(s) Return-2 REG-Increase/ Decrease in Prior Year(s) Tax-2 REG-Interest Due on Increase-2 REG-Interest to be Refunded on Decrease-2 REG-Year Ended-3 Taxable Income/Loss for Prior Year(s)-3 Adjustment to Income-3 REG-Schedule of Separate Contracts-3 Adjusted Taxable Income for LookBack Purposes-3 Interest Computation Under the Look-Back Method Form Ref. ---Part I Part I Part I Part I 1b 2b 2b 3b Length -----12 12 6 12 Field Description ----------------N or blank N or blank "STMbnn" or blank N or blank 0290 Part I 4b 12 N or blank 0300 Part I 5b 12 N or blank 0310 Part I 6b 12 N or blank 0320 0330 Part I Part I 7b 8b 12 12 N or blank N or blank 0340 0350 0360 @0365 0370 Part I Part I Part I Part I Part I c 1c 2c 2c 3c 6 12 12 6 12 DT or blank N or blank N or blank "STMbnn" or blank N or blank Publication 1346 August 30, 2002 Part II Page 585 Section 4 FORM 8697 PAGE 1 Field Identification No. ----- -------------0380 Income Tax Liability on Line 3c Amount-3 Income Tax Liability on Prior Year(s) Return-3 REG-Increase/ Decrease in Prior Year(s) Tax-3 REG-Interest Due on Increase-3 REG-Interest to be Refunded on Decrease-3 REG-Interest Due on Increase-Totals REG-Interest to be Refunded on Decrease-Totals REG-Net Amount of Interest to be Refunded REG-Net Amount of Interest You Owe Interest Computation Under the Look-Back Method Form Ref. ---Part I 4c Length -----12 Field Description ----------------N or blank 0390 Part I 5c 12 N or blank 0400 Part I 6c 12 N or blank 0410 0420 Part I Part I 7c 8c 12 12 N or blank N or blank 0430 0440 Part I Part I 7d 8d 12 12 N or blank N or blank 0450 Part I 9d 12 NO ENTRY 0460 Part I 10d 12 N Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 586 Section 4 FORM 8697 PAGE 2 Field Identification No. ----- -------------Byte Count Interest Computation Under the Look-Back Method Form Ref. ---Length -----4 Field Description ----------------"0469" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" "8697bb" "PG02b" N (Primary SSN) blank N 0000001 - 0000004 DT N Start of Record Sentinel 0480 0481 0482 0483 Record ID Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number SMI-Year Ended-1 Adjustment to Regular Taxable Income-1 SMI-Schedule of Separate Contracts 1 Increase/Decrease in Prior Year(s) Regular Tax-1 Adjustment to Alternative Minimum Taxable Income-1 SMI-Schedule of Separate Contracts (AMT)-1 Increase/Decrease in AMT for Prior Year(s)-1 Greater of Line 2a or Line 4a-1 Part II a 4 6 6 5 9 0484 0485 0500 0510 1 7 6 12 Part II 1a @0515 Part II 1a 6 "STMbnn" or blank 0520 Part II 2a 12 N 0530 Part II 3a 12 N @0535 Part II 3a 6 "STMbnn" or blank 0540 Part II 4a 12 N 0550 Part II 5a August 30, 2002 12 N Part II Page 587 Section 4 Publication 1346 FORM 8697 PAGE 2 Field Identification No. ----- -------------0560 0570 Overpayment Ceiling1 SMI-Increase/ Decrease in Prior Year(s) Tax-1 SMI-Interest Due on Increase-1 SMI-Interest to be Refunded on Decrease-1 SMI-Year Ended-2 Adjustment to Regular Taxable Income-2 SMI-Schedule of Separate Contracts-2 Increase/Decrease in Prior Year(s) Regular Tax-2 Adjustment to Alternative Minimum Taxable Income-2 SMI-Schedule of Separate Contracts (AMT)-2 Increase/Decrease in AMT for Prior Year(s)-2 Greater of Line 2b or Line 4b-2 Overpayment Ceiling2 SMI-Increase/ Decrease in Prior Year(s) Tax-2 Interest Computation Under the Look-Back Method Form Ref. ---Part II 6a Part II 7a Length -----12 12 Field Description ----------------N N 0580 0590 Part II 8a Part II 9a 12 12 N N 0600 0610 Part II b 6 12 DT or blank N or blank Part II 1b @0615 0620 Part II 1b Part II 2b 6 12 "STMbnn" or blank N or blank 0630 Part II 3b 12 N or blank @0635 Part II 3b 6 "STMbnn" or blank 0640 Part II 4b 12 N or blank 0650 0660 0670 Part II 5b Part II 6b Part II 7b 12 12 12 N or blank N or blank N or blank Publication 1346 August 30, 2002 Part II Page 588 Section 4 FORM 8697 PAGE 2 Field Identification No. ----- -------------0680 0690 SMI-Interest Due on Increase-2 SMI-Interest to be Refunded on Decrease-2 SMI-Year Ended-3 Adjustment to Regular Taxable Income-3 SMI-Schedule of Separate Contracts-3 Increase/Decrease in Prior Year(s) Regular Tax-3 Adjustment to Alternative Minimum Taxable Income-3 SMI-Schedule of Separate Contracts (AMT)-3 Increase/Decrease in AMT for Prior Year(s)-3 Greater of Line 2c or Line 4c-3 Overpayment Ceiling3 SMI-Increase/ Decrease in Prior Year(s) Tax-3 SMI-Interest Due on Increase-3 SMI-Interest to be Refunded on Decrease-3 Interest Computation Under the Look-Back Method Form Ref. ---Part II 8b Part II 9b Length -----12 12 Field Description ----------------N or blank N or blank 0700 0710 Part II c 6 12 DT or blank N or blank Part II 1c @0715 0720 Part II 1c Part II 2c 6 12 "STMbnn" or blank N or blank 0730 Part II 3c 12 N or blank @0735 Part II 3c 6 "STMbnn" or blank 0740 Part II 4c 12 N or blank 0750 0760 0770 Part II 5c Part II 6c Part II 7c 12 12 12 N or blank N or blank N or blank 0780 0790 Part II 8c Part II 9c 12 12 N or blank N or blank Publication 1346 August 30, 2002 Part II Page 589 Section 4 FORM 8697 PAGE 2 Field Identification No. ----- -------------0800 0810 SMI-Interest Due On Increase-Totals SMI-Interest to be Refunded on Decrease-Totals SMI-Net Amount of Interest to be Refunded SMI-Net Amount of Interest You Owe Interest Computation Under the Look-Back Method Form Ref. ---Part II 8d Part II 9d Length -----12 12 Field Description ----------------N or blank N or blank 0820 Part II 10 12 NO ENTRY 0830 Part II 11 12 N or blank Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 590 Section 4 FORM 8801 PAGE 1 Field Identification No. ----- -------------Byte Count Credit For Prior Year Minimum Tax Form Ref. ---Length -----4 Field Description ----------------"0364" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" "8801bb" "PG01b" N (Primary SSN) Start of Record Sentinel 0000 0001 0002 0003 Record ID Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number Reserved Net Minimum Tax Taxable Income (Loss) Net Minimum Tax Adjustments Minimum Tax Credit Net Operating Loss Deduction Combine Lines 1, 2, and 3 Net Minimum Tax Exemption Amount Net Minimum Tax Phase-Out Line 4 Minus Line 6 Multiply Line 7 by 25% (.25) Line 5 Minus Line 8 1 4 6 6 5 9 0004 0005 0010 0020 1 7 9 12 blank N 0000001 Blank N 0030 0040 2 3 12 12 N N 0050 0060 0070 0080 0090 0100 4 5 6 7 8 9 August 30, 2002 12 12 12 12 12 12 N N N N N N Part II Page 591 Section 4 Publication 1346 FORM 8801 PAGE 1 Field Identification No. ----- -------------0110 0120 0130 Line 4 Minus Line 9 Multiply Line 10 by 26% or by 28% Minimum Tax Foreign Tax Credit on Exclusion Items Tentative Minimum Tax on Exclusion Items Applicable Return Tax Net Minimum Tax on Exclusion Items Alternative Minimum Tax Net Minimum Tax on Exclusion Items Net Alternative Minimum Tax Previous Year Minimum Tax Credit Carryforward Total of PY Unallowed Fuel & Vehicle Credits Total Tax Credits CY Regular Tax Liability Minus Allowable Credit Tentative Minimum Tax Net Regular Income Tax Liability Minimum Tax Credit Credit For Prior Year Minimum Tax Form Ref. ---10 11 12 Length -----12 12 12 Field Description ----------------N N N 0140 13 12 N 0150 0160 0170 0180 0190 0200 14 15 16 17 18 19 12 12 12 12 12 12 N N N N N N 0210 20 12 N 0220 0230 21 22 12 12 N N 0240 0250 0260 23 24 25 August 30, 2002 12 12 12 N N N Part II Page 592 Section 4 Publication 1346 FORM 8801 PAGE 1 Field Identification No. ----- -------------0270 Minimum Tax Credit Carryforward to Next Year Credit For Prior Year Minimum Tax Form Ref. ---26 Length -----12 Field Description ----------------N Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 593 Section 4 FORM 8801 PAGE 2 Field Identification No. ----- -------------Byte Count Credit For Prior Year Minimum Tax Form Ref. ---Length -----4 Field Description ----------------"0307" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" "8801bb" "PG02b" N (Primary SSN) Start of Record Sentinel 0290 0291 0292 0293 Record ID Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number Amount from Line 10 Amount from Prior Year Sch D, Line 27 Amount from Prior Year Sch D, Line 25 Add Lines 28 and 29 Amount from Prior Year Sch D, Line 22 Smaller of Line 30 or Line 31 Line 27 Minus Line 32 Multiply Line 33 by 26% (.26) or by 28% (.28) Amount from Prior Year Sch D, Line 36 Smallest of Lines 27, 28 or 35 27 28 29 30 31 32 33 34 4 6 6 5 9 0294 0295 0300 0310 0320 0330 0340 0350 0360 0370 1 7 12 12 12 12 12 12 12 12 blank N 0000001 N N N N N N N N 0380 0390 35 36 August 30, 2002 12 12 N N Part II Page 594 Section 4 Publication 1346 FORM 8801 PAGE 2 Field Identification No. ----- -------------0400 0410 0420 0430 0440 0450 0460 0470 0480 0490 0500 Multiply Line 36 by 10% (.10) Smaller of Lines 27 or 28 Amount from Line 36 Line 38 Minus Line 39 Multiply Line 40 by 20% (.20) Amount from Line 27 Add Lines 33, 36 and 40 Line 42 Minus Line 43 Multiply Line 44 by 25% (.25) Add Lines 34, 37, 41 and 45 Multiply Line 27 by 26% (.26) or by 28% (.28) Smaller of Lines 46 or 47 Credit For Prior Year Minimum Tax Form Ref. ---37 38 39 40 41 42 43 44 45 46 47 Length -----12 12 12 12 12 12 12 12 12 12 12 Field Description ----------------N N N N N N N N N N N 0510 48 12 N Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 595 Section 4 INTENTIONAL BLANK PAGE Publication 1346 August 30, 2002 Part II Page 596 Section 4 FORM 8812 Field Identification No. ----- -------------Byte Count Additional Child Tax Credit Form Ref. ---Length -----4 Field Description ----------------"0203" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" "8812bb" "PG01b" N (Primary SSN) Start of Record Sentinel 0000 0001 0002 0003 Record ID Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number Amount from Line 1 of Child Tax Credit Worksheet Child Tax Credit Net Amount From Line 1 of Worksheet Total Taxable Earned Income Total Taxable Earned Income > $10,000 - No Box Total Taxable Earned Income > $10,000 - Yes Box Net Total Taxable Earned Income 10% of Net Total Taxable Earned Income 1 4 6 6 5 9 0004 0005 0008 1 7 12 blank N 0000001 N 0012 0016 0021 0025 2 3 4 5 12 12 12 1 N N N "X" or blank 0035 5 1 "X" or blank 0038 0045 5 6 12 12 N N Publication 1346 August 30, 2002 Part II Page 597 Section 4 FORM 8812 Field Identification No. ----- -------------0054 Three or More Qualifying Children - No Box Three or More Qualifying Children - Yes Box Total SS & Medicare Taxes Withheld Total Other Taxes and Deductions Total SS, Medicare Taxes, Other Taxes & Deductions Total EIC & Additional Child Tax Credit Net SS, Medicare Taxes, Other Taxes & Deductions Larger of 10% of Net Tot Taxable Inc Or Net Deduc. Additional Child Tax Credit: Lines 3 or 12 Additional Child Tax Credit Form Ref. ---6 Length -----1 Field Description ----------------"X" or blank 0058 6 1 "X" or blank 0075 0085 0095 7 8 9 12 12 12 N N N 0105 10 12 N 0110 11 12 N 0115 12 12 N 0140 13 12 N or blank Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 598 Section 4 FORM 8814 Field Identification No. ----- -------------Byte Count Parent's Election to Report Child's... Form Ref. ---Length -----4 Field Description ----------------"0300" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" "8814bb" "PG01b" N (Primary SSN) Start of Record Sentinel 0000 0001 0002 0003 Record ID Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number Child Name A 4 6 6 5 9 0004 0005 0010 1 7 25 blank N 0000001 - 0000010 AN (first name, space middle initial, less-than (<), last name) First 4 significant characters of Child's Last Name (see 1040 seq# 050, Primary Name Control) N "X" or blank "TAX-EXEMPTbINTEREST", "STMbnn" or blank N "ND", "STMbnn" or blank N 0015 Child Name Control A 4 0020 0030 *0040 +0050 *0060 +0070 Child SSN Multiple F8814 Indicator Tax Exempt Literal Tax Exempt Amount Nominee Dist. Literal 1 Nominee Dist. Amount 1 B C 1a 1a 1a 1a 9 1 19 12 6 12 Publication 1346 August 30, 2002 Part II Page 599 Section 4 FORM 8814 Field Identification No. ----- -------------*0080 Non-Taxable Literal Parent's Election to Report Child's... Form Ref. ---1a Length -----16 Field Description ----------------"ACCRUEDbINTEREST", "ABPbADJUSTMENT", "OIDbADJUSTMENT", "STMbnn" or blank N N N "ND" or blank N N "ND" or blank N N N "CGD" or blank N N N "X" or blank +0090 0100 0110 0120 0130 0135 0141 0146 0151 0170 0180 0190 0200 0210 0212 Non-Taxable Amount Child Taxable Interest Income Child Tax-Exempt Interest Income Nominee Dist. Literal 2 Nominee Dist. Amount 2 Child Ordinary Dividends Nominee Dist. Literal 3 Nominee Dist. Amount 3 Child Capital Gain Distributions Child Taxable Unearned Income Capital Gain Dist. Lit. CGD Worksheet Amount Form 1040 Other Income Tax Amount Basis Amount on Line 8 Less Than $750 - No Box 1a 1a 1b 2 2 2 3 3 3 4 6 6 6 8 9 12 12 12 2 12 12 2 12 12 12 3 12 12 12 1 Publication 1346 August 30, 2002 Part II Page 600 Section 4 FORM 8814 Field Identification No. ----- -------------0216 Amount on Line 8 Less Than $750 Yes Box Form 8814 Tax Parent's Election to Report Child's... Form Ref. ---9 Length -----1 Field Description ----------------"X" or blank 0220 9 12 N Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 601 Section 4 INTENTIONAL BLANK PAGE Publication 1346 August 30, 2002 Part II Page 602 Section 4 FORM 8815 Field Identification No. ----- -------------Byte Count Exclusion of Interest From Series EE U.S.... Form Ref. ---Length -----4 Field Description ----------------"0547" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" "8815bb" "PG01b" N (Primary SSN) Start of Record Sentinel 0000 0001 0002 0003 Record ID Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number Eligible Enrollee Name 1 1(a)1 4 6 6 5 9 0004 0005 *0010 1 7 25 blank N 0000001 AN (first name, space, middle initial, less than (<), last name) or "STMbnn" AN, Allowable special characters are: ampersand (&), hyphen (-), slash (/), comma (,), plus (+), blank and literal "EDbIRA" or "QSTP" AN, Allowable special characters are: ampersand (&), hyphen (-), slash (/), comma (,), percent (%) and literal "NONE" or "STMbnn". AN, Allowable special characters are: hyphen (-), comma (,) and blank Part II Page 603 Section 4 +0020 Eligible Institution Name 1 1(b)1 30 *+0030 Eligible Institution Address 1 1(b)1 35 +0040 Eligible Institution City/ State/Zip code 1 1(b)1 30 Publication 1346 August 30, 2002 FORM 8815 Field Identification No. ----- -------------0050 Eligible Enrollee Name 2 Exclusion of Interest From Series EE U.S.... Form Ref. ---1(a)2 Length -----25 Field Description ----------------AN (first name, space, middle initial, less than (<), last name) 'See 1st Occ.' AN, Allowable special characters are: ampersand (&), hyphen (-), slash (/), comma (,), percent (%) and literal "NONE" 'See 1st Occ.' 0060 0070 Eligible Institution Name 2 Eligible Institution Address 2 1(b)2 1(b)2 30 35 0080 Eligible Institution City/ State/Zip code 2 Eligible Enrollee Name 3 1(b)2 30 0090 1(a)3 25 AN (first name, space, middle initial, less than (<), last name) 'See 1st Occ.' AN, Allowable special characters are: ampersand (&), hyphen (-), slash (/), comma (,), percent (%) and literal "NONE" 'See 1st Occ.' 0100 0110 Eligible Institution Name 3 Eligible Institution Address 3 1(b)3 1(b)3 30 35 0120 Eligible Institution City/ State/Zip code 3 Education Expenses Nontaxable Benefits Taxable Expenses Total Bonds Proceeds Interest 1(b)3 30 0170 0180 0190 0200 0210 2 3 4 5 6 August 30, 2002 12 12 12 12 12 N N N N N Part II Page 604 Section 4 Publication 1346 FORM 8815 Field Identification No. ----- -------------0220 0230 0240 0250 0260 0270 0280 0290 Taxable Expenses/ Bonds Proceeds Rati Tentative Bond Interest Modified AGI Allowable Write-In Amount Excess AGI Excess AGI Ratio Excludable Bond Interest Offset Excludable Savings Bond Interest Exclusion of Interest From Series EE U.S.... Form Ref. ---7 8 9 10 11 12 13 14 Length -----6 12 12 12 12 6 12 12 Field Description ----------------R N N N, 55750 or 83650 N R N N Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 605 Section 4 INTENTIONAL BLANK PAGE Publication 1346 August 30, 2002 Part II Page 606 Section 4 FORM 8820 Field Identification No. ----- -------------Byte Count Orphan Drug Credit Form Ref. ---Length -----4 Field Description ----------------"0388" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" "8820bb" "PG01b" N (Primary SSN) | Start of Record Sentinel 0000 0001 0002 0003 Record ID Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number Identifying Number Qualified Clinical Testing Expenses Paid Current Year Credit Flow-through Orphan Drug Credit(s) 1041 Portion Amount Total Current Year Orphan Drug Credit Regular Tax Before Credits Alternative Minimum Tax Regular Tax Plus Alternative Minimum Tax Foreign Tax Credit 1 4 6 6 5 9 0004 0005 0010 0020 1 7 9 12 blank N 0000001 NO ENTRY N | 0030 0040 0045 0050 0060 0070 0080 2 3 4 4 5 6 7 12 12 12 12 12 12 12 N N NO ENTRY N N N N 0090 8a August 30, 2002 12 N Part II Page 607 Section 4 Publication 1346 FORM 8820 Field Identification No. ----- -------------0100 Credit for Child & Dependent Care Expenses (F2441) Credit for Elderly or Disabled (Sch R) Education Credits (Form 8863) Credit for Qualified Retirement Savings Child Tax Credit Mortgage Interest Credit (Form 8396) Adoption Credit (Form 8839) District of Columbia First Time HomeBuyer Credit Possessions Tax Credit (Form 5735) Credit for Fuel from a Nonventional Source Qualified Electric Vehicle Credit (Form 8834) Add Lines 8a through 8l Net Income Tax Net Regular Tax Enter 25% of Excess Tentative Minimum Tax Orphan Drug Credit Form Ref. ---8b Length -----12 Field Description ----------------N 0110 0120 0125 8c 8d 8e 12 12 12 N N N | 0130 0140 0150 0160 8f 8g 8h 8i 12 12 12 12 N N N N 0170 0180 8j 8k 12 12 NO ENTRY N 0190 8l 12 N 0200 0210 0230 0240 0245 8m 9 10 11 12 August 30, 2002 12 12 12 12 12 N N N N N --| | | | Part II Page 608 Section 4 Publication 1346 FORM 8820 Field Identification No. ----- -------------0250 0260 0270 Greater of Line 11 or Line 12 Subtract Line 13 from Line 9 Orphan Drug Credit Allowed for Current Year Orphan Drug Credit Form Ref. ---13 14 15 Length -----12 12 12 Field Description ----------------N N N | Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 609 Section 4 INTENTIONAL BLANK PAGE Publication 1346 August 30, 2002 Part II Page 610 Section 4 FORM 8824 PAGE 1 Field Identification No. ----- -------------Byte Count Like-Kind Exchanges Form Ref. ---Length -----4 Field Description ----------------"0522" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" "8824bb" "PG01b" N (Primary SSN) Start of Record Sentinel 0000 0001 0002 0003 Record ID Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number Identifying Number Description of LikeKind Property Given Reserved Description of LikeKind Property Received Reserved Date Like-Kind Property Given Up Date Property Actually Transferred Date Like-Kind Property Was Identified Date Property Actually Received Was The Exchange with a Related Party - Yes, CY 1 1 2 4 6 6 5 9 0004 0005 0010 *0020 0025 *0030 1 7 9 50 6 50 blank N 0000001 - 0000005 N or Blank | AN, "STMbnn" or blank NO ENTRY AN, "STMbnn" or blank 0035 0040 0050 0060 2 3 4 5 6 8 8 8 NO ENTRY YYYYMMDD or blank | YYYYMMDD or blank | YYYYMMDD or blank | 0070 0080 6 7a 8 1 YYYYMMDD or blank | "X" or blank Publication 1346 August 30, 2002 Part II Page 611 Section 4 FORM 8824 PAGE 1 Field Identification No. ----- -------------0090 Was The Exchange with a Related Party - Yes, PY Was The Exchange with a Related Party - No Name of Related Party Related ID Street Address City State Code Zip Code Relationship During This Year, Did Related Party Sell - Yes During This Year, Did Related Party Sell - No During This Year, Did You Sell or Dispose of - Yes During This Year, Did You Sell or Dispose of - No Disposition after Death of Either Related Parties Disposition Was an Involuntary Conversion Like-Kind Exchanges Form Ref. ---7b Length -----1 Field Description ----------------"X" or blank 0100 7c 1 "X" or blank 0110 0120 0130 0140 0150 0160 0170 0180 8 8 8 8 8 8 8 9 35 9 35 22 2 12 15 1 AN N or "APPLD FOR" AN AN AN N or nnnnnbbbbbbb or nnnnnnnnnbbb AN "X" or blank 0185 9 1 "X" or blank 0190 10 1 "X" or blank 0195 10 1 "X" or blank 0200 11a 1 "X" or blank 0210 11b 1 "X" or blank Publication 1346 August 30, 2002 Part II Page 612 Section 4 FORM 8824 PAGE 1 Field Identification No. ----- -------------0220 You Can Establish to Satisfaction of the IRS Explanation Fair Market Value (FMV) Adjusted Basis Gain or (Loss) (Line 12 Minus Line 13) Cash, FMV & Net Liabilities of Other Party FMV of Like-Kind Property Received Amount Realized (Add Lines 15 And 16) Adjusted Basis Of Like-Kind Property Realized Gain Or Loss (Line 17 Minus Line 18) Attach Statement Smaller Of Lines 15 Or 19 Ordinary Income Under Recapture Rules Line 20 Minus Line 21 Recognized Gain (Add Lines 21 And 22) Attach Statement Like-Kind Exchanges Form Ref. ---11c Length -----1 Field Description ----------------"X" or blank @0225 0230 0240 0250 11c 12 13 14 6 12 12 12 "STMbnn" or blank N N N 0260 15 12 N 0270 0280 16 17 12 12 N N 0290 0300 18 19 12 12 N N @0305 0310 0320 19 20 21 6 12 12 "STMbnn" or blank N N 0330 0340 22 23 12 12 N N @0345 23 August 30, 2002 6 "STMbnn" or blank Part II Page 613 Section 4 Publication 1346 FORM 8824 PAGE 1 Field Identification No. ----- -------------0350 Deferred Gain Or (Loss) (Line 19 Minus Line 23) Basis of Like-Kind Property Received Like-Kind Exchanges Form Ref. ---24 Length -----12 Field Description ----------------N 0360 25 12 N Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 614 Section 4 FORM 8824 PAGE 2 Field Identification No. ----- -------------Byte Count Like-Kind Exchanges Form Ref. ---Length -----4 Field Description ----------------"0276" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" "8824bb" "PG02b" N (Primary SSN) Start of Record Sentinel 0370 0371 0372 0373 Record ID Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number Certificate of Divesture Number Description of Divested Property Reserved Description of Replacement Property Reserved Date Divested Property Was Sold Sales Price of Divested Property Basis of Divested Property Realized Gain (Line 30 Minus Line 31) Cost of Replacement Property Within 60 Days 26 27 27 28 28 29 30 31 32 33 4 6 6 5 9 0374 0375 0380 *0390 0395 *0400 0405 0410 0420 0430 0440 0450 1 7 5 50 6 50 6 8 12 12 12 12 blank N 0000001 - 0000005 N AN, "STMbnn" or blank NO ENTRY AN, "STMbnn" or blank NO ENTRY DT N N N N Publication 1346 August 30, 2002 Part II Page 615 Section 4 FORM 8824 PAGE 2 Field Identification No. ----- -------------0460 0470 Recognized Gain Ordinary Income Under Recapture Rules Line 34 Minus Line 35 Deferred Gain (Line 32 Minus Line 34) Basis of Replacement Property Like-Kind Exchanges Form Ref. ---34 35 Length -----12 12 Field Description ----------------N N 0480 0490 0500 36 37 38 12 12 12 N N N Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 616 Section 4 FORM 8826 Field Identification No. ----- -------------Byte Count Disabled Access Credit Form Ref. ---Length -----4 Field Description ----------------"0406" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" "8826bb" "PG01b" N (Primary SSN) | Start of Record Sentinel 0000 0001 0002 0003 Record ID Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number Identifying Number Total Eligible Access Expenditures Controlled Group Schedule Attached Subtract Line 2 from Line 1 Smaller Amount of Line 3 or Line 4 Current Year Credit Disabled Access Credits From FlowThrough Entities Total Current Year Disabled Access Credit Regular Tax Before Credits Alternative Minimum Tax 1 1 3 5 6 7 4 6 6 5 9 0004 0005 0010 0020 @0025 0030 0040 0050 0060 1 7 9 12 6 12 12 12 12 Blank N 0000001 NO ENTRY N "STMbnn" or blank N N N N | 0070 8 12 N 0080 0090 9 10 August 30, 2002 12 12 N N Part II Page 617 Section 4 Publication 1346 FORM 8826 Field Identification No. ----- -------------0100 Regular Tax Plus Alternative Minimum Tax Foreign Tax Credit Credit for Child and Dependent Care Expenses Credit for Elderly or Disabled Education Credits Credit for Qualified Retirement Savings Child Tax Credit Mortgage Interest Credit Adoption Credit District of Columbia First Time Homebuyer Credit Possession Tax Credit Credit for Fuel from A Nonconventional Source Qualified Electric Vehicle Credit Add Line 12a - Line 12l Net Income Tax Net Regular Tax Enter 25% of Excess Disabled Access Credit Form Ref. ---11 Length -----12 Field Description ----------------N 0110 0120 12a 12b 12 12 N N 0130 0140 0145 12c 12d 12e 12 12 12 N N N | 0150 0160 0170 0180 12f 12g 12h 12i 12 12 12 12 N N N N 0190 0200 12j 12k 12 12 NO ENTRY N 0210 0220 0230 0250 0260 12l 12m 13 14 15 August 30, 2002 12 12 12 12 12 N N N N N --| | | Part II Page 618 Section 4 Publication 1346 FORM 8826 Field Identification No. ----- -------------0265 0270 0280 0290 Tentative Minimum Tax Greater of Line 15 or Line 16 Subtract Line 17 from Line 13 Disabled Access Credit Allowed for Current Year Disabled Access Credit Form Ref. ---16 17 18 19 Length -----12 12 12 12 Field Description ----------------N N N N | | Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 619 Section 4 INTENTIONAL BLANK PAGE Publication 1346 August 30, 2002 Part II Page 620 Section 4 FORM 8828 Field Identification No. ----- -------------Byte Count Recapture of Federal Mortgage Subsidy Form Ref. ---Length -----4 Field Description ----------------"0443" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" "8828bb" "PG01b" N (Primary SSN) Start of Record Sentinel 0000 0001 0002 0003 Record ID Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number Property Address 1 4 6 6 5 9 0004 0005 0010 1 7 35 blank N 0000001 AN. Allowable special characters are: ampersand (&), hyphen(-), slash(/), comma(,), percent(%) and Literal "NONE" AN. Allowable special characters are: hyphen and comma(,) or blank "X" or blank "X" or blank 0020 Property City/State/ Zip Code Mortgage Tax-Exempt Bond Indicator Mortgage Credit Certificate Indicator Certificate Issuer State Certificate Issuer Subdivision Certificate Issuer Agency 1 30 0030 0040 2a 2b 1 1 0050 0060 0070 3 3 3 2 20 20 AN AN AN Publication 1346 August 30, 2002 Part II Page 621 Section 4 FORM 8828 Field Identification No. ----- -------------0080 0090 0100 0110 0120 0130 0135 0140 0150 0160 0170 0180 0190 0200 0210 0220 0230 0240 0250 Original Lending Institution Name Original Lending Institution Address Original Loan Closing Date Sale or Disposition of Interest Date Closing/Sale Elapsed Yrs Closing/Sale Elapsed Mos Original Loan Payment Date Sale Price Expenses of Sale Amount Realized Adjusted Basis Gain or Loss Gain or Loss Adjusted Modified AGI Adjusted Qualifying Income Income Basis Income Percentage Federally Subsidized Amt Holding Period Percentage Recapture of Federal Mortgage Subsidy Form Ref. ---4 4 5 6 7 7 8 9 10 11 12 13 14 15 16 17 18 19 20 Length -----30 65 8 8 2 2 8 12 12 12 12 12 12 12 12 12 6 12 6 Field Description ----------------AN AN DT DT N N DT N N N N N N N N N R N R Publication 1346 August 30, 2002 Part II Page 622 Section 4 FORM 8828 Field Identification No. ----- -------------0260 Federally Subsidized Amount Adjusted Recapture Amount Recapture Tax Due Recapture of Federal Mortgage Subsidy Form Ref. ---21 Length -----12 Field Description ----------------N 0270 0280 22 23 12 12 N N Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 623 Section 4 INTENTIONAL BLANK PAGE Publication 1346 August 30, 2002 Part II Page 624 Section 4 FORM 8829 Field Identification No. ----- -------------Byte Count Expenses for Business Use of Your Home Form Ref. ---Length -----4 Field Description ----------------"0677" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" "8829bb" "PG01b" N (Primary SSN) | Start of Record Sentinel 0000 0001 0002 0003 Record ID Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number Name of Proprietor SSN of Proprietor Business Use Square Feet Total Home Square Feet Business Square Feet Percent Business Use Hours Total Hours Available Business Hours Percent Business Percentage Attach Computation Tentative Profit/ Loss Schedule C Casualty Loss Direct 1 2 3 4 5 6 7 7 8 9a 4 6 6 5 9 0004 0005 0010 0020 0030 0040 0050 0060 0065 0070 0080 @0085 0090 0100 1 7 35 9 6 6 6 4 4 6 6 6 12 12 blank N 0000001 - 0000008 A N N N R N N R R "STMbnn" or blank | N N Part II Page 625 Section 4 Publication 1346 August 30, 2002 FORM 8829 Field Identification No. ----- -------------0110 0120 0130 0140 0150 0160 0170 0180 0190 0200 0210 Casualty Loss Indirect Deductible Mortgage Interest Direct Deductible Mortgage Interest Indirect Real Estate Taxes Direct Real Estate Taxes Indirect Direct Deducted Subtotal Indirect Deducted Subtotal Allowable Indirect Deducted Expenses Deductible Net Reduced Profit/Loss Non-Deductible Mortgage Interest Direct Non-Deductible Mortgage Interest Indirect Insurance Direct Insurance Indirect Repairs/Maint. Direct Repairs/Maint. Indirect Utilities Direct Utilities Indirect Expenses for Business Use of Your Home Form Ref. ---9b 10a 10b 11a 11b 12a 12b 13b 14 15 16a Length -----12 12 12 12 12 12 12 12 12 12 12 Field Description ----------------N N N N N N N N N N N 0220 16b 12 N 0230 0240 0250 0260 0270 0280 17a 17b 18a 18b 19a 19b August 30, 2002 12 12 12 12 12 12 N N N N N N Part II Page 626 Section 4 Publication 1346 FORM 8829 Field Identification No. ----- -------------0290 0300 0310 0320 0330 Other Expenses Direct Other Expenses Indirect Direct Non-Deducted Subtotal Indirect NonDeducted Subtotal Allowable Indirect Non-Deducted Expenses Operating Expenses Carryover Non-Deductible Net Allowable Operating Expenses Casualty Loss and Depreciation Limit Non-Deductible Casualty Loss Home Depreciation Part III Excess Casualty Losses & Deprec. Carryover Casualty Losses and Depreciation Net Allowable Casualty Losses and Depreciation Total Allowable Expenses Form 4684 Casualty Losses Expenses for Business Use of Your Home Form Ref. ---20a 20b 21a 21b 22 Length -----12 12 12 12 12 Field Description ----------------N N N N N 0340 0350 0360 0370 0380 0390 0400 23 24 25 26 27 28 29 12 12 12 12 12 12 12 N N N N N N N 0410 0420 30 31 12 12 N N 0430 0440 32 33 August 30, 2002 12 12 N N Part II Page 627 Section 4 Publication 1346 FORM 8829 Field Identification No. ----- -------------0450 0460 @0465 0470 0480 0490 0500 0510 @0515 0520 0530 Schedule C Allowable Expenses Home Adjusted Basis or Fair Market Attach Schedule Land Value Building Value Building ValueBusiness Home Depreciation Percent Allowable Home Depreciation Attach Schedule Unallowed Operating Expenses Unallowed Excess Casualty Losses and Depreciation Expenses for Business Use of Your Home Form Ref. ---34 35 35 36 37 38 39 40 40 41 42 Length -----12 12 6 12 12 12 6 12 6 12 12 Field Description ----------------N N "STMbnn" or blank | N N N R (Please see Part I, Sect 5.01.2.b) N "STMbnn" or blank | N N Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 628 Section 4 FORM 8830 Field Identification No. ----- -------------Byte Count ENHANCED OIL RECOVERY CREDIT Form Ref. ---Length -----4 Field Description ----------------"0376" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" "8830bb" "PG01b" N (Primary SSN) | Start of Record Sentinel 0000 0001 0002 0003 Record ID Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number Identifying Number Qualified enhanced oil recovery costs Current year credit Enhanced oil recovery credits from flow-through Total current year credit Regular tax before credits Alternative minimum tax Regular Tax Plus Alternative Minimum Tax Foreign tax credit Credit for child & dependent care expenses 1 2 3 4 6 6 5 9 0004 0005 0010 0020 0030 0040 1 7 9 12 12 12 blank N 0000001 NO ENTRY N N N | 0050 0060 0070 0080 4 5 6 7 12 12 12 12 N N N N 0090 0100 8a 8b 12 12 N N Publication 1346 August 30, 2002 Part II Page 629 Section 4 FORM 8830 Field Identification No. ----- -------------0110 0120 0125 Credit for elderly or disabled Education credits Credit for Qualified Retirement Savings Child tax credit Mortgage Interest Credit Adoption Credit District of Columbia first time homebuyer credit Possessions tax credit (Form 5735) Credit for fuel from a nonconventional source Qualified electric vehicle credit Add lines 8a through 8l Net income tax Net regular tax Enter 25% of Excess Tentative minimum tax Greater of line 11 or line 12 Subtract line 13 from line 9 ENHANCED OIL RECOVERY CREDIT Form Ref. ---8c 8d 8e Length -----12 12 12 Field Description ----------------N N N | 0130 0140 0150 0160 8f 8g 8h 8i 12 12 12 12 N N N N 0170 0180 8j 8k 12 12 NO ENTRY N 0190 0200 0210 0230 0240 0245 0250 0260 8l 8m 9 10 11 12 13 14 August 30, 2002 12 12 12 12 12 12 12 12 N N N N N N N N Part II Page 630 Section 4 --| | | | | Publication 1346 FORM 8830 Field Identification No. ----- -------------0270 Enhanced oil recovery credit allowed current year ENHANCED OIL RECOVERY CREDIT Form Ref. ---15 Length -----12 Field Description ----------------N Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 631 Section 4 INTENTIONAL BLANK PAGE Publication 1346 August 30, 2002 Part II Page 632 Section 4 FORM 8834 Field Identification No. ----- -------------Byte Count Qualified Electric Vehicle Credit Form Ref. ---Length -----4 Field Description ----------------"0580" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" "8834bb" "PG01b" N (Primary SSN) | Start of Record Sentinel 0000 0001 0002 0003 Record ID Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number Identifying Number Date Vehicle Place in Service 1 Cost of Vehicle 1 Section 179 expense deduction - 1st vehicle Subtract line 3 from line 2 - 1st vehicle Multiply Line 4 by Appropriate Percent1st Vehicle Maximum Credit Per Vehicle 1 Smaller of line 5 or line 6 - 1st vehicle Date Vehicle Placed in Service 2 1(a) 2(a) 3(a) 4 6 6 5 9 0004 0005 0010 0015 0020 0030 1 7 9 8 12 12 blank N 0000001 - 0000005 NO ENTRY YYYYMMDD N N | | 0040 4(a) 12 N 0050 5(a) 12 N 0055 0060 6(a) 7(a) 12 12 N N 0065 1(b) August 30, 2002 8 YYYYMMDD or Blank | Part II Page 633 Section 4 Publication 1346 FORM 8834 Field Identification No. ----- -------------0070 0080 Cost of Vehicle 2 Section 179 expense deduction - 2nd vehicle Subtract line 3 from line 2 - 2nd vehicle Multiply line 4 by Appropriate Percent2nd vehicle Maximum Credit Per Vehicle 2 Smaller of line 5 or line 6 - 2nd vehicle Date Vehicle Place in Service 3 Cost of Vehicle 3 Section 179 expense deduction - 3rd vehicle Subtract line 3 from line 2 - 3rd vehicle Multiply line 4 by Appropriate Percent3rd vehicle Maximum Credit Per Vehicle 3 Smaller of line 5 or line 6 - 3rd vehicle Current year qualified electric vehicle credit Qualified Electric Vehicle Credit Form Ref. ---2(b) 3(b) Length -----12 12 Field Description ----------------N N 0090 4(b) 12 N 0100 5(b) 12 N 0105 0110 6(b) 7(b) 12 12 N N 0115 0120 0130 1(c) 2(c) 3(c) 8 12 12 YYYYMMDD or Blank | N N 0140 4(c) 12 N 0150 5(c) 12 N 0155 0160 6(c) 7(c) 12 12 N N 0170 8 12 N Publication 1346 August 30, 2002 Part II Page 634 Section 4 FORM 8834 Field Identification No. ----- -------------0175 0190 0200 0210 0220 0230 Credit From PassThrough Entities Total current year credit Passive activity credits Subtract line 11 from line 10 Passive activity credits allowed Tentative qualified electric vehicle credit Regular tax before credits Foreign tax credit Credit for child and dependent care expenses Credit for elderly or disabled Education credits Credit for Qualified Retirement Savings Child tax credit Mortgage interest credit Adoption credit District of Columbia first time homebuyer credit Possessions tax credit (Form 5735) Qualified Electric Vehicle Credit Form Ref. ---9 10 11 12 13 14 Length -----12 12 12 12 12 12 Field Description ----------------N N N N N N 0240 0250 0260 15 16a 16b 12 12 12 N N N 0270 0280 0285 16c 16d 16e 12 12 12 N N N | 0290 0300 0310 0320 16f 16g 16h 16i 12 12 12 12 N N N N 0330 16j August 30, 2002 12 NO ENTRY Part II Page 635 Section 4 Publication 1346 FORM 8834 Field Identification No. ----- -------------0340 Credit for fuel from a nonconventional source Add line 16a - Line 16k Net regular tax (subtract line 16l from line 15) Tentative minimum tax Excess of net tax over tentative minimum tax Qualified electric vehicle credit Qualified Electric Vehicle Credit Form Ref. ---16k Length -----12 Field Description ----------------N 0350 0360 16l 17 12 12 N N 0370 0380 18 19 12 12 N N 0390 20 12 N Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 636 Section 4 FORM 8835 Field Identification No. ----- -------------Byte Count RENEWABLE ELECTRICITY PRODUCTION CREDIT Form Ref. ---Length -----4 Field Description ----------------"0588" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" "8835bb" "PG01b" N (Primary SSN) | Start of Record Sentinel 0000 0001 0002 0003 Record ID Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number Identifying Number Fiscal Year Filer literal Kilowatt hours produced and sold Total Kilowatt hours produced and sold Attach fiscal year computation Phaseout adjustment Phaseout adjustment rate Total phaseout adjustment Attach fiscal year computation 1 1 1 4 6 6 5 9 0004 0005 0010 0015 0020 0030 1 7 9 2 12 12 blank N 0000001 NO ENTRY "FY" or blank N N | @0035 0040 0045 0050 @0055 1 2 2 2 2 6 12 6 12 6 "STMbnn" or blank N R N "STMbnn" or blank Publication 1346 August 30, 2002 Part II Page 637 Section 4 FORM 8835 Field Identification No. ----- -------------0060 Credit for electricity produced by closedloop Kilowatt hours produced and sold Total kilowatt hours produced and sold Attach fiscal year computation Phaseout adjustment Phaseout adjustment rate Total phaseout adjustment Attach fiscal year computation Credit for electricity produced by wind facility Total credit before reduction Total of government grants Total of additions to the capital account Divide line 8 by line 9 Multiply line 7 by line 10 Current year credit RENEWABLE ELECTRICITY PRODUCTION CREDIT Form Ref. ---3 Length -----12 Field Description ----------------N 0070 0080 4 4 12 12 N N @0085 0090 0100 0110 @0115 0120 4 5 5 5 5 6 6 12 6 12 6 12 "STMbnn" or blank N R N "STMbnn" or blank N 0130 0140 0150 7 8 9 12 12 12 N N N 0160 0170 0180 10 11 12 August 30, 2002 6 12 12 N N N Part II Page 638 Section 4 Publication 1346 FORM 8835 Field Identification No. ----- -------------0190 0195 0200 0210 0220 0230 Credit(s) from flowthrough entities Form 1041 portion amount Total current year credit Regular tax before credits Alternative minimum tax Regular Tax Plus Alternative Minimum Tax Foreign tax credit Credit for child care and dependent care expenses Credit for elderly or disabled Education credits Credit for Qualified Retirement Savings Child tax credit Mortgage interest credit Adoption credit District of Columbia first time homebuyer credit Possessions tax credit (Form 5735) RENEWABLE ELECTRICITY PRODUCTION CREDIT Form Ref. ---13 14 14 15 16 17 Length -----12 12 12 12 12 12 Field Description ----------------N NO ENTRY N N N N 0240 0250 18a 18b 12 12 N N 0260 0270 0275 18c 18d 18e 12 12 12 N N N | 0280 0290 0300 0310 18f 18g 18h 18i 12 12 12 12 N N N N 0320 18j 12 NO ENTRY Publication 1346 August 30, 2002 Part II Page 639 Section 4 FORM 8835 Field Identification No. ----- -------------0330 Credit for fuel from a nonconventional source Qualified electric vehicle credit Add line 18a - Line 18l Net income tax Net Regular Tax Enter 25% of Excess Tentative Minimum Tax Greater of line 21 or line 22 Subtract line 23 from line 19 Renewable electricity credit allowed RENEWABLE ELECTRICITY PRODUCTION CREDIT Form Ref. ---18k Length -----12 Field Description ----------------N 0340 0350 0360 0380 0390 0395 0400 0410 0420 18l 18m 19 20 21 22 23 24 25 12 12 12 12 12 12 12 12 12 N N N N N N N N N --| | | | | Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 640 Section 4 FORM 8839 PAGE 1 Field Identification No. ----- -------------Byte Count Qualified Adoption Expenses Form Ref. ---Length -----4 Field Description ----------------"0347" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" "8839bb" "PG01b" N (Primary SSN) Start of Record Sentinel 0000 0001 0002 0003 Record ID Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number Eligible Child First Name - 1 Eligible Child Last Name - 1 Eligible Child Name Control - 1 1a 1a 4 6 6 5 9 0004 0005 0010 0020 0030 1 7 10 15 4 blank N 0000001 AN (first name) AN (last name) First 4 significant characters of child's last name, no leading or embedded spaces; allowable characters are alpha, hyphen (see special instructions) DT "X" or blank "X" or blank "X" or blank N Part II Page 641 Section 4 0040 0049 0060 0070 0080 Year of Birth - 1 Disabled Over 18 Box - 1 Special Needs Box 1 Foreign Child Box 1 Identifying Number Child - 1 1b 1c 1d 1e 1f August 30, 2002 4 1 1 1 9 Publication 1346 FORM 8839 PAGE 1 Field Identification No. ----- -------------0090 0100 0110 Eligible Child First Name - 2 Eligible Child Last Name - 2 Eligible Child Name Control - 2 Qualified Adoption Expenses Form Ref. ---1a 1a Length -----10 15 4 Field Description ----------------AN (first name) or blank AN (last name) or blank First 4 significant characters of child's last name, no leading or embedded spaces; allowable characters are alpha, hyphen or space (see special instructions) DT or blank 'See 1st Occ.' 'See 1st Occ.' 'See 1st Occ.' N or blank N "X" or blank "X" or blank N N N 0120 0129 0140 0150 0160 0170 0171 0173 0174 0177 0180 Year of Birth - 2 Disabled Over 18 Box - 2 Special Needs Box 2 Foreign Child Box 2 Identifying Number Child - 2 Allowed Tax Credit Child - 1 Previous Year Form 8839 No Box - 1 Previous Year Form 8839 Yes Box - 1 Previous Year Form 8839 - 1 Subtract Line 3 From Line 2 - 1 Total Qualified Adoption Expenses Paid Child - 1 1b 1c 1d 1e 1f 2 3 3 3 4 5 4 1 1 1 9 12 1 1 12 12 12 Publication 1346 August 30, 2002 Part II Page 642 Section 4 FORM 8839 PAGE 1 Field Identification No. ----- -------------0190 Smaller of All. Credit or Qual. Expenses Child - 1 Allowed Tax Credit Child - 2 Previous Year Form 8839 No Box - 2 Previous Year Form 8839 Yes Box - 2 Previous Year Form 8839 - 2 Subtract Line 3 From Line 2 - 2 Total Qualified Adoption Expenses Paid Child - 2 Smaller of All. Credit or Qual. Expenses Child - 2 Total of Amounts on Line 6 Modified AGI Modified AGI Minus 75,000 Line 9 divided by 40,000 Multiply Line 7 By Line 10 Subtract Line 11 From Line 7 Carryforward of Adoption Credit to Current Year Add Lines 12 and 13 Qualified Adoption Expenses Form Ref. ---6 Length -----12 Field Description ----------------N 0200 0201 0203 0204 0207 0210 2 3 3 3 4 5 12 1 1 12 12 12 N "X" or blank "X" or blank N N N 0220 6 12 N 0230 0240 0250 0260 0270 0280 0284 7 8 9 10 11 12 13 12 12 12 6 12 12 12 N N N or blank R N N N 0289 14 August 30, 2002 12 N Part II Page 643 Section 4 Publication 1346 FORM 8839 PAGE 1 Field Identification No. ----- -------------- Qualified Adoption Expenses Form Ref. ---Length -----Field Description ----------------- Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 644 Section 4 FORM 8839 PAGE 2 Field Identification No. ----- -------------Byte Count Qualified Adoption Expenses Form Ref. ---Length -----4 Field Description ----------------"0259" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" "8839bb" "PG02b" N (Primary SSN) Start of Record Sentinel 0300 0301 0302 0303 Record ID Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number Allowed Tax Credit Child - 1 Prev Yr EmployerProvided Benefits No Box - 1 Prev Yr EmployerProvided Benefits Yes Box - 1 Prev Yr EmployerProvided Adoption Benefits - 1 Subtract Line 16 From Line 15 - 1 Employer Provided Adoption Benefits Child - 1 Allowed Tax Credit Child - 2 Prev Yr EmployerProvided Benefits No Box - 2 15 16 4 6 6 5 9 0304 0305 0310 0311 1 7 12 1 blank N 0000001 N "X" or blank 0313 16 1 "X" or blank 0314 16 12 N 0317 0320 17 18 12 12 N N 0330 0331 15 16 12 1 N "X" or blank Publication 1346 August 30, 2002 Part II Page 645 Section 4 FORM 8839 PAGE 2 Field Identification No. ----- -------------0333 Prev Yr EmployerProvided Benefits Yes Box - 2 Prev Yr EmployerProvided Adoption Benefits - 2 Subtract Line 20 From Line 19 - 2 Employer Provided Adoption Benefits Child - 2 Total of Employer Provided Adoption Benefits Smaller of All. Tax Credit or Adoption Benefits 1 Smaller of All. Tax Credit or Adoption Benefits 2 Tot. of Smaller of All. Tax Credit or Adop. Ben. Modified AGI Modified AGI > $75,000 No Box Modified AGI > $75,000 Yes Box Modified AGI minus 75,000 Line 23 Divided by 40,000 Multiply Line 21 By Line 24 Excluded Benefits Qualified Adoption Expenses Form Ref. ---16 Length -----1 Field Description ----------------"X" or blank 0334 16 12 N 0337 0340 17 18 12 12 N N 0350 19 12 N 0360 20 12 N 0370 20 12 N 0380 21 12 N 0390 0393 0395 0400 0410 0420 0440 22 23 23 23 24 25 26 August 30, 2002 12 1 1 12 6 12 12 N "X" or blank "X" or blank N or blank R N N Part II Page 646 Section 4 Publication 1346 FORM 8839 PAGE 2 Field Identification No. ----- -------------0450 Taxable Benefits Qualified Adoption Expenses Form Ref. ---27 Length -----12 Field Description ----------------N Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 647 Section 4 INTENTIONAL BLANK PAGE Publication 1346 August 30, 2002 Part II Page 648 Section 4 FORM 8844 Field Identification No. ----- -------------Byte Count EMPOWERMENT ZONE AND RENEWAL COMMUNITY ... Form Ref. ---Length -----4 Field Description ----------------"0532" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" "8844bb" "PG01b" N (Primary SSN) | Start of Record Sentinel 0000 0001 0002 0003 Record ID Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number Identifying Number Qualified Empowerment Zone Wages Total Qualified Empowerment Zone Wages Qualified Renewal Community Wages Total Qualified Renewal Community Wages Current year credit Credits from flowthrough entities Total current year credit Credit from passive activities 1a 4 6 6 5 9 0004 0005 0010 0015 1 7 9 12 blank N 0000001 NO ENTRY N | | 0020 1a 12 N | 0025 0027 1b 1b 12 12 N N | | 0030 0040 0050 0060 2 3 4 5 August 30, 2002 12 12 12 12 N N N N | | | Part II Page 649 Section 4 Publication 1346 FORM 8844 Field Identification No. ----- -------------0070 0080 0090 0100 0110 0120 0130 0140 0150 Subtract line 5 from line 4 Passive activity credit allowed Carryforward of credit Carryback of credit 1041 portion amount Tentative credit Regular tax before credits Alternative minimum tax Regular Tax Plus Alternative Minimum Tax Foreign tax credit Credit for child & dependent care expenses Credit for elderly or disabled Education credits Credit for Qualified Retirement Savings Child tax credit Mortgage interest credit Adoption credit EMPOWERMENT ZONE AND RENEWAL COMMUNITY ... Form Ref. ---6 7 8 9 10 10 11 12 13 Length -----12 12 12 12 12 12 12 12 12 Field Description ----------------N N N NO ENTRY NO ENTRY N N N N | | | | 0160 0170 14a 14b 12 12 N N 0180 0190 0195 14c 14d 14e 12 12 12 N N N | 0200 0210 0220 14f 14g 14h 12 12 12 N N N Publication 1346 August 30, 2002 Part II Page 650 Section 4 FORM 8844 Field Identification No. ----- -------------0230 District of Columbia first time homebuyer credit Possessions tax credit (Form 5735) Credit for fuel from a nonconventional source Qualified electric vehicle credit Add lines 14a through 14l Net income tax EMPOWERMENT ZONE AND RENEWAL COMMUNITY ... Form Ref. ---14i Length -----12 Field Description ----------------N 0240 0250 14j 14k 12 12 NO ENTRY N 0260 0270 0280 14l 14m 15 12 12 12 N N N --| --| | | | | | 0310 0315 0320 0325 0330 0340 0350 0360 0370 Net Regular Tax Tentative Minimum Tax Enter 25% of Excess Multiply line 16 by 75% Greater of line 18 or line 19 Subtract line 20 from line 15 General business credit Subtract line 22 from line 21 Credit allowed for current year 16 17 18 19 20 21 22 23 24 12 12 12 12 12 12 12 12 12 N N N N N N N N N | Publication 1346 August 30, 2002 Part II Page 651 Section 4 FORM 8844 Field Identification No. ----- -------------- EMPOWERMENT ZONE AND RENEWAL COMMUNITY ... Form Ref. ---Length -----Field Description ----------------- Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 652 Section 4 FORM 8845 Field Identification No. ----- -------------Byte Count INDIAN EMPLOYMENT CREDIT Form Ref. ---Length -----4 Field Description ----------------"0412" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" "8845bb" "PG01b" N (Primary SSN) | Start of Record Sentinel 0000 0001 0002 0003 Record ID Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number Identifying Number Total of qualified wages Calendar year 1993 qualified wages Incremental increase (subtract line 2 from line 1) Current year credit (multiply line 3 by 20%) Indian employment credits from flowthrough Form 1041 portion amount Total current year credit Regular tax before credits 1 2 3 4 6 6 5 9 0004 0005 0010 0020 0030 0040 1 7 9 12 12 12 blank N 0000001 NO ENTRY N N N | 0050 4 12 N 0060 5 12 N 0065 0070 0080 6 6 7 August 30, 2002 12 12 12 NO ENTRY N N Part II Page 653 Section 4 Publication 1346 FORM 8845 Field Identification No. ----- -------------0090 0100 Alternative minimum tax Regular Tax Plus Alternative Minimum Tax Foreign tax credit Credit for child & dependent care expenses Credit for elderly or disabled Education credits Credit for Qualified Retirement Savings Child tax credit Mortgage interest credit Adoption credit District of Columbia first time homebuyer credit Possessions tax credit (Form 5735) Credit for fuel from a nonconventional source Qualified electric vehicle credit Add lines 10a through 10l Net income tax INDIAN EMPLOYMENT CREDIT Form Ref. ---8 9 Length -----12 12 Field Description ----------------N N 0110 0120 10a 10b 12 12 N N 0130 0140 0145 10c 10d 10e 12 12 12 N N N | 0150 0160 0170 0180 10f 10g 10h 10i 12 12 12 12 N N N N 0190 0200 10j 10k 12 12 NO ENTRY N 0210 0220 0230 10l 10m 11 August 30, 2002 12 12 12 N N N --| Part II Page 654 Section 4 Publication 1346 FORM 8845 Field Identification No. ----- -------------0250 0260 0265 0270 0280 0290 Net Regular Tax Enter 25% of Excess Tentative Minimum Tax Greater of line 13 or line 14 Subtract line 15 from line 11 Indian employment credit allowed for current year INDIAN EMPLOYMENT CREDIT Form Ref. ---12 13 14 15 16 17 Length -----12 12 12 12 12 12 Field Description ----------------N N N N N N | | | | Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 655 Section 4 INTENTIONAL BLANK PAGE Publication 1346 August 30, 2002 Part II Page 656 Section 4 FORM 8846 Field Identification No. ----- -------------Byte Count CREDIT FOR EMPLOYER SS AND MEDICARE TAXES Form Ref. ---Length -----4 Field Description ----------------"0407" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" "8846bb" "PG01b" N (Primary SSN) | Start of Record Sentinel 0000 0001 0002 0003 Record ID Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number Identifying Number Tips received by employees for services Tips not subject to the credit provisions Creditable tips (subtract line 2 from line 1) Tipped Employee(s) Wages Exceeded Maximum Amt Current year credit (multiply line 3 by 7.65%) Computation showing amount of tips Form 8846 credits from flow-through entities 1 4 6 6 5 9 0004 0005 0010 0020 1 7 9 12 blank N 0000001 NO ENTRY N | 0030 2 12 N 0040 3 12 N 0050 4 1 "X" or blank 0060 4 12 N @0065 0070 4 5 6 12 "STMbnn" or blank N Publication 1346 August 30, 2002 Part II Page 657 Section 4 FORM 8846 Field Identification No. ----- -------------0080 Total current year credit (add lines 4 and 5) Regular tax before credits Alternative minimum tax Regular Tax Plus Alternative Minimum Tax Foreign tax credit Credit for child care and dependent care expenses Credit for elderly or disabled Education credits Credit for Qualified Retirement Savings Child tax credit Mortgage interest credit Adoption credit District of Columbia first time homebuyer credit Possessions tax credit (Form 5735) Credit for fuel from a nonconventional source CREDIT FOR EMPLOYER SS AND MEDICARE TAXES Form Ref. ---6 Length -----12 Field Description ----------------N 0090 0100 0110 7 8 9 12 12 12 N N N 0120 0130 10a 10b 12 12 N N 0140 0150 0155 10c 10d 10e 12 12 12 N N N | 0160 0170 0180 0190 10f 10g 10h 10i 12 12 12 12 N N N N 0200 0210 10j 10k 12 12 NO ENTRY N Publication 1346 August 30, 2002 Part II Page 658 Section 4 FORM 8846 Field Identification No. ----- -------------0220 0230 0240 0260 0270 0275 0280 0290 0300 Qualified electric vehicle credit Add line 10a - line 10l Net income tax Net Regular Tax Enter 25% of Excess Tentative minimum tax Greater of line 13 or line 14 Subtract line 15 from line 11 Credit allowed for current year CREDIT FOR EMPLOYER SS AND MEDICARE TAXES Form Ref. ---10l 10m 11 12 13 14 15 16 17 Length -----12 12 12 12 12 12 12 12 12 Field Description ----------------N N N N N N N N N --| | | | | Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 659 Section 4 INTENTIONAL BLANK PAGE Publication 1346 August 30, 2002 Part II Page 660 Section 4 FORM 8847 Field Identification No. ----- -------------Byte Count CREDIT FOR CONTRIBUTIONS TO SELECTED COMMUNITY Form Ref. ---Length -----4 Field Description ----------------"0376" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" "8847bb" "PG01b" N (Primary SSN) | Start of Record Sentinel 0000 0001 0002 0003 Record ID Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number Identifying Number Total qualified CDC contributions Current year CDC credit CDC credits from flow-through entities Total current year CDC credit Regular tax before credits Alternative minimum tax Regular Tax Plus Alternative Minimum Tax Foreign tax credit 1 2 3 4 6 6 5 9 0004 0005 0010 0020 0030 0040 1 7 9 12 12 12 blank N 0000001 NO ENTRY N N N | 0050 0060 0070 0080 4 5 6 7 12 12 12 12 N N N N 0090 8a August 30, 2002 12 N Part II Page 661 Section 4 Publication 1346 FORM 8847 Field Identification No. ----- -------------0100 Credit for child & dependent care expenses Credit for elderly or disabled Education credits Credit for Qualified Retirement Savings Child tax credit Mortgage interest credit Adoption credit District of Columbia first time homebuyer credit Possessions tax credit (Form 5735) Credit for fuel from a nonconventional source Qualified electric vehicle credit Add lines 8a through 8l Net income tax Net Regular Tax Enter 25% of Excess Tentative Minimum Tax CREDIT FOR CONTRIBUTIONS TO SELECTED COMMUNITY Form Ref. ---8b Length -----12 Field Description ----------------N 0110 0120 0125 8c 8d 8e 12 12 12 N N N | 0130 0140 0150 0160 8f 8g 8h 8i 12 12 12 12 N N N N 0170 0180 8j 8k 12 12 NO ENTRY N 0190 0200 0210 0230 0240 0245 8l 8m 9 10 11 12 12 12 12 12 12 12 N N N N N N --| | | | Publication 1346 August 30, 2002 Part II Page 662 Section 4 FORM 8847 Field Identification No. ----- -------------0250 0260 0270 Greater of line 11 or line 12 Subtract line 13 from line 9 CDC credit allowed for current year CREDIT FOR CONTRIBUTIONS TO SELECTED COMMUNITY Form Ref. ---13 14 15 Length -----12 12 12 Field Description ----------------N N N | Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 663 Section 4 INTENTIONAL BLANK PAGE Publication 1346 August 30, 2002 Part II Page 664 Section 4 FORM 8853 PAGE 1 Field Identification No. ----- -------------Byte Count Archer MSAs and Long-Term Care Insurance Contracts Form Ref. ---Length -----4 Field Description ----------------"0249" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" "8853bb" "PG01b" N (Primary SSN) Start of Record Sentinel 0000 0001 0002 0003 Record ID Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number MSA Acct Holder SSN Primary Archer Contribution for Current TY - Yes Primary Archer Contribution for Current TY - No Primary Uninsured Acct Holder - Yes Primary Uninsured Account Holder - No Primary Self HDHP Coverage Box Primary Family HDHP Coverage Box Spouse Archer Contribution for Current TY - Yes 1a 4 6 6 5 9 0004 0005 0009 0010 1 7 9 1 blank N 0000001 N "X" or blank 0020 1a 1 "X" or blank 0030 0040 0050 0060 0070 1b 1b 1c 1c 2a 1 1 1 1 1 "X" or blank "X" or blank "X" or blank "X" or blank "X" or blank Publication 1346 August 30, 2002 Part II Page 665 Section 4 FORM 8853 PAGE 1 Field Identification No. ----- -------------0080 Spouse Archer Contribution for Current TY - No Spouse Uninsured Acct Holder - Yes Spouse Uninsured Acct Holder - No Spouse Self HDHP Coverage Box Spouse Family HDHP Coverage Box HDHP with Self Coverage For Both Box Employer Contributions - Yes Employer Contributions - No Total Employer Contributions for Current Tax Year TaxPayer MSA Contributions for Current Tax Year Limitation Amount Compensation Amount Medical Savings Account Deduction Total MSA Distributions Received Distributions Rolled Over & Excess Contributions Archer MSAs and Long-Term Care Insurance Contracts Form Ref. ---2a Length -----1 Field Description ----------------"X" or blank 0090 0100 0110 0120 0130 2b 2b 2c 2c Part II 1 1 1 1 1 "X" or blank "X" or blank "X" or blank "X" or blank No Entry 0140 0150 0160 3a 3a 3b 1 1 12 "X" or blank "X" or blank N 0170 4 12 N 0180 0190 0200 0210 5 6 7 8a 12 12 12 12 N N N N 0220 8b 12 N Publication 1346 August 30, 2002 Part II Page 666 Section 4 FORM 8853 PAGE 1 Field Identification No. ----- -------------0230 0240 Net MSA Distributions Total Unreimbursed Qualified Medical Expenses Taxable MSA Distributions Exceptions to 15% Tax Box Total Taxable MSA Distributions Total Medicare & Choice MSA Distributions Received Tot Medicare & Choice Unreimbursed Med Expenses Taxable Medicare & Choice MSA Distributions Exceptions to 50% Tax Box Total Taxable Medicare & Choice MSA Distributions Archer MSAs and Long-Term Care Insurance Contracts Form Ref. ---8c 9 Length -----12 12 Field Description ----------------N N 0250 0260 0270 0272 10 11a 11b 12 12 1 12 12 N "X" or blank N N 0274 13 12 N 0276 14 12 N 0278 0279 15a 15b 1 12 "X" or blank N Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 667 Section 4 FORM 8853 PAGE 2 Field Identification No. ----- -------------Byte Count Archer MSAs & Long-Term Care Insurance Contracts Form Ref. ---Length -----4 Field Description ----------------"0260" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" "8853bb" "PG02b" N (Primary SSN) Start of Record Sentinel 0280 0281 0282 0283 Record ID Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number Policyholder Name 4 6 6 5 9 0284 0285 0288 1 7 35 blank N 0000001 AN, Allowable Special Characters are space, less-than (<), hyphen (-) and ampersand (&) N No Entry First 4 significant characters of the insured last name, no leading or embedded spaces; allowable characters are alpha, hyphen or space (see special instructions ) AN, Allowable Special Characters are space, less-than (<), hyphen (-) and ampersand (&) N "X" or blank Part II Page 668 Section 4 0289 0290 0295 Policyholder SSN More Than One Section C Box Insured Name Control Section C 9 1 4 0300 Name of Insured 16a 35 0310 0320 Insured SSN Payments or Death Benefits - Yes 16b 17 August 30, 2002 9 1 Publication 1346 FORM 8853 PAGE 2 Field Identification No. ----- -------------0330 0340 0350 0360 0370 Payments or Death Benefits - No Insured Terminally Ill - Yes Insured Terminally Ill - No Gross LTC Payment Amounts Qualified LTC Insurance Contract Amount Accelerated Death Benefits Received Qual LTC Insur Contract & Acc Death Benefit Totals Multiply $190 By Number of Days of LTC Period Qualified LTC Service Incurred Costs Larger of Line 23 or Line 24 Total Reimbursements Received Per Diem Limitation Taxable Payments Archer MSAs & Long-Term Care Insurance Contracts Form Ref. ---17 18 18 19 20 Length -----1 1 1 12 12 Field Description ----------------"X" or blank "X" or blank "X" or blank N N 0380 0390 21 22 12 12 N N 0400 23 12 N 0410 24 12 N 0420 0430 25 26 12 12 N N 0440 0450 27 28 12 12 N N Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 669 Section 4 INTENTIONAL BLANK PAGE Publication 1346 August 30, 2002 Part II Page 670 Section 4 FORM 8859 Field Identification No. ----- -------------Byte Count DC First-Time Homebuyer Credit Form Ref. ---Length -----4 Field Description ----------------"0277" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" "8859bb" "PG01b" N (Primary SSN) Start of Record Sentinel 0000 0001 0002 0003 Record ID Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number SSN Street Address of Home City of Home State of Home Zip Code of Home Lot Number Square Number Settlement or Closing Date Maximum Allowable Amount Modified Adjusted Gross Income Subtract Maximum From Amt on Line 2 A A A A B C D 1 2 3 4 6 6 5 9 0004 0005 0010 0020 0030 0040 0050 0060 0070 0080 0090 0100 0130 1 7 9 35 22 2 12 4 4 8 12 12 12 blank N 0000001 N AN AN AN N or nnnnnbbbbbbb or nnnnnnnnnbbb N AN YYYYMMDD N N N | Publication 1346 August 30, 2002 Part II Page 671 Section 4 FORM 8859 Field Identification No. ----- -------------0140 0150 0160 0170 0180 0190 Divide Line 3 by $20,000 Multiply line 1 by line 4 Tentative Credit Prior Year Carryforward Credit Tax from Form 1040 Additional Credit Amounts from Form 1040 Tax (line 8) minus credits (line 9) Credit allowed for current year Credit carryforward to next year DC First-Time Homebuyer Credit Form Ref. ---4 5 6 7 8 9 Length -----6 12 12 12 12 12 Field Description ----------------R N N N N N 0200 0230 0240 10 11 12 12 12 12 N N N Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 672 Section 4 FORM 8861 Field Identification No. ----- -------------Byte Count Welfare-To-Work Credit Form Ref. ---Length -----4 Field Description ----------------"0436" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" "8861bb" "PG01b" N (Primary SSN) | Start of Record Sentinel 0000 0001 0002 0003 Record ID Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number Identifying Number Qualified firstyear wages Total qualified first-year wages Qualified secondyear wages Total qualified second-year wages Current year credit Group credit division schedule Line 2 difference statement Welfare-to-work credit (s) flowthrough entities Form 1041 portion amount 1a 1a 1b 1b 2 2 2 3 4 6 6 5 9 0004 0005 0010 0020 0030 0040 0050 0060 @0065 @0067 0070 1 7 9 12 12 12 12 12 6 6 12 Blank N 0000001 NO ENTRY N N N N N "STMbnn" or blank "STMbnn" or blank N | 0075 4 August 30, 2002 12 NO ENTRY Part II Page 673 Section 4 Publication 1346 FORM 8861 Field Identification No. ----- -------------0080 Total current year welfare-to-work credit Regular tax before credits Alternative minimum tax Regular Tax Plus Alternative Minimum Tax Foreign tax credit Credit for child & dependent care expenses Credit for elderly or disabled Education credits Credit for Qualified Retirement Savings Child tax credit Mortgage interest credit Adoption credit District of Columbia first time homebuyer credit Possessions tax credit (Form 5735) Credit for fuel from a nonconventional source Qualified electric vehicle credit Welfare-To-Work Credit Form Ref. ---4 Length -----12 Field Description ----------------N 0090 0100 0110 5 6 7 12 12 12 N N N 0120 0130 8a 8b 12 12 N N 0140 0150 0155 8c 8d 8e 12 12 12 N N N | 0160 0170 0180 0190 8f 8g 8h 8i 12 12 12 12 N N N N 0200 0210 8j 8k 12 12 NO ENTRY N 0220 8l August 30, 2002 12 N Part II Page 674 Section 4 Publication 1346 FORM 8861 Field Identification No. ----- -------------0230 0240 0260 0270 0275 0280 0290 0300 Add lines 8a through 8l Net income tax Net Regular Tax Enter 25% of Excess Tentative Minimum Tax Greater of line 11 or line 12 Subtract line 13 from line 9 Welfare-to-work credit allowed for current year Welfare-To-Work Credit Form Ref. ---8m 9 10 11 12 13 14 15 Length -----12 12 12 12 12 12 12 12 Field Description ----------------N N N N N N N N --| | | | | Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 675 Section 4 INTENTIONAL BLANK PAGE Publication 1346 August 30, 2002 Part II Page 676 Section 4 FORM 8862 PAGE 1 Field Identification No. ----- -------------Byte Count Information To Claim Earned Income Credit... Form Ref. ---Length -----4 Field Description ----------------"0759" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" "8862bb" "PG01b" N (Primary SSN) Start of Record Sentinel 0000 0001 0002 0003 Record ID Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number Year for Which You Are Filing This Form Qualifying Child of Another Person Yes Box Qualifying Child of Another Person No Box Beginning Date Your Home In The USA Ending Date Your Home in The USA Beginning Date Your Spouse Home In The USA Ending Date Your Spouse Home in The USA Relationship Yes Box - 1 1 2 4 6 6 5 9 0004 0005 0010 0020 1 7 4 1 blank N 0000001 Value "2001" "X" or blank 0030 2 1 "X" 0040 0045 0050 3a 3a 3b 8 8 8 DT DT DT 0055 3b 8 DT 0060 4 August 30, 2002 1 "X" or blank Part II Page 677 Section 4 Publication 1346 FORM 8862 PAGE 1 Field Identification No. ----- -------------0070 0080 0090 0100 Relationship No Box - 1 Did the Child Live with You Yes Box - 1 Did the Child Live with You No Box - 1 Street Address During the Filing Tax Year - 1 City, State and Zip Code - 1 Street Address During the Filing Tax Year - 2 City, State and Zip Code - 2 Street Address During the Filing Tax Year - 3 City, State and Zip Code - 3 Name of School or Care Providers - 1 Name of School or Care Providers - 2 Name of School or Care Providers - 3 Related to the Child or Child With You-Yes Box - 1 Related to the Child or Child With You-No Box - 1 Information To Claim Earned Income Credit... Form Ref. ---4 5a 5a 5b Child 1 Length -----1 1 1 35 Field Description ----------------"X" or blank "X" or blank "X" or blank AN, Allowable special characters are space, slash, hyphen AN AN, Allowable special characters are space, slash, hyphen AN AN, Allowable special characters are space, slash, hyphen AN AN AN AN "X" or blank 0105 0106 5b Child 1 5b Child 1 25 35 0107 0108 5b Child 1 5b Child 1 25 35 0109 0110 0113 0116 0120 5b Child 1 5c Child 1 5c Child 1 5c Child 1 6a 25 35 35 35 1 0130 6a 1 "X" or blank Publication 1346 August 30, 2002 Part II Page 678 Section 4 FORM 8862 PAGE 1 Field Identification No. ----- -------------0140 Child's Relationship to You - 1 Name of the Placement Agency - 1 Information To Claim Earned Income Credit... Form Ref. ---6b Length -----11 Field Description ----------------AN or blank 0143 6b 35 AN, Allowable special characters are space, slash, hyphen or blank "X" or blank 0146 Did You Care for The Child Yes Box 1 Did You Care for The Child No Box - 1 Relationship Yes Box - 2 Relationship No Box - 2 Did the Child Live with You Yes Box - 2 Did the Child Live with You No Box - 2 Street Address During The Filing Tax Year - 1 City, State and Zip Code - 1 Street Address During the Filing Tax Year - 2 City, State and Zip Code - 2 Street Address During the Filing Tax Year - 3 City, State and Zip Code - 3 6c 1 0148 0150 0160 0170 0180 0190 6c 4 4 5a 5a 5b Child 2 1 1 1 1 1 35 "X" or blank 'See 1st Occ.' 'See 1st Occ.' 'See 1st Occ.' 'See 1st Occ.' 'See 1st Occ.' 0195 0196 5b Child 2 5b Child 2 25 35 'See 1st Occ.' 'See 1st Occ.' 0197 0198 5b Child 2 5b Child 2 25 35 'See 1st Occ.' 'See 1st Occ.' 0199 5b Child 2 August 30, 2002 25 'See 1st Occ.' Part II Page 679 Section 4 Publication 1346 FORM 8862 PAGE 1 Field Identification No. ----- -------------0200 0203 0206 0210 Name of School or Care Providers - 1 Name of School or Care Providers - 2 Name of School or Care Providers - 3 Related to the Child or Child With You-Yes Box - 2 Related to the Child or Child With You-No Box - 2 Child's Relationship to You - 2 Name of the Placement Agency - 2 Information To Claim Earned Income Credit... Form Ref. ---5c Child 2 5c Child 2 5c Child 2 6a Length -----35 35 35 1 Field Description ----------------'See 1st Occ.' 'See 1st Occ.' 'See 1st Occ.' 'See 1st Occ.' 0220 6a 1 'See 1st Occ.' 0230 6b 11 'See 1st Occ.' 0233 6b 35 AN, Allowable special characters are space, slash, hyphen or blank 'See 1st Occ.' 0236 Did You Care for The Child Yes Box 2 Did You Care for The Child No Box - 2 6c 1 0238 6c 1 'See 1st Occ.' Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 680 Section 4 FORM 8862 PAGE 2 Field Identification No. ----- -------------Byte Count Information To Claim Earned Income Credit... Form Ref. ---Length -----4 Field Description ----------------"1109" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" "8862bb" "PG02b" N (Primary SSN) Start of Record Sentinel 0240 0241 0242 0243 Record ID Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number Did The Child Live With You in The USA Yes Box - 1 Did The Child Live With You in The USA No Box - 1 Street Address Lived During the Filing TY - 1 City, State and Zip Code Lived - 1 Street Address Lived During the Filing TY - 2 City, State and Zip Code Lived - 2 Street Address Lived During the Filing TY - 3 City, State and Zip Code Lived - 3 6d 4 6 6 5 9 0244 0245 0290 1 7 1 blank N 0000001 "X" or blank 0300 6d 1 "X" or blank 0310 6e Child 1 35 AN, Allowable special characters are space, slash, hyphen AN AN, Allowable special characters are space, slash, hyphen AN AN, Allowable special characters are space, slash, hyphen AN Part II Page 681 Section 4 0315 0316 6e Child 1 6e Child 1 25 35 0317 0318 6e Child 1 6e Child 1 25 35 0319 6e Child 1 August 30, 2002 25 Publication 1346 FORM 8862 PAGE 2 Field Identification No. ----- -------------0320 Name of School or Day Care Providers 1 Name of School or Day Care Providers 2 Name of School or Day Care Providers 3 Child Lived With Any Other Yes Box 1 Child Lived With Any Other No Box - 1 Child's Parent or Grandparent Yes Box - 1 Child's Parent or Grandparent No Box 1 Did This Person Live with The Child Yes Box - 1 Did This Person Live with The Child No Box - 1 Relationship With This Person Yes Box - 1 Relationship With This Person No Box 1 Child's Relationship To Person - 1 Information To Claim Earned Income Credit... Form Ref. ---6f Child 1 Length -----35 Field Description ----------------AN 0323 6f Child 1 35 AN 0326 6f Child 1 35 AN 0330 7a 1 "X" or blank 0340 0350 7a 7b 1 1 "X" or blank "X" or blank 0360 7b 1 "X" or blank 0370 7c 1 "X" or blank 0380 7c 1 "X" or blank 0382 7d 1 "X" or blank 0384 7d 1 "X" or blank 0386 7e 11 AN or blank Publication 1346 August 30, 2002 Part II Page 682 Section 4 FORM 8862 PAGE 2 Field Identification No. ----- -------------0388 Name of the Person's Agency - 1 Information To Claim Earned Income Credit... Form Ref. ---7e Length -----35 Field Description ----------------AN, Allowable special characters are space, slash, hyphen or blank AN, Allowable special characters are: space, less-than (<), hyphen (-) and ampersand (&) N "X" or blank 0390 Person's Name - 1 7f 35 0400 0410 Person's SSN - 1 Is Your AGI Higher Than The Other 's Yes Box - 1 Is Your AGI Higher Than The Other 's No Box - 1 Was The Child Under 19 And A student Yes Box - 1 Was The Child Under 19 And A student No Box - 1 Was The Child Under 24 And A Student Yes Box - 1 Was The Child Under 24 And A Student No Box - 1 Name of School, State, County, Local Gov Agency-1 Name of School, State, County, Local Gov Agency-2 Name of School, State, County, Local Gov Agency-3 7f 7g 9 1 0420 7g 1 "X" or blank 0430 8a 1 "X" or blank 0440 8a 1 "X" or blank 0450 8b 1 "X" or blank 0460 8b 1 "X" or blank 0470 8c Child 1 35 AN 0473 8c Child 1 35 AN 0476 8c Child 1 35 AN Publication 1346 August 30, 2002 Part II Page 683 Section 4 FORM 8862 PAGE 2 Field Identification No. ----- -------------0480 0490 0500 Was The Child Disabled Yes Box - 1 Was The Child Disabled No Box - 1 Name of Health Care Provider or Social Worker - 1 Did The Child Live With You in The USA Yes Box - 2 Did The Child Live With You in The USA No Box - 2 Street Address Lived During the Filing TY - 1 City, State and Zip Code Lived - 1 Street Address Lived During the Filing TY - 2 City, State and Zip Code Lived - 2 Street Address Lived During the Filing TY - 3 City, State and Zip Code Lived - 3 Name of School or Day Care Providers 1 Name of School or Day Care Providers 2 Information To Claim Earned Income Credit... Form Ref. ---8d 8d 8e Length -----1 1 35 Field Description ----------------"X" or blank "X" or blank AN 0550 6d 1 'See 1st Occ.' 0560 6d 1 'See 1st Occ.' 0570 6e Child 2 35 'See 1st Occ.' 0575 0576 6e Child 2 6e Child 2 25 35 'See 1st Occ.' 'See 1st Occ.' 0577 0578 6e Child 2 6e Child 2 25 35 'See 1st Occ.' 'See 1st Occ.' 0579 0580 6e Child 2 6f Child 2 25 35 'See 1st Occ.' 'See 1st Occ.' 0583 6f Child 2 35 'See 1st Occ.' Publication 1346 August 30, 2002 Part II Page 684 Section 4 FORM 8862 PAGE 2 Field Identification No. ----- -------------0586 Name of School or Day Care Providers 3 Child Lived With Any Other Yes Box 2 Child Lived With Any Other No Box - 2 Child's Parent or Grandparent Yes Box - 2 Child's Parent or Grandparent No Box 2 Did This Person Live With The Child Yes Box - 2 Did This Person Live With The Child No Box - 2 Relationship With This Person Yes Box - 2 Relationship With This Person No Box 2 Child's Relationship To Person - 2 Name of the Person's Agency - 2 Information To Claim Earned Income Credit... Form Ref. ---6f Child 2 Length -----35 Field Description ----------------'See 1st Occ.' 0590 7a 1 'See 1st Occ.' 0600 0610 7a 7b 1 1 'See 1st Occ.' 'See 1st Occ.' 0620 7b 1 'See 1st. Occ.' 0630 7c 1 'See 1st Occ.' 0640 7c 1 'See 1st Occ.' 0642 7d 1 "X" or blank 0644 7d 1 "X" or blank 0646 7e 11 AN, Allowable special characters are: space, AN, Allowable special characters are space, slash, hyphen or blank 'See 1st Occ.' 'See 1st Occ.' Part II Page 685 Section 4 0648 7e 35 0650 0660 Person's Name - 2 Person's SSN - 2 7f 7f August 30, 2002 35 9 Publication 1346 FORM 8862 PAGE 2 Field Identification No. ----- -------------0670 Is Your AGI Higher Than The Other 's Yes Box - 2 Is Your AGI Higher Than The Other 's No Box - 2 Was The Child Under 19 And A Student Yes Box - 2 Was The Child Under 19 And A Student No Box - 2 Was The Child Under 24 And A Student Yes Box - 2 Was The Child Under 24 And A Student No Box - 2 Name of School, State, County, Local Gov Agency-1 Name of School, State, County, Local Gov Agency-2 Name of School, State, County, Local Gov Agency-3 Was the Child Disabled Yes Box - 2 Was the Child Disabled No Box - 2 Name of Health Care Provider or Social Worker - 2 Information To Claim Earned Income Credit... Form Ref. ---7g Length -----1 Field Description ----------------'See 1st Occ.' 0680 7g 1 'See 1st Occ.' 0690 8a 1 'See 1st Occ.' 0700 8a 1 'See 1st Occ.' 0710 8b 1 'See 1st Occ.' 0720 8b 1 'See 1st Occ.' 0730 8c Child 2 35 'See 1st Occ.' 0733 8c Child 2 35 'See 1st Occ.' 0736 8c Child 2 35 'See 1st Occ.' 0740 0750 0760 8d 8d 8e 1 1 35 'See 1st Occ.' 'See 1st Occ.' 'See 1st Occ.' Record Terminus Character Publication 1346 August 30, 2002 1 Value "#" Part II Page 686 Section 4 FORM 8863 Field Identification No. ----- -------------Byte Count Education Credits (Hope and Lifetime... Form Ref. ---Length -----4 Field Description ----------------"0749" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" "8863bb" "PG01b" N (Primary SSN) Start of Record Sentinel 0000 0001 0002 0003 Record ID Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number Student's First Name - 1 Student's Last Name - 1 Student's Name Control - 1 1a 1a 1a 4 6 6 5 9 0004 0005 0010 0020 0030 1 7 10 15 4 blank N 0000001 AN (first name) or blank AN (last name) or blank First 4 significant characters of student's last name, no leading or embedded spaces; allowable characters are alpha, hyphen or space (see special instructions) or blank N or blank N 0035 0040 Student's SSN - 1 Qualified Expenses Paid in Current Tax Year - 1 Smaller of Exp Paid in Current TY or $1000 - 1 Subtract Columns d from c - 1 1b 1c 9 12 0050 1d 12 N 0060 1e 12 N Publication 1346 August 30, 2002 Part II Page 687 Section 4 FORM 8863 Field Identification No. ----- -------------0070 0080 0090 0100 0105 0110 Enter 1/2 of the Amt in Column e - 1 Student's First Name - 2 Student's Last Name - 2 Student's Name Control - 2 Student's SSN - 2 Qualified Expenses Paid in Current Tax Year - 2 Smaller of Exp Paid in Current TY or $1000 - 2 Subtract Columns d from c - 2 Enter 1/2 of the Amt in Column e - 2 Student's First Name - 3 Student's Last Name - 3 Student's Name Control - 3 Student's SSN - 3 Qualified Expenses Paid in Current Tax Year - 3 Smaller of Exp Paid in Current TY or $1000 - 3 Subtract Columns d from c - 3 Education Credits (Hope and Lifetime... Form Ref. ---1f 1a 1a 1a 1b 1c Length -----12 10 15 4 9 12 Field Description ----------------N 'See 1st Occ.' 'See 1st Occ.' 'See 1st Occ.' 'See 1st Occ.' N 0120 1d 12 N 0130 0140 0150 0160 0170 0175 0180 1e 1f 1a 1a 1a 1b 1c 12 12 10 15 4 9 12 N N 'See 1st Occ.' 'See 1st Occ.' 'See 1st Occ.' 'See 1st Occ.' N 0190 1d 12 N 0200 1e August 30, 2002 12 N Part II Page 688 Section 4 Publication 1346 FORM 8863 Field Identification No. ----- -------------0210 0220 0230 0240 0250 0260 0270 Enter 1/2 of the Amt in Column e - 3 Total of Column d Total of Column f Add Amounts in Line 2, Columns d and f Student's First Name - 1 Student's Last Name - 1 Student's Name Control - 1 Education Credits (Hope and Lifetime... Form Ref. ---1f 2d 2f 3f 4a 4a 4a Length -----12 12 12 12 10 15 4 Field Description ----------------N N N N AN (first name) or blank AN (last name) or blank First 4 significant characters of student's last name, no leading or embedded spaces; allowable characters are alpha, hyphen or space (see special instructions) or blank N or blank N 'See 1st Occ.' 'See 1st Occ.' 'See 1st Occ.' 'See 1st Occ.' 'See 1st Occ.' 'See 1st Occ.' 'See 1st Occ.' Part II Page 689 Section 4 0275 0280 0290 0300 0310 0315 0320 0330 0340 Student's SSN - 1 Qualified Expenses 1 Student's First Name - 2 Student's Last Name - 2 Student's Name Control - 2 Student's SSN - 2 Qualified Expenses 2 Student's First Name - 3 Student's Last Name - 3 4b 4c 4a 4a 4a 4b 4c 4a 4a August 30, 2002 9 12 10 15 4 9 12 10 15 Publication 1346 FORM 8863 Field Identification No. ----- -------------0350 0355 0360 0370 0380 0390 0395 0400 0410 0420 0430 0435 0440 0450 0460 0470 0480 Student's Name Control - 3 Student's SSN - 3 Qualified Expenses 3 Student's First Name - 4 Student's Last Name - 4 Student's Name Control - 4 Student's SSN - 4 Qualified Expenses 4 Student's First Name - 5 Student's Last Name - 5 Student's Name Control - 5 Student's SSN - 5 Qualified Expenses 5 Total Qualified Expenses Smaller of Line 5 or $5000 Multiply Line 6 by 20% Tentative Education Credits - Add Lines 3 and 7 Education Credits (Hope and Lifetime... Form Ref. ---4a 4b 4c 4a 4a 4a 4b 4c 4a 4a 4a 4b 4c 5c 6c 7c 8c Length -----4 9 12 10 15 4 9 12 10 15 4 9 12 12 12 12 12 Field Description ----------------'See 1st Occ.' 'See 1st Occ.' 'See 1st Occ.' 'See 1st Occ.' 'See 1st Occ.' 'See 1st Occ.' 'See 1st Occ.' 'See 1st Occ.' 'See 1st Occ.' 'See 1st Occ.' 'See 1st Occ.' 'See 1st Occ.' 'See 1st Occ.' N N N N Publication 1346 August 30, 2002 Part II Page 690 Section 4 FORM 8863 Field Identification No. ----- -------------0490 Enter $50,000 ($100,000 if Married Filing Jointly) Modified AGI from 1040 or 1040A Subtract Lines 10 from 9 Enter $10,000 ($20,000 if Married Filing Jointly) Divide Line 11 by $10,000 (by $20,000 if Married) Multiply Line 8 by Line 13 Tax from 1040 or 1040A Total 1040/1040A other credits Subtract Line 16 from Line 15 Education Credits Education Credits (Hope and Lifetime... Form Ref. ---9 Length -----12 Field Description ----------------N 0500 0510 0515 10 11 12 12 12 12 N N N 0520 13 6 R 0529 0540 0550 0560 0590 14 15 16 17 18 12 12 12 12 12 N N N N N Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 691 Section 4 INTENTIONAL BLANK PAGE Publication 1346 August 30, 2002 Part II Page 692 Section 4 FORM 8865 PAGE 1 Field Identification No. ----- -------------Byte Count Return of U.S. Persons with Respect to Certain ... Form Ref. ---Length -----4 Field Description ----------------"1678" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" "8865bb" "PG01b" N (Primary SSN) | Start of Record Sentinel 0000 0001 0002 0003 Record Id Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number Tax Period Category/Filer Attachment Partnership's Tax Year Beginning Partnership's Tax Year Ending Name Control 4 6 6 5 9 0004 0005 0006 @0007 0010 0020 0025 1 7 6 6 8 8 4 Blank N 0000001 - 0000005 YYYYMM "STMbnn" or blank | YYYYMMDD YYYYMMDD AN --| --| --| --| | | | 0080 0090 0100 0110 0120 Category 1 Filer Category 2 Filer Category 3 Filer Category 4 Filer Filer's Tax Year Beginning A A A A B August 30, 2002 1 1 1 1 8 NO ENTRY "X" or blank "X" or blank "X" or blank YYYYMMDD | Part II Page 693 Section 4 Publication 1346 FORM 8865 PAGE 1 Field Identification No. ----- -------------0130 0140 Filer's Tax Year Ending Filer's Share Of Liabilities Nonrecourse Qualified Nonrecourse Financing Other Parent Filer's Name Parent Filer's Address Parent Filer's City Parent Filer's State Parent Filer's Zip Code Parent Filer's Ein Name Other Partner Address Other Partner City Other Partner State Other Partner Zip Code Other Partner Identifying Number Other Partner First Category 1 Filer First Category 2 Filer Constructive Owner Return of U.S. Persons with Respect to Certain ... Form Ref. ---B C Length -----8 12 Field Description ----------------YYYYMMDD N | 0150 C 12 N 0160 0170 0180 0190 0200 0210 0220 *0230 +0240 *+0250 +0260 +0270 +0280 +0290 +0300 +0310 C D D D D D D E(1) E(2) E(2) E(2) E(2) E(3) E(4) E(4) E(4) August 30, 2002 12 35 35 22 2 12 9 35 35 22 2 12 9 1 1 1 N AN AN AN AN N or nnnnnbbbbbbb or nnnnnnnnnbbb N AN or "STMbnn" or blank AN AN or "STMbnn" AN N or nnnnnbbbbbbb or nnnnnnnnnbbb N "X" or blank "X" or blank "X" or blank Part II Page 694 Section 4 Publication 1346 FORM 8865 PAGE 1 Field Identification No. ----- -------------0320 0330 0340 0350 0360 0370 0380 0390 0400 0410 0420 0430 0440 0450 0460 0470 Name Other Partner 2 Address Other Partner - 2 City Other Partner 2 State Other Partner - 2 Zip Code Other Partner - 2 Indentifying Number Other Partner - 2 Second Category 1 Filer Second Category 2 Filer Constructive Owner 2 Name Other Partner 3 Address Other Partner - 3 City Other Partner 3 State Other Partner - 3 Zip Code Other Partner - 3 Identifying Number Other Partner - 3 Third Category 1 Filer Return of U.S. Persons with Respect to Certain ... Form Ref. ---E(1) E(2) E(2) E(2) E(2) E(3) E(4) E(4) E(4) E(1) E(2) E(2) E(2) E(2) E(3) E(4) Length -----35 35 22 2 12 9 1 1 1 35 35 22 2 12 9 1 Field Description ----------------AN AN AN AN N or nnnnnbbbbbbb or nnnnnnnnnbbb N "X" or blank "X" or blank "X" or blank AN AN AN AN N or nnnnnbbbbbbb or nnnnnnnnnbbb N "X" or blank Publication 1346 August 30, 2002 Part II Page 695 Section 4 FORM 8865 PAGE 1 Field Identification No. ----- -------------0480 0490 0500 0510 0520 0530 0540 0550 0560 0570 0580 0585 0590 0600 0610 0620 Third Category 2 Filer Constructive Owner 3 Name Other Partner 4 Address Other Partner - 4 City Other Partner 4 State Other Partner - 4 Zip Code Other Partner - 4 Identifying Number Other Partner - 4 Fourth Category 1 Filer Fourth Category 2 Filer Constructive Owner 4 Statement Reference - BMF Use Only Name Line 1 Foreign Partnership Name Line 2 Foreign Partnership Address Foreign Partnership City Foreign Partnership Return of U.S. Persons with Respect to Certain ... Form Ref. ---E(4) E(4) E(1) E(2) E(2) E(2) E(2) E(3) E(4) E(4) E(4) E F(1) F1 F1 F1 Length -----1 1 35 35 22 2 12 9 1 1 1 6 35 35 35 22 Field Description ----------------"X" or blank "X" or blank AN AN AN AN N or nnnnnbbbbbbb or nnnnnnnnnbbb N "X" or blank "X" or blank "X" or blank Blank AN AN AN AN | Publication 1346 August 30, 2002 Part II Page 696 Section 4 FORM 8865 PAGE 1 Field Identification No. ----- -------------0630 0640 0645 0650 0660 0670 0680 0690 State Foreign Partnership Zip Code Foreign Partnership Country Foreign Partnership EIN Foreign Partnership Country Under Whose Laws Organized Date Of Organization Principal Business Place Business Activity Code Principal Business Activity Functional Currency Name Exchange Rate Attach Statement Identifying QBU Name Line 1 U.S. Agent Name Line 2 U.S. Agent Address U.S. Agent City U.S. Agent State U.S. Agent Zip Code U.S. Agent Return of U.S. Persons with Respect to Certain ... Form Ref. ---F1 F1 F1 F2 F3 F4 F5 F6 Length -----2 12 35 9 35 8 35 6 Field Description ----------------AN N or nnnnnbbbbbbb or nnnnnnnnnbbb AN N or blank AN YYYYMMDD AN N or blank | Valid Range:111100-813000 AN AN N (nnnnnnn.nnnn) "STMbnn" or blank AN AN AN AN AN N or nnnnnbbbbbbb or nnnnnnnnnbbb Part II Page 697 Section 4 | | | | 0700 0710 0712 @0715 0720 0730 0740 0750 0760 0770 F7 8a 8b F8 G1 G1 G1 G1 G1 G1 August 30, 2002 35 20 11 6 35 35 35 22 2 12 Publication 1346 FORM 8865 PAGE 1 Field Identification No. ----- -------------0775 0780 0790 0800 0805 0810 0820 0830 0840 0850 0860 0865 0870 0880 0890 0900 0910 0920 Identifying Number Of Agent File Form 1042 File Form 8804 File Form 1065 Reserved Name Line 1 Foreign Partnership's Agent Name Line 2 Foreign Partnership's Agent Address Foreign Agent City Foreign Agent State Foreign Agent Zip Code Foreign Agent Country Foreign Agent Name Line 1 Person With Books/Records Name Line 2 Person With Books/Records Address Person With Books City Person With Books State Person With Books Zip Code Person With Books Return of U.S. Persons with Respect to Certain ... Form Ref. ---G1 G2 G2 G2 G2 G3 G3 G3 G3 G3 G3 G3 G4 G4 G4 G4 G4 G4 Length -----9 1 1 1 12 35 35 35 22 2 12 35 35 35 35 22 2 12 Field Description ----------------N "X" or blank "X" or blank "X" or blank Blank AN AN AN AN AN N or nnnnnbbbbbbb or nnnnnnnnnbbb AN AN AN AN AN AN N or nnnnnbbbbbbb or nnnnnnnnnbbb Part II Page 698 Section 4 Publication 1346 August 30, 2002 FORM 8865 PAGE 1 Field Identification No. ----- -------------0925 0930 0940 0950 0960 @0965 0970 0980 Country Person With Books Location Books Special Allocations Made (Yes Box) Special Allocations Made (No Box) Number Of Foreign Disregarded Entities Attach List of Entities How Is Partnership Classified Partnership Own Separate Units (Yes Box) Partnership Own Separate Units (No Box) Attach Schedule of Separate Units Total Receipts & Assets Less Than Limit (Yes) Total Receipts & Assets Less Than Limit (No) Form 8865 Page 1 Global Statement Return of U.S. Persons with Respect to Certain ... Form Ref. ---G4 G4 G5 G5 G6 G6 G 7 G8 Length -----35 35 1 1 12 6 25 1 Field Description ----------------AN AN "X" or blank "X" or blank N "STMbnn" or AN "X" or blank BLANK 0990 G8 1 "X" or blank @0995 1000 G8 G9 6 1 "STMbnn" OR BLANK "X" or blank 1010 G9 1 "X" or blank @1015 6 "STMbnn" or blank Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 699 Section 4 FORM 8865 PAGE 2 Field Identification No. ----- -------------Byte Count Return of U.S. Persons with Respect to Certain ... Form Ref. ---Length -----4 Field Description ----------------"2218" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" "8865bb" "PG02b" N (Primary SSN) | Start of Record Sentinel 1030 1031 1032 1033 Record ID Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number Owns Direct Interest Owns Constructive Interest Name Constructive Ownership Address Constructive Ownership City Constructive Ownership State Constructive Ownership Zip Code Constructive Ownership Identifying Number Constructive Ownership Foreign Person SCH A a SCH A b SCH A SCH A 4 6 6 5 9 1034 1035 1040 1045 *1050 +1060 1 7 1 1 35 35 Blank N 0000001 - 0000005 "X" or blank "X" or blank AN or "STMbnn" OR BLANK AN *+1070 +1080 +1090 SCH A SCH A SCH A 22 2 12 AN or "STMbnn" AN N or nnnnnbbbbbbb or nnnnnnnnnbbb N +1100 SCH A 9 +1110 SCH A August 30, 2002 1 "X" or blank Part II Page 700 Section 4 Publication 1346 FORM 8865 PAGE 2 Field Identification No. ----- -------------+1120 1130 1140 Direct Partner Name Constructive Ownership - 2 Address Constructive Ownership - 2 City Constructive Ownership - 2 State Constructive Ownership - 2 Zip Code Constructive Ownership - 2 Identifying Number Constructive Ownership - 2 Foreign Person - 2 Direct Partner - 2 Name Constructive Ownership - 3 Address Constructive Ownership - 3 City Constructive Ownership - 3 State Constructive Ownership - 3 Zip Code Constructive Ownership - 3 Identifying Number Constructive Ownership Foreign Person - 3 Return of U.S. Persons with Respect to Certain ... Form Ref. ---SCH A SCH A SCH A Length -----1 35 35 Field Description ----------------"X" or blank AN AN 1150 1160 1170 SCH A SCH A SCH A 22 2 12 AN AN N or nnnnnbbbbbbb or nnnnnnnnnbbb N 1180 SCH A 9 1190 1200 1210 1220 SCH A SCH A SCH A SCH A 1 1 35 35 "X" or blank "X" or blank AN AN 1230 1240 1250 SCH A SCH A SCH A 22 2 12 AN AN N or nnnnnbbbbbbb or nnnnnnnnnbbb N 1260 SCH A 9 1270 SCH A August 30, 2002 1 "X" or blank Part II Page 701 Section 4 Publication 1346 FORM 8865 PAGE 2 Field Identification No. ----- -------------1280 1290 1300 Direct Partner - 3 Name Constructive Ownership - 4 Address Constructive Ownership - 4 City Constructive Ownership - 4 State Constructive Ownership - 4 Zip Code Constructive Ownership - 4 Identifying Number Constructive Ownership - 4 Foreign Person - 4 Direct Partner - 4 Name Constructive Ownership - 5 Address Constructive Ownership - 5 City Constructive Ownership - 5 State Constructive Ownership - 5 Zip Code Constructive Ownership - 5 Identifying Number Constructive Ownership - 5 Foreign Person - 5 Return of U.S. Persons with Respect to Certain ... Form Ref. ---SCH A SCH A SCH A Length -----1 35 35 Field Description ----------------"X" or blank AN AN 1310 1320 1330 SCH A SCH A SCH A 22 2 12 AN AN N or nnnnnbbbbbbb or nnnnnnnnnbbb N 1340 SCH A 9 1350 1360 1370 1380 SCH A SCH A SCH A SCH A 1 1 35 35 "X" or blank "X" or blank AN AN 1390 1400 1410 SCH A SCH A SCH A 22 2 12 AN AN N or nnnnnbbbbbbb or nnnnnnnnnbbb N 1420 SCH A 9 1430 SCH A August 30, 2002 1 "X" or blank Part II Page 702 Section 4 Publication 1346 FORM 8865 PAGE 2 Field Identification No. ----- -------------1440 1445 *1450 +1460 *+1470 +1480 +1490 +1500 +1510 1520 1530 1540 1550 1560 1570 1580 1590 1600 1610 1620 Direct Partner - 5 Reserved Name Of Partners Address of Partners City of Partners State of Partners Zip Code of Partners Identifying Number of Partners Foreign Person Check Name Of Partners - 2 Address of Partners - 2 City of Partners - 2 State of Partners 2 Zip Code of Partners - 2 Identifying Number of Partners - 2 Foreign Person Check - 2 Name Of Partners - 3 Address of Partners - 3 City of Partners - 3 State of Partners 3 Return of U.S. Persons with Respect to Certain ... Form Ref. ---SCH A Length -----1 6 SCH A-1 SCH A-1 SCH A-1 SCH A-1 SCH A-1 SCH A-1 SCH A-1 SCH A-1 SCH A-1 SCH A-1 SCH A-1 SCH A-1 SCH A-1 SCH A-1 SCH A-1 SCH A-1 SCH A-1 SCH A-1 August 30, 2002 35 35 22 2 12 9 1 35 35 22 2 12 9 1 35 35 22 2 Field Description ----------------"X" or blank Blank AN, "STMbnn" or blank AN AN OR "STMbnn" AN N or nnnnnbbbbbbb or nnnnnnnnnbbb N "X" or blank AN AN AN AN N or nnnnnbbbbbbb or nnnnnnnnnbbb N "X" or blank AN AN AN AN Part II Page 703 Section 4 Publication 1346 FORM 8865 PAGE 2 Field Identification No. ----- -------------1630 1640 1650 1660 1670 1680 1690 1700 1710 1720 1730 1740 1750 1760 1770 1780 1790 1795 Zip Code of Partners - 3 Identifying Number of Partners - 3 Foreign Person Check - 3 Name Of Partners - 4 Address of Partners - 4 City of Patners - 4 State of Partners 4 Zip Code of Partners - 4 Identifying Number of Partners - 4 Foreign Person Check - 4 Name Of Partners - 5 Address of Partners - 5 City of Partners - 5 State of Partners 5 Zip Code of Partners - 5 Identifying Number of Partners - 5 Foreign Person Check - 5 Reserved Return of U.S. Persons with Respect to Certain ... Form Ref. ---SCH A-1 SCH A-1 SCH A-1 SCH A-1 SCH A-1 SCH A-1 SCH A-1 SCH A-1 SCH A-1 SCH A-1 SCH A-1 SCH A-1 SCH A-1 SCH A-1 SCH A-1 SCH A-1 SCH A-1 Length -----12 9 1 35 35 22 2 12 9 1 35 35 22 2 12 9 1 6 August 30, 2002 Field Description ----------------N or nnnnnbbbbbbb or nnnnnnnnnbbb N "X" or blank AN AN AN AN N or nnnnnbbbbbbb or nnnnnnnnnbbb N "X" or blank AN AN AN AN N or nnnnnbbbbbbb or nnnnnnnnnbbb N "X" or blank Blank Part II Page 704 Section 4 Publication 1346 FORM 8865 PAGE 2 Field Identification No. ----- -------------1800 Other Foreign Person Direct Partner (Yes Box) Other Foreign Person Direct Partner (No Box) Name Of Partnership Address of Partnership City of Partnership State of Partnership Zip Code of Partnership EIN Of Partnership Ordinary Income Or Loss Foreign Partnership Name Of Partnership - 2 Address of Partnership - 2 City of Partnership - 2 State of Partnership - 2 Zip Code of Partnership - 2 EIN of Partnership 2 Ordinary Income Or Loss - 2 Return of U.S. Persons with Respect to Certain ... Form Ref. ---SCH A-1 Length -----1 Field Description ----------------"X" or blank 1810 SCH A-1 1 "X" or blank *1820 +1830 *+1840 +1850 +1860 +1870 +1880 +1890 1900 1910 1920 1930 1940 1950 1960 SCH A-2 SCH A-2 SCH A-2 SCH A-2 SCH A-2 SCH A-2 SCH A-2 SCH A-2 SCH A-2 SCH A-2 SCH A-2 SCH A-2 SCH A-2 SCH A-2 SCH A-2 August 30, 2002 35 35 22 2 12 9 12 1 35 35 22 2 12 9 12 AN or "STMbnn" OR BLANK AN AN or "STMbnn" AN N or nnnnnbbbbbbb or nnnnnnnnnbbb N N "X" or blank AN AN AN AN N or nnnnnbbbbbbb or nnnnnnnnnbbb N N Part II Page 705 Section 4 Publication 1346 FORM 8865 PAGE 2 Field Identification No. ----- -------------1970 1980 1990 2000 2010 2020 2030 2040 2050 2060 2070 2080 2090 2100 2110 2120 Foreign Partnership - 2 Name Of Partnership - 3 Address of Partnership - 3 City of Partnership - 3 State of Partnership - 3 Zip Code of Partnership - 3 EIN of Partnership 3 Ordinary Income Or Loss - 3 Foreign Partnership - 3 Name Of Partnership - 4 Address of Partnership - 4 City of Partnership - 4 State of Partnership - 4 Zip Code of Partnership - 4 EIN of Partnership 4 Ordinary Income Or Loss - 4 Return of U.S. Persons with Respect to Certain ... Form Ref. ---SCH A-2 SCH A-2 SCH A-2 SCH A-2 SCH A-2 SCH A-2 SCH A-2 SCH A-2 SCH A-2 SCH A-2 SCH A-2 SCH A-2 SCH A-2 SCH A-2 SCH A-2 SCH A-2 Length -----1 35 35 22 2 12 9 12 1 35 35 22 2 12 9 12 Field Description ----------------"X" or blank AN AN AN N N or nnnnnbbbbbbb or nnnnnnnnnbbb N N "X" or blank AN AN AN AN N or nnnnnbbbbbbb or nnnnnnnnnbbb N N Publication 1346 August 30, 2002 Part II Page 706 Section 4 FORM 8865 PAGE 2 Field Identification No. ----- -------------2130 2140 2150 2160 2170 2180 2190 2200 2210 2215 2220 @2225 2230 2240 2250 2260 2270 Foreign Partnership - 4 Name Of Partnership - 5 Address of Partnership - 5 City of Partnership - 5 State of Partnership - 5 Zip Code of Partnership - 5 EIN of Partnership 5 Ordinary Income Or Loss - 5 Foreign Partnership - 5 Reserved Gross Receipts Or Sales Attach Schedule of Line 1a Less Returns And Allowances Total Cost Of Goods Sold Gross Profit Ordinary Income (loss) Return of U.S. Persons with Respect to Certain ... Form Ref. ---SCH A-2 SCH A-2 SCH A-2 SCH A-2 SCH A-2 SCH A-2 SCH A-2 SCH A-2 SCH A-2 Length -----1 35 35 22 2 12 9 12 1 6 SCH B 1a SCH B 1a SCH B 1b SCH B 1c SCH B 2 SCH B 3 SCH B 4 12 6 12 12 12 12 12 Field Description ----------------"X" or blank AN AN AN AN N or nnnnnbbbbbbb or nnnnnnnnnbbb N N "X" or blank Blank N "STMbnn" or blank N N N N N Publication 1346 August 30, 2002 Part II Page 707 Section 4 FORM 8865 PAGE 2 Field Identification No. ----- -------------@2275 Ordinary Income (Loss) (Attach Schedule) Net Farm Profit (Loss) Net Gain (loss) Other Income (loss) Other Income (loss) (attach Schedule) Total Income (loss) Salaries & Wages Guaranteed Payments To Partners Repairs & Maintenance Bad Debts Rent Taxes & Licenses Interest Interest Attachment Depreciation Less Depreciation Reported On Schedule A Total Depreciation Depletion Retirement Plans, Etc. Employee Benefits Programs Return of U.S. Persons with Respect to Certain ... Form Ref. ---SCH B 4 Length -----6 Field Description ----------------"STMbnn" or blank 2280 2290 2300 @2305 2310 2320 2330 2340 2350 2360 2370 2380 @2385 2390 2400 SCH B 5 SCH B 6 SCH B 7 SCH B 7 SCH B 8 SCH B 9 SCH B 10 SCH B 11 SCH B 12 SCH B 13 SCH B 14 SCH B 15 SCH B 15 SCH B 16a SCH B 16b 12 12 12 6 12 12 12 12 12 12 12 12 6 12 12 N N N "STMbnn" OR BLANK N N N N N N N N "STMbnn" or blank | N N 2405 2410 2420 2430 SCH B 16c SCH B 17 SCH B 18 SCH B 19 August 30, 2002 12 12 12 12 N N N N Part II Page 708 Section 4 Publication 1346 FORM 8865 PAGE 2 Field Identification No. ----- -------------2440 @2445 2450 2460 @2465 Other Deductions Other Deductions (Attach Schedule) Total Deductions Ordinary Income (Loss) From Trade Form 8865 Page 2 Global Statement Return of U.S. Persons with Respect to Certain ... Form Ref. ---SCH B 20 SCH B 20 SCH B 21 SCH B 22 Length -----12 6 12 12 6 Field Description ----------------N "STMbnn" or blank N N "STMbnn" or blank | Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 709 Section 4 FORM 8865 PAGE 3 Field Identification No. ----- -------------Byte Count Return of U.S. Persons With Respect to Certain ... Form Ref. ---Length -----4 Field Description ----------------"0813" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" "8865bb" "PG03b" N (Primary SSN) Start of Record Sentinel 2470 2471 2472 2473 Record ID Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number S-T Description of Property S-T Date Acquired S-T Date Sold S-T Sales Price S-T Cost or Other Basis S-T Gain or Loss S-T Description of Property - 2 S-T Date Acquired 2 S-T Date Sold - 2 S-T Sales Price - 2 S-T Cost or Other Basis - 2 S-T Gain or Loss - 2 SCH D 1(a) SCH D 1(b) SCH D 1(c) SCH D 1(d) SCH D 1(e) SCH D 1(f) SCH D 1(a) SCH D 1(b) SCH D 1(c) SCH D 1(d) SCH D 1(e) SCH D 1(f) 4 6 6 5 9 2474 2475 *2480 +2490 +2500 +2510 +2520 +2530 2540 2550 2560 2570 2580 2590 1 7 15 8 8 12 12 12 15 8 8 12 12 12 Blank N 0000001 - 0000005 AN, "STCGL", or blank | YYYYMMDD, or "VARIOUS" | YYYYMMDD N, or "EXPIRED" N, or "EXPIRED" N AN 'See 1st Occ.' YYYYMMDD N, or "EXPIRED" N, or "EXPIRED" N Part II Page 710 Section 4 | | | Publication 1346 August 30, 2002 FORM 8865 PAGE 3 Field Identification No. ----- -------------2600 2610 2620 2630 2640 2650 2660 2670 2680 2690 2700 2710 2715 2720 S-T Description of Property - 3 S-T Date Acquired 3 S-T Date Sold - 3 S-T Sales Price - 3 S-T Cost or Other Basis - 3 S-T Gain or Loss - 3 S-T Description of Property - 4 S-T Date Acquired 4 S-T Date Sold - 4 S-T Sales Price - 4 S-T Cost or Other Basis - 4 S-T Gain or Loss - 4 Reserved S-T Capital Gain From Installment Sales S-T Capital Gain (Loss) Like-Kind Exchange Partnership's Share Net S-T Capital Gain (Loss) Net Short-Term Capital Gain Or (Loss) Return of U.S. Persons With Respect to Certain ... Form Ref. ---SCH D 1(a) SCH D 1(b) SCH D 1(c) SCH D 1(d) SCH D 1(e) SCH D 1(f) SCH D 1(a) SCH D 1(b) SCH D 1(c) SCH D 1(d) SCH D 1(e) SCH D 1(f) Length -----15 8 8 12 12 12 15 8 8 12 12 12 6 SCH D 2 12 Field Description ----------------AN 'See 1st Occ.' YYYYMMDD N, or "EXPIRED" N, or "EXPIRED" N AN 'See 1st Occ.' YYYYMMDD N, or "EXPIRED" N, or "EXPIRED" N Blank N | | 2730 SCH D 3 12 N 2740 SCH D 4 12 N 2750 SCH D 5 12 N Publication 1346 August 30, 2002 Part II Page 711 Section 4 FORM 8865 PAGE 3 Field Identification No. ----- -------------*2760 +2770 +2780 +2790 +2800 +2810 +2820 2830 2840 2850 2860 2870 2880 2890 2900 2910 2920 2930 2940 L-T Description of Property L-T Date Acquired L-T Date Sold L-T Sales Price L-T Cost or Other Basis L-T Gain or Loss L-T 28% Rate Gain or Loss L-T Description of Property - 2 L-T Date Acquired 2 L-T Date Sold - 2 L-T Sales Price - 2 L-T Cost or Other Basis - 2 L-T Gain or Loss - 2 L-T 28% Rate Gain or Loss - 2 L-T Description of Property - 3 L-T Date Acquired 3 L-T Date Sold-3 L-T Sales Price- 3 L-T Cost or Other Basis - 3 Return of U.S. Persons With Respect to Certain ... Form Ref. ---SCH D 6(a) SCH D 6(b) SCH D 6(c) SCH D 6(d) SCH D 6(e) SCH D 6(f) SCH D 6(g) SCH D 6(a) SCH D 6(b) SCH D 6(c) SCH D 6(d) SCH D 6(e) SCH D 6(f) SCH D 6(g) SCH D 6(a) SCH D 6(b) SCH D 6(c) SCH D 6(d) SCH D 6(e) August 30, 2002 Length -----15 8 8 12 12 12 12 15 8 8 12 12 12 12 15 8 8 12 12 Field Description ----------------AN or "LTCGL" or blank | YYYYMMDD, or "INHERIT", | or "VARIOUS" YYYYMMDD N, or "EXPIRED" N, or "EXPIRED" N N AN 'See 1st Occ.' YYYYMMDD N, or "EXPIRED" N, or "EXPIRED" N N AN 'See 1st Occ.' YYYYMMDD N, or "EXPIRED" N, or "EXPIRED" Part II Page 712 Section 4 | | | Publication 1346 FORM 8865 PAGE 3 Field Identification No. ----- -------------2950 2960 2970 2980 2990 3000 3010 3020 3030 3035 3040 L-T Gain or Loss - 3 L-T 28% Rate Gain or Loss - 3 L-T Description of Property - 4 L-T Date Acquired 4 L-T Date Sold - 4 L-T Sales Price - 4 L-T Cost or Other Basis - 4 L-T Gain or Loss - 4 L-T 28% Rate Gain or Loss - 4 Reserved L-T Capital Gain Installment Sales Gain or (Loss) L-T Capital Gain Installment Sales 28% Rate Gain Long-term Capital Gain Like-Kind Exchange Gain L-T Capital Gain Like-Kind Exch 28% Rate Gain Partnership's Share Net L-T Capital Gain Or (Loss) Partnership's Share Net L-T Capital 28% Rate Gain Return of U.S. Persons With Respect to Certain ... Form Ref. ---SCH D 6(f) SCH D 6(g) SCH D6(a) SCH D 6(b) SCH D 6(c) SCH D 6(d) SCH D 6(e) SCH D 6(f) SCH D 6(g) Length -----12 12 15 8 8 12 12 12 12 6 SCH D 7(f) 12 Field Description ----------------N N AN 'See 1st Occ.' YYYYMMDD N, or "EXPIRED" N, or "EXPIRED" N N Blank N | 3050 SCH D 7(g) 12 N 3060 SCH D 8(f) 12 N 3070 SCH D 8(g) 12 N 3080 SCH D 9(f) 12 N 3090 SCH D 9(g) 12 N Publication 1346 August 30, 2002 Part II Page 713 Section 4 FORM 8865 PAGE 3 Field Identification No. ----- -------------3100 3110 Capital Gain Distributions Capital Gain Distributions 28% Rate Gain Or (Loss) Combine Lines 6-10 In Column (g) Net Long-Term Capital Gain Or Loss Form 8865, Page 3, Global Statement Return of U.S. Persons With Respect to Certain ... Form Ref. ---SCH D10(f) SCH D19(g) Length -----12 12 Field Description ----------------N N 3120 3130 @3135 SCH D11(g) SCH D12(f) 12 12 6 N N "STMbnn" or blank Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 714 Section 4 FORM 8865 PAGE 4 Field Identification No. ----- -------------Byte Count Return of U.S. Persons with Respect to Certain ... Form Ref. ---Length -----4 Field Description ----------------"0646" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" "8865bb" "PG04b" N (Primary SSN) | Start of Record Sentinel 3140 3141 3142 3143 Record ID Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number Ordinary Income (Loss) From Trade Or Business Net Income (Loss) From Rental Gross Income From Other Rental Activities Expenses From Other Rental Activities Expenses (Attach Schedule) Net Income (Loss) From Other Rental Activities Interest Income Ordinary Dividends Royalty Income SCH K 1 4 6 6 5 9 3144 3145 3150 1 7 12 Blank N 0000001 - 0000005 N 3160 3170 SCH K 2 SCH K 3a 12 12 N N 3180 @3185 3190 SCH K 3b SCH K 3b SCH K 3c 12 6 12 N "STMbnn" OR BLANK N 3200 3210 3220 SCH K 4a SCH K 4b SCH K 4c August 30, 2002 12 12 12 N N N Part II Page 715 Section 4 Publication 1346 FORM 8865 PAGE 4 Field Identification No. ----- -------------3230 3240 3250 3260 3270 @3275 Net Short-term Capital Gain (Loss) Net Long-term Capital Gain (Loss) 28% Rate Gain (Loss) Qualified 5-Year Gain Other Portfolio Income (Loss) Other Portfolio Income (Loss) (Attach Schedule) Guaranteed Payments To Partners Net Section 1231 Gain (Loss) Other Income (Loss) Other Income (Loss) (Attach Schedule) Charitable Contributions Charitable Contributions (Attach Schedule) Section 179 Expense Deduction Deductions Related To Portfolio Income Deductions Related To Portfolio Income (Itemize) Other Deductions Return of U.S. Persons with Respect to Certain ... Form Ref. ---SCH K 4d SCH K4e(1) SCH K4e(2) SCH K4e(3) SCH K 4f SCH K 4f Length -----12 12 12 12 12 6 Field Description ----------------N N N N N "STMbnn" OR BLANK 3280 3290 3300 @3305 3310 @3315 SCH K 5 SCH K 6 SCH K 7 SCH K 7 SCH K 8 SCH K 8 12 12 12 6 12 6 N N N "STMbnn" OR BLANK N "STMbnn" OR BLANK 3320 3330 @3335 SCH K 9 SCH K 10 SCH K 10 12 12 6 N N "STMbnn" OR BLANK 3340 SCH K 11 August 30, 2002 12 N Part II Page 716 Section 4 Publication 1346 FORM 8865 PAGE 4 Field Identification No. ----- -------------@3345 3350 Other Deductions (Attach Schedule) Low-income Housing Credit-Section 42(J)(5) Line 12a(1) Attachment Low-income Housing Credit Other Line 12a(2) Attachment Expenditures Related To Rental Real Estate Statement Reference - BMF Use Only Credits Related To Rental Real State Type Of Rental Credit Statement Reference - BMF Use Only Credits Related To Other Rental Activities Type Of Other Rental Credit Statement Reference - BMF Use Only Other Credits Type Of Other Credit Statement Reference - BMF Use Only Return of U.S. Persons with Respect to Certain ... Form Ref. ---SCH K 11 SCHK12a(1) Length -----6 12 Field Description ----------------"STMbnn" OR BLANK N @3355 3360 @3365 *3390 SCHK12a(1) SCHK12a(2) SCHK12a(2) SCH K 12b 6 12 6 12 "STMbnn" or blank | N "STMbnn" or blank | N or "STMbnn" or blank 3397 *3400 +3405 3407 *3410 SCH K 12b SCH K 12c SCH K 12c SCH K 12c SCH K 12d 6 12 15 6 12 Blank --| | N or "STMbnn" or blank AN Blank | N or "STMbnn" or blank +3415 3417 *3420 +3425 @3427 SCH K 12d SCH K 12d SCH K 13 SCH K 13 SCH K 13 August 30, 2002 15 6 12 15 6 AN Blank | N or "STMbnn" or blank AN Blank | Part II Page 717 Section 4 Publication 1346 FORM 8865 PAGE 4 Field Identification No. ----- -------------3430 3440 3450 3460 3470 3480 3490 3500 @3505 3510 3520 Interest Expense On Investment Debts Investment Income Investment Expenses Net Earnings (Loss) From Self-Employment Gross Farming Or Fishing Income Gross Nonfarm Income Depreciation Adjustment Adjusted Gain Or Loss Adjusted Gain or Loss Attachment Depletion (Other Than Oil And Gas) Gross Income From Oil Gas, & Geothermal Properties Oil, Gas & Geothermal Attachment Deductions Allocable To Oil Gas & Geothermal Prop. Deductions Oil, Gas Attachment Other Adjustments & Tax Preference Items Other Adjustments (Attach Schedule) Return of U.S. Persons with Respect to Certain ... Form Ref. ---SCH K 14a SCHK14b(1) SCHK14b(2) SCHK15a SCHK15b SCHK15c SCHK16a SCH K 16b SCH K 16b SCH K 16c SCHK16d(1) Length -----12 12 12 12 12 12 12 12 6 12 12 Field Description ----------------N N N N N N N N "STMbnn" or blank | N N @3525 SCHK16d(1) 6 "STMbnn" or blank | 3530 SCHK16d(2) 12 N @3535 3540 @3545 SCHK16d(2) SCH K 16e SCH K 16e August 30, 2002 6 12 6 "STMbnn" or blank | N "STMbnn" OR BLANK Part II Page 718 Section 4 Publication 1346 FORM 8865 PAGE 4 Field Identification No. ----- -------------@3547 Form 8865 Page 4 Global Statement Return of U.S. Persons with Respect to Certain ... Form Ref. ---Length -----6 Field Description ----------------"STMbnn" or blank | Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 719 Section 4 FORM 8865 PAGE 5 Field Identification No. ----- -------------Byte Count Return of U.S. Persons with Respect to Certain ... Form Ref. ---Length -----4 Field Description ----------------"1174" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" "8865bb" "PG05b" N (Primary SSN) | Start of Record Sentinel 3560 3561 3562 3563 Record ID Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number Name Of Foreign Country Or U.S. Possession Foreign Country Attachment Gross Income From All Sources Gross Income Sourced At Partner Level Schedule of Reductions Passive Income Listed Categories Income Listed Categories Income (Attach Schedule) General Limitation Income SCH K 17a 4 6 6 5 9 3564 3565 3570 1 7 35 Blank N 0000001 - 0000005 AN @3573 3575 3580 SCH K 17a SCH K 17b SCH K 17c 6 12 12 "STMbnn" or blank | N N @3585 3590 3600 @3605 SCH K 17c SCHK17d(1) SCHK17d(2) SCHK17d(2) 6 12 12 6 "STMbnn" or blank | N N "STMbnn" OR BLANK 3610 SCHK17d(3) August 30, 2002 12 N Part II Page 720 Section 4 Publication 1346 FORM 8865 PAGE 5 Field Identification No. ----- -------------3620 3630 3640 3650 @3655 Interest Expense At Partner Level Other At Partner Level Passive Deductions Listed Categories Deductions Listed Categories Deductions (Attach Schedule) General Limitation Deductions Foreign Taxes (Paid) Foreign Taxes (Accrued) Total Foreign Taxes Total Foreign Taxes Attachment Reduction In Taxes Available Reduction In Taxes Available (Attach Schedule) Section 59(e)(2) Expenditures: type Section 59(e)(2) Expenditure: Amount Expenditures Attachment Tax-Exempt Interest Income Other Tax-Exempt Income Return of U.S. Persons with Respect to Certain ... Form Ref. ---SCHK17e(1) SCHK17e(2) SCHK17f(1) SCHK17f(2) SCHK17f(2) Length -----12 12 12 12 6 Field Description ----------------N N N N "STMbnn" OR BLANK 3660 3670 3680 3690 @3695 3700 @3705 SCHK17f(3) SCH K 17g SCH K 17g SCH K 17g SCH K 17g SCH K 17h SCHK17h 12 1 1 12 6 12 6 N "X" or blank "X" or blank N "STMbnn" or blank | N "STMbnn" OR BLANK 3720 3730 @3735 3740 3750 SCHK18a SCH K 18b SCH K 18b SCH K 19 SCH K 20 August 30, 2002 50 12 6 12 12 AN N "STMbnn" or blank | N N Part II Page 721 Section 4 Publication 1346 FORM 8865 PAGE 5 Field Identification No. ----- -------------3760 3770 @3775 Nondeductible Expenses Distributions Of Money Adjusted Basis & FMV Of Securities (Attach) Distributions Of Property Other Than Money Adjusted Basis & FMV Of Property (Attach) Other Items & Amounts (Attach Schedule) Global Schedule K Attachments Cash Beginning Of Tax Year Cash End Of Tax Year Trade Notes Beginning Of Tax Year Trade Notes End Of Tax Year Less Allowance For Bad Debts Beg. Of Tax Year Less Allowance For Bad Debts Beg. Of Tax Year Less Allowance For Bad Debts End Of Tax Year Return of U.S. Persons with Respect to Certain ... Form Ref. ---SCH K 21 SCH K 22 SCH K 22 Length -----12 12 6 Field Description ----------------N N "STMbnn" or blank 3780 SCH K 23 12 N @3785 SCH K 23 6 "STMbnn" or blank @3790 SCH K 24 6 "STMbnn" OR BLANK @3795 3800 3810 3820 SCH K SCH L 1(b) SCH L 1(d) SCH L2a(a) 6 12 12 12 "STMbnn" or blank N N N 3830 3840 SCH L2a(c) SCH L2b(a) 12 12 N N 3850 SCH L2b(b) 12 N 3860 SCH L2b(c) 12 N Publication 1346 August 30, 2002 Part II Page 722 Section 4 FORM 8865 PAGE 5 Field Identification No. ----- -------------3870 Less Allowance For Bad Debts End Of Tax Year Inventories Beginning Of Tax Year Inventories End Of Tax Year U.S. Government Obligations Beginning Of Tax Year U.S. Government Obligations End Of Tax Year Tax-Exempt Securities Beginning Of Tax Year Tax-Exempt Securities End Of Tax Year Other Current Assets Beginning Of Tax Year Other Current Assets End Of Tax Year Other Current Assets (Attach Schedule) Mortgage & Real Estate Loans Beginning Of Tax Year Return of U.S. Persons with Respect to Certain ... Form Ref. ---SCH L2b(d) Length -----12 Field Description ----------------N 3880 SCH L 3(b) 12 N 3890 3900 SCH L3(d) SCH L 4(b) 12 12 N N 3910 SCH L 4(d) 12 N 3920 SCH L 5(b) 12 N 3930 SCH L 5(d) 12 N 3940 SCH L 6(b) 12 N --| 3950 SCH L 6(d) 12 N @3955 SCH L 6 6 "STMbnn" OR BLANK 3960 SCH L 7(b) 12 N Publication 1346 August 30, 2002 Part II Page 723 Section 4 FORM 8865 PAGE 5 Field Identification No. ----- -------------3970 Mortgage & Real Estate Loans End Of Tax Year Other Investment Beginning Of Tax Year Other Investments End Of Tax Year Other Investments (Attach Schedule) Buildings & Other Assets Beginning Of Tax Year Buildings & Other Depreciable Assets End Of TY Less Accumulated Depreciation Beg. Of Tax Year Less Depreciation Beginning Of Tax Year Less Accumulated Depreciation End Of Tax Year Less Depreciation End of Tax Year Depletable Assets Beginning Of Tax Year Depletable Assets End Of Tax Year Less Accumulated Depletion Beginning Of Tax Year Return of U.S. Persons with Respect to Certain ... Form Ref. ---SCH L 7(d) Length -----12 Field Description ----------------N 3980 SCH L 8(b) 12 N --| 3990 @3995 4000 SCH L 8(d) SCH L 8 SCH L9a(a) 12 6 12 N "STMbnn" OR BLANK N 4010 SCH L9a(c) 12 N 4020 SCH L9b(a) 12 N 4030 SCH L9b(b) 12 N 4040 SCH L9b(c) 12 N 4050 4060 SCH L9b(d) SCHL10a(a) 12 12 N N 4070 4080 SCHL10a(c) SCHL10b(a) 12 12 N N Publication 1346 August 30, 2002 Part II Page 724 Section 4 FORM 8865 PAGE 5 Field Identification No. ----- -------------4090 Less Depletion Beginning Of Tax Year Less Accumulated Depletion End of Tax Year Less Depletion End of Tax Year Land Beginning Of Tax Year Land End Of Tax Year Intangible Assets Beginning Of Tax Year Intangible Assets End Of Tax Year Less Accumulated Amortization Beg. Of Tax Year Less Amortization Beginning Of Tax Year Less Accumulated Amortization End Of Year Less Amortization End Of Tax Year Other Assets Beginning Of Tax Year Other Assets End Of Tax Year Other Assets (Attach Schedule) Return of U.S. Persons with Respect to Certain ... Form Ref. ---SCHL10b(b) Length -----12 Field Description ----------------N 4100 SCHL10b(c) 12 N 4110 4120 4130 4140 SCHL10b(d) SCHL11(b) SCHL11(d) SCHL12a(a) 12 12 12 12 N N N N 4150 4160 SCHL12a(c) SCHL12b(a) 12 12 N N 4170 SCHL12b(b) 12 N 4180 SCHL12b(c) 12 N 4190 4200 SCHL12b(d) SCHL13(b) 12 12 N N --| 4210 @4215 SCH L13(d) SCH L 13 August 30, 2002 12 6 N "STMbnn" OR BLANK Part II Page 725 Section 4 Publication 1346 FORM 8865 PAGE 5 Field Identification No. ----- -------------4220 Total Assets Beginning Of Tax Year Total Assets End Of Tax Year Accounts Payable Beginning Of Tax Year Accounts Payable End Of Tax Year Mortgages Payable Less Than 1 Year BOY Mortgages Payable Less Than 1 Year EOY Other Current Liabilities Beginning Of Tax Year Reserved Other Current Liabilities End Of Tax Year Other Current Liabilities (Attach Schedule) All Nonrecourse Loans Beginning Of Tax Year All Nonrecourse Loans End Of Tax Year Mortgage Payable 1 Year Or More BOY Mortgages Payable in 1 Year Or More EOY Return of U.S. Persons with Respect to Certain ... Form Ref. ---SCH L14(b) Length -----12 Field Description ----------------N 4230 4240 SCH L14(d) SCH L15(b) 12 12 N N 4250 4260 4270 4280 SCH L15(d) SCHL16(b) SCH L16(d) SCH L17(b) 12 12 12 12 N N N N 4285 4290 SCH L17(b) SCH L17(d) 6 12 Blank N @4295 SCH L 17 6 "STMbnn" OR BLANK 4300 SCH L18(b) 12 N 4310 SCH L18(d) 12 N 4320 4330 SCH L19(b) SCH L19(d) 12 12 N N Publication 1346 August 30, 2002 Part II Page 726 Section 4 FORM 8865 PAGE 5 Field Identification No. ----- -------------4340 Other Liabilities Beginning Of Tax Year Other Liabilities End Of Tax Year Other Liabilities (Attach Schedule) Partner's Capital Accounts Beginning Of Tax Year Partner's Capital Accounts End Of Tax Year Total Liabilities & Capital Beginning Of Tax Year Total Liabilities & Capital End Of Tax Year Form 8865 Page 5 Global Statement Return of U.S. Persons with Respect to Certain ... Form Ref. ---SCH L20(b) Length -----12 Field Description ----------------N --| 4350 @4355 4360 SCH L20(d) SCH L 20 SCH L21(b) 12 6 12 N "STMbnn" OR BLANK N 4370 SCH L21(d) 12 N 4380 SCH L22(b) 12 N 4390 SCH L22(d) 12 N @4395 6 "STMbnn" or blank | Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 727 Section 4 FORM 8865 PAGE 6 Field Identification No. ----- -------------Byte Count Return of U.S. Persons with Respect to Certain ... Form Ref. ---Length -----4 Field Description ----------------"0517" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" "8865bb" "PG06b" N (Primary SSN) | Start of Record Sentinel 4410 4411 4412 4413 Record ID Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number Total U.S. Assets Beginning Of Tax Year Total U.S. Assets End Of Tax Year Passive Income Category Beginning Of Tax Year Passive Income Category End Of Tax Year Listed Categories Beginning Of Tax Year Listed Categories End Of Tax Year Listed Categories (Attach Schedule) General Limitation Income Category BOY SCH M 1(a) 4 6 6 5 9 4414 4415 4420 1 7 12 Blank N 0000001 - 0000005 N 4430 4440 SCH M 1(b) SCH M2a(a) 12 12 N N 4450 SCH M2a(b) 12 N 4460 SCH M2b(a) 12 N --| 4470 @4475 4480 SCH M2b(b) SCH M 2b SCH M2c(a) August 30, 2002 12 6 12 N "STMbnn" OR BLANK N Part II Page 728 Section 4 Publication 1346 FORM 8865 PAGE 6 Field Identification No. ----- -------------4490 General Limitation Income Category End Of Tax Year Net Income (Loss) Per Books Income Included On Schedule K Income Included On Schedule K (Itemize) Guaranteed Payments Depreciation Expenses Travel & Entertainment Attach Statement For Other Expenses Total For Other Expenses Total Expenses Line 4 Add Lines 1-4 Tax Exempt Interest Attach Statement For Other Income Total For Other Income Total Income Line 6a Depreciation Deductions Attach Statement For Other Deductions Return of U.S. Persons with Respect to Certain ... Form Ref. ---SCH M2c(b) Length -----12 Field Description ----------------N 4500 4510 @4515 4520 4530 4540 @4545 4550 4560 4570 4580 @4585 4590 4600 4610 @4615 SCH M-1 SCH M-1 SCH M-1 SCH M-1 1 2 2 3 12 12 6 12 12 12 6 12 12 12 12 6 12 12 12 6 N N "STMbnn" or blank N N N "STMbnn" or blank N N N N "STMbnn" or blank N N N "STMbnn" or blank SCH M-1 4a SCH M-1 4b SCH M-1 4 SCH M-1 4b SCH M-1 4b SCH M-1 5 SCH M-1 6a SCH M-1 6a SCH M-1 6a SCH M-1 6a SCH M-1 7a SCH M-1 7a Publication 1346 August 30, 2002 Part II Page 729 Section 4 FORM 8865 PAGE 6 Field Identification No. ----- -------------4620 4630 4640 4650 4660 Total For Other Deductions Total Deductions Line 7a Add Lines 6 And 7 Income (Loss) Capital Accounts Balance Beginning Of Year Capital Contributed During Year - Cash Capital Contributed During Year Property Net Income (Loss) Per Books Other Increases (itemize) Total Other Increases Capital Accounts. Add Lines 1-4 Distributions: Cash Distributions: Property Other Decreases (Itemize) Total Other Decreases Capital Accounts. Add Lines 6 And 7 Capital Accounts. Balance End Of Year Return of U.S. Persons with Respect to Certain ... Form Ref. ---SCH M-1 7a SCH M-1 7a SCH M-1 8 SCH M-1 SCH M-2 9 1 Length -----12 12 12 12 12 Field Description ----------------N N N N N 4670 4675 SCH M-2 2a SCH M-2 2b 12 12 N N | | 4680 @4685 4690 4700 4710 4720 @4725 4730 4740 4750 SCH M-2 SCH M-2 SCH M-2 SCH M-2 3 4 4 5 12 6 12 12 12 12 6 12 12 12 N "STMbnn" OR BLANK N N N N "STMbnn" OR BLANK N N N Part II Page 730 Section 4 SCH M-2 6a SCH M-2 6b SCH M-2 SCH M-2 SCH M-2 SCH M-2 7 7 8 9 Publication 1346 August 30, 2002 FORM 8865 PAGE 6 Field Identification No. ----- -------------@4755 Reconcile Schedule L Differences Attachment Form 8865 Page 6 Global Statement Return of U.S. Persons with Respect to Certain ... Form Ref. ---SCH M-2 Length -----6 Field Description ----------------"STMbnn" or blank @4757 6 "STMbnn" or blank | Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 731 Section 4 FORM 8865 PAGE 7 Field Identification No. ----- -------------Byte Count Return of U.S. Persons with Respect to Certain ... Form Ref. ---Length -----4 Field Description ----------------"1057" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" "8865bb" "PG07b" N (Primary SSN) | Start of Record Sentinel 4770 4771 4772 4773 Record ID Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number Sales Of Inventory U.S. Person Filing Return Sales Of Inventory Domestic Corporation Sales Of Inventory Foreign Corporation Sales Of Inventory Person With 10% Sales Of Property Rights U.S. Person Filing Return Sales Of Property Rights Domestic Corporation Sales Of Property Rights Foreign Corporation SCH N 1(a) 4 6 6 5 9 4774 4775 4780 1 7 12 Blank N 0000001 - 0000005 N 4790 SCH N 1(b) 12 N 4800 4810 4820 SCH N 1(c) SCH N 1(d) SCH N 2(a) 12 12 12 N N N 4830 SCH N 2(b) 12 N 4840 SCH N 2(c) 12 N Publication 1346 August 30, 2002 Part II Page 732 Section 4 FORM 8865 PAGE 7 Field Identification No. ----- -------------4850 Sales Of Property Rights Person With 10% Compensation Received U.S. Person Filing Return Compensation Received-Domestic Corporation Compensation Received-Foreign Corporation Compensation Received-Person With 10% Commissions Received-U.S. Person Filing Return Commissions Received-Domestic Corporation Commissions Received-Foreign Corporation Commissions Received Person With 10% Rents Received-U.S. Person Rents ReceivedDomestic Corporation Rents ReceivedForeign Corporation Rents ReceivedPerson With 10% Return of U.S. Persons with Respect to Certain ... Form Ref. ---SCH N 2(d) Length -----12 Field Description ----------------N 4860 SCH N 3(a) 12 N 4870 SCH N 3(b) 12 N 4880 SCH N 3(c) 12 N 4890 SCH N 3(d) 12 N 4900 SCH N 4(a) 12 N 4910 SCH N 4(b) 12 N 4920 SCH N 4(c) 12 N 4930 SCH N 4(d) 12 N 4940 4950 4960 4970 SCH N 5(a) SCH N 5(b) SCH N 5(c) SCH N 5(d) 12 12 12 12 N N N N Publication 1346 August 30, 2002 Part II Page 733 Section 4 FORM 8865 PAGE 7 Field Identification No. ----- -------------4980 Distributions Received-U.S. Person Filing Return Distributions Received-Domestic Corporation Distributions Received-Foreign Corporation Distributions Received-Person With 10% Interest ReceivedU.S. Person Filing Return Interest ReceivedDomestic Corporation Interest ReceivedForeign Corporation Interest ReceivedPerson With 10% Other U.S. Person Other Domestic Corporation Other Foreign Corporation Other Person With 10% Add Lines 1-8 U.S. Person Add Lines 1-8 Domestic Corporation Add Lines 1-8 Foreign Corporation Return of U.S. Persons with Respect to Certain ... Form Ref. ---SCH N 6(a) Length -----12 Field Description ----------------N 4990 SCH N 6(b) 12 N 5000 SCH N 6(c) 12 N 5010 SCH N 6(d) 12 N 5020 SCH N 7(a) 12 N 5030 5040 5050 5060 5070 5080 5090 5100 5110 5120 SCH N 7(b) SCH N 7(c) SCH N 7(d) SCH N 8(a) SCH N 8(b) SCH N 8(c) SCH N 8(d) SCH N 9(a) SCH N 9(b) SCH N 9(c) 12 12 12 12 12 12 12 12 12 12 N N N N N N N N N N Part II Page 734 Section 4 Publication 1346 August 30, 2002 FORM 8865 PAGE 7 Field Identification No. ----- -------------5130 5140 Add Lines 1-8 Person With 10% Purchases Of Inventory - U.S. Person Purchases Of Inventory Domestic Corporation Purchases Of Inventory - Foreign Corporation Purchases Of Inventory - Person With 10% Purchases Of Tangible Property U.S. Person Purchases Of Tangible PropertyDomestic Corp. Purchases Of Tangible PropertyForeign Corporation Purchases Of Tangible PropertyPerson With 10% Purchases Of Property RightsU.S. Person Purchases Of Property RightsDomestic Corporation Purchases Of Property RightsForeign Corporation Return of U.S. Persons with Respect to Certain ... Form Ref. ---SCH N 9(d) SCH N10(a) Length -----12 12 Field Description ----------------N N 5150 SCH N10(b) 12 N 5160 SCH N10(c) 12 N 5170 SCH N10(d) 12 N 5180 SCH N11(a) 12 N 5190 SCH N11(b) 12 N 5200 SCH N11(c) 12 N 5210 SCH N11(d) 12 N 5220 SCH N12(a) 12 N 5230 SCH N12(b) 12 N 5240 SCH N12(c) 12 N Publication 1346 August 30, 2002 Part II Page 735 Section 4 FORM 8865 PAGE 7 Field Identification No. ----- -------------5250 Purchases Of Property RightsPerson With 10% Compensation PaidU.S. Person Compensation PaidDomestic Corporation Compensation PaidForeign Corporation Compensation Paid Person With 10% Commissions PaidU.S. Person Commissions PaidDomestic Corporation Commissions PaidForeign Corporation Commissions PaidPerson With 10% Rents Paid - U.S. Person Rents Paid-Domestic Corporation Rents Paid Foreign Corporation Rents Paid Person With 10% Distributions PaidU.S. Person Distributions Paid Domestic Corporation Distributions PaidForeign Corporation Return of U.S. Persons with Respect to Certain ... Form Ref. ---SCH N12(d) Length -----12 Field Description ----------------N 5260 5270 5280 5290 5300 5310 5320 5330 5340 5350 5360 5370 5380 5390 SCH N13(a) SCH N13(b) SCH N13(c) SCH N13(d) SCH N14(a) SCH N14(b) SCH N14(c) SCH N14(d) SCH N15(a) SCH N15(b) SCH N15(c) SCH N15(d) SCH N16(a) SCH N16(b) 12 12 12 12 12 12 12 12 12 12 12 12 12 12 N N N N N N N N N N N N N N 5400 SCH N16(c) August 30, 2002 12 N Part II Page 736 Section 4 Publication 1346 FORM 8865 PAGE 7 Field Identification No. ----- -------------5410 5420 5430 5440 5450 5460 5470 5480 5490 5500 5510 5520 5530 5540 5550 5560 Distributions Paid Person With 10% Interest Paid U.S. Person Interest Paid Domestic Corporation Interest Paid Foreign Corporation Interest Paid Person With 10% Other Paid - U.S. Person Other Paid Domestic Corporation Other Paid Foreign Corporation Other Paid - Person With 10% Add Lines 10-18 U.S. Person Add Lines 10-18 Domestic Corporation Add Lines 10-18 Foreign Corporation Add Lines 10-18 Person With 10% Amounts Borrowed U.S. Person Amounts BorrowedDomestic Corporation Amounts Borrowed Foreign Corporation Return of U.S. Persons with Respect to Certain ... Form Ref. ---SCH N16(d) SCH N17(a) SCH N17(b) SCH N17(c) SCH N17(d) SCH N18(a) SCH N18(b) SCH N18(c) SCH N18(d) SCH N19(a) SCH N19(b) SCH N19(c) SCH N19(d) SCH N20(a) SCH N20(b) SCH N20(c) Length -----12 12 12 12 12 12 12 12 12 12 12 12 12 12 12 12 Field Description ----------------N N N N N N N N N N N N N N N N Publication 1346 August 30, 2002 Part II Page 737 Section 4 FORM 8865 PAGE 7 Field Identification No. ----- -------------5570 5580 5590 5600 5610 @5615 Amounts Borrowed Person With 10% Amounts Loaned U.S Person Amounts Loaned Domestic Corporation Amounts LoanedForeign Corporation Amounts Loaned Person With 10% Form 8865 Page 7 Global Statement Return of U.S. Persons with Respect to Certain ... Form Ref. ---SCH N20(d) SCH N21(a) SCH N21(b) SCH N21(c) SCH N21(d) Length -----12 12 12 12 12 6 Field Description ----------------N N N N N "STMbnn" or blank | Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 738 Section 4 SCHEDULE K-1 PAGE 1 (FORM 8865) Field Identification No. ----- -------------Byte Count Form Ref. ---- Partner's Share of Income, Credits, Deductions, .. Length -----4 Field Description ----------------"0882" for Fixed; "nnnn" for variable format Value "****" "SCHbK1" "8865bb" "PG01b" N (Primary SSN) | Start of Record Sentinel 0000 0001 0002 0003 Record ID Schedule Type Page Number Taxpayer Identification Number Filler Schedule Occurrence Number Fiscal Year Beginning Fiscal Year Ending Partner's Identifying Number (EIN or SSN) Partner's Name 1 Partner's Address 1 Partner's City Partner's State Partner's Zip Code 4 6 6 5 9 0004 0005 0010 0020 0030 1 7 8 8 9 Blank N 0000001 - 0000005 YYYYMMDD YYYYMMDD N, "APPLD FOR" OR "FOREIGNUS" AN AN AN A OR ".b" N OR nnnnnbbbbbbb OR nnnnnnnnnbbb OR BLANK --| --| --| --| --| N or "FOREIGNUS" | Part II Page 739 Section 4 | | 0040 0050 0060 0070 0080 35 35 22 2 12 0140 Identifying Number August 30, 2002 9 Publication 1346 SCHEDULE K-1 PAGE 1 (FORM 8865) Field Identification No. ----- -------------0150 0160 0170 0180 0190 0200 Partnership's Name 1 Partnership's Name 2 Partnership's Address Partnership's City Partnership's State Partnership's Zip Code Partner's % Of Profits Beginning Of Tax Year Partner's % Of Profits End Of Tax Year Partner's % Of Capital Beginning Of Tax Year Partner's % Of Capital End Of Tax Year Partner's % Of Deductions Beginning Of Tax Year Partner's % Of Deductions End Of Tax Year Partner's % Of Losses Beginning Of Tax Year Partner's % Of Losses End Of Tax Year (a) Form Ref. ---- Partner's Share of Income, Credits, Deductions, .. Length -----35 35 35 22 2 12 Field Description ----------------AN AN AN AN A OR ".b" N or nnnnnbbbbbbb or nnnnnnnnnbbb or blank R 0210 6 0220 (b) 6 R 0230 (a) 6 R 0240 (b) 6 R 0250 (a) 6 R 0260 (b) 6 R 0270 (a) 6 R 0280 (b) 6 R Publication 1346 August 30, 2002 Part II Page 740 Section 4 SCHEDULE K-1 PAGE 1 (FORM 8865) Field Identification No. ----- -------------0290 0300 0310 0320 0330 0340 Capital Account At Beginning Of Year Capital Contributed During Year Partner's Share Withdrawals And Distribution Capital Account At End Of Year Ordinary Income (Loss) From Trade Or Business More Than One Trade Net Income (Loss) From Rental Real Estate More Than One Real Estate Rental Activity Net Income (Loss) From Other Rental Activities More Than One Rental Activity Interest Ordinary Dividends Royalties Net Short Term Capital Gain (Loss) Net Long-Term Capital Gain (Loss) Total 28% Rate Gain (Loss) Form Ref. ---(a) (b) (c) (d) (e) 1 Partner's Share of Income, Credits, Deductions, .. Length -----12 12 12 12 12 12 Field Description ----------------N N N N N N @0345 0350 1 2 6 12 "STMbnn" or blank N @0355 2 6 "STMbnn" or blank 0360 3 12 N @0365 0370 0380 0390 0400 0410 3 4a 4b 4c 4d 4e(1) 6 12 12 12 12 12 "STMbnn" or blank N N N N N 0415 4e(2) 12 N Part II Page 741 Section 4 Publication 1346 August 30, 2002 SCHEDULE K-1 PAGE 1 (FORM 8865) Field Identification No. ----- -------------0420 @0425 0430 @0435 0440 0450 0460 @0465 0470 @0475 Qualified 5-Year Gain Qualified 5 Year Gain Attachment Other Portfolio Income (Loss) Attach Statement Other Porfolio Info Guaranteed Payments To Partner Net Section 1231 Gain (Loss) Other Income (Loss) Attach Schedule of Other Income Charitable Contributions Attach Schedule of Charitable Contributions Section 179 Expense Deduction Deductions Related To Portfolio Income Attach Schedule of Portfolio Deductions Other Deductions Attach Schedule of Other Deductions Low Income Housing Credit 42(J)(5) Line 12a(1) Attachment Form Ref. ---4e(3) 4e(3) 4f 4f 5 6 7 7 8 8 Partner's Share of Income, Credits, Deductions, .. Length -----12 6 12 6 12 12 12 6 12 6 Field Description ----------------N "STMbnn" or blank | N "STMbnn" or blank N N N "STMbnn" or blank N "STMbnn" or blank 0480 0490 @0495 0500 @0505 0510 @0515 9 10 10 11 11 12a(1) 12a(1) August 30, 2002 12 12 6 12 6 12 6 N N "STMbnn" or blank N "STMbnn" or blank N "STMbnn" or blank | Part II Page 742 Section 4 Publication 1346 SCHEDULE K-1 PAGE 1 (FORM 8865) Field Identification No. ----- -------------0520 @0525 *0545 +0550 Low Income Housing Credit Other Line 12a(2) Attachment Form 3468 Line Reference Qualified Rehabilitation Expenditures Type of Expenditures Statement Reference - BMF Use Only Credits Related To Rental Real Estates Activities Identify Type Of Rental Credits Statement Reference - BMF Use Only Credits Related To Other Rental Activities Identify Type Of Other Rental Credits Statement Reference - BMF Use Only Other Credits Identify Type Of Other Credits Statement Reference - BMF Use Only Schedule K-1 Page 1 Global Statement Form Ref. ---- Partner's Share of Income, Credits, Deductions, .. Length -----12 6 6 12 Field Description ----------------N "STMbnn" or blank | AN or "STMbnn" or blank N 12a(2) 12a(2) 12b 12b +0555 0557 *0560 12b 12b 12c 15 6 12 AN Blank | N or "STMbnn" or blank +0565 0567 *0570 12c 12c 12d 15 6 12 AN Blank | N or "STMbnn" or blank +0575 0577 *0580 +0585 0587 @0590 12d 12d 13 13 13 15 6 12 15 6 6 AN Blank N or AN Blank "STMbnn" or blank Part II Page 743 Section 4 | | "STMbnn" or blank Publication 1346 August 30, 2002 SCHEDULE K-1 PAGE 1 (FORM 8865) Field Identification No. ----- -------------Form Ref. ---- Partner's Share of Income, Credits, Deductions, .. Length -----Field Description ----------------- Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 744 Section 4 SCHEDULE K-1 PAGE 2 (FORM 8865) Field Identification No. ----- -------------Byte Count Form Ref. ---- Partner's Share of Income, Credits, Deductions... Length -----4 Field Description ----------------"0598" for Fixed; "nnnn" for variable format Value "****" "SCHbK1" "8865bb" "PG02b" N (Primary SSN) | Start of Record Sentinel 0600 0601 0602 0603 Record ID Schedule Type Page Number Taxpayer Identification Number Filler Schedule Occurrence Number Interest Expense On Investment Debts Investment Income Investment Expenses Investment Income Attachment Investment Expenses Attachment Net Earnings (Loss) From Self-Employment Gross Farming Or Fishing Income Gross Nonfarm Income Depreciation Adjustment Adjusted Gain Or Loss 14a 14a(1) 14a(2) 14b(1) 14b(2) 15a 15b 15c 16a 16b 4 6 6 5 9 0604 0605 0610 0620 0630 @0635 @0637 0640 0650 0660 0670 0680 1 7 12 12 12 6 6 12 12 12 12 12 Blank N 0000001 - 0000005 N N N "STMbnn" or blank | "STMbnn" or blank | N N N N N Publication 1346 August 30, 2002 Part II Page 745 Section 4 SCHEDULE K-1 PAGE 2 (FORM 8865) Field Identification No. ----- -------------0690 0700 Depletion (Other Than Oil And Gas) Gross Income (Oil, Gas And Geothermal Property) Oil, Gas & Geothermal Attachment Deductions Allocable To Oil, Gas, & Geothermal Deductions Oil, Gas Attachment Other Adjustments Other Adjustments (Attach Schedule) Name Of Foreign Country Or U.S. Possession Gross Income From All Sources Gross Income Sourced At Partner Level Schedule of Reductions Passive Income Listed Categories Income Listed Categories Income (Attach Schedule) General Limitation Income Form Ref. ---16c Partner's Share of Income, Credits, Deductions... Length -----12 12 Field Description ----------------N N 16d(1) @0705 16d(1) 6 "STMbnn" or blank | 0710 16d(2) 12 N @0715 0720 @0725 0730 16d(2) 16e 16e 17a 6 12 6 35 "STMbnn" or blank | N "STMbnn" or blank AN 0735 0740 17b 17c 12 12 N N @0745 0750 0760 @0765 17c 17d(1) 17d(2) 17d(2) 6 12 12 6 "STMbnn" or blank | N N "STMbnn" or blank 0770 17d(3) August 30, 2002 12 N Part II Page 746 Section 4 Publication 1346 SCHEDULE K-1 PAGE 2 (FORM 8865) Field Identification No. ----- -------------0780 0790 0800 0810 @0815 Interest Expense at Partner Level Other at Partner Level Passive Deductions Listed Categories Deductions Listed Categories Deductions (Attach Schedule) General Limitation Deductions Total Foreign Taxes Paid Total Foreign Taxes Accrued Total Foreign Taxes Reduction In Taxes Available Reduction In Taxes Available (Attach Schedule) Section 59(e)(2) Expenditures: Type Section 59(e)(2) Expenditures: Amount Tax Exempt Interest Income Other Tax Exempt Income Nondeductible Expenses Form Ref. ---- Partner's Share of Income, Credits, Deductions... Length -----12 12 12 12 6 Field Description ----------------N N N N "STMbnn" or blank 17e(1) 17e(2) 17f(1) 17f(2) 17f(2) 0820 0830 0840 0850 0860 @0865 17f(3) 17g 17g 17g 17h 17h 12 1 1 12 12 6 N "X" or blank "X" or blank N N "STMbnn" or blank 0870 0880 0890 0900 0910 18a 18b 19 20 21 50 12 12 12 12 AN N N N N Publication 1346 August 30, 2002 Part II Page 747 Section 4 SCHEDULE K-1 PAGE 2 (FORM 8865) Field Identification No. ----- -------------0920 @0925 Distributions Of Money Adjusted Basis & FMV of Securities (Attach) Distributions Of Property Other Than Money Adjusted Basis & FMV of Property (Attach) Recapture Low Income Housing Credit: Partnerships Low-Income Housing Credit Attachment Recapture Low Income Housing Credit: Other Supplemental Information Schedule K-1 Page 2 Global Statement Form Ref. ---22 22 Partner's Share of Income, Credits, Deductions... Length -----12 6 Field Description ----------------N "STMbnn" or blank *0930 23 12 N @0935 23 6 "STMbnn" or blank 0940 24a 12 N @0945 0950 24a 24b 6 12 "STMbnn" or blank | N @0960 @0965 25 6 6 "STMbnn" or blank "STMbnn" or blank Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 748 Section 4 SCHEDULE O (FORM 8865) Field Identification No. ----- -------------Byte Count Transfer of Property To A Foreign Partnership Form Ref. ---Length -----4 Field Description ----------------"2258" for Fixed; "nnnn" for variable format Value "****" "SCHbbO" "8865bb" "PG01b" N (Primary SSN) | Start of Record Sentinel 0000 0001 0002 0003 Record ID Schedule Type Page Number Taxpayer Identification Number Filler Schedule Occurrence Number Identifying Number Name Of Foreign Partnership Cash Date of Transfer Cash Fair Market Value Cash % Interest In Partnership "See Below" Indicator Marketable Securities: Date Of Transfer Marketable Securities: Number Of Items Transferred Marketable Securities: FMV On Date Of Transfer I(a) I(c) I(g) I(g) I(a) 4 6 6 5 9 0004 0005 0010 0020 0030 0040 0050 0055 *0060 1 7 9 35 8 12 6 1 8 Blank N 0000001 - 0000005 N or blank AN YYYYMMDD N R "X" or blank YYYYMMDD or "STMbnn" or | blank N | | +0070 I(b) 12 +0080 I(c) 12 N Publication 1346 August 30, 2002 Part II Page 749 Section 4 SCHEDULE O (FORM 8865) Field Identification No. ----- -------------+0090 Marketable Securities: Cost Or Other Basis Marketable Securities: 704(c) Allocation Method Marketable Securities: Gain Recognized Marketable Securities: % Interest In Partnership "See Below" Indicator Marketable Securities: Date Of Transfer - 2 Marketable Securities: No. Items Transferred 2 Marketable Securities: FMV On Date Of Transfer - 2 Marketable Securities: Cost Or Other Basis - 2 Marketable Securities: 704(c) Allocation Method-2 Marketable Securities: Gain Recognized - 2 Transfer of Property To A Foreign Partnership Form Ref. ---I(d) Length -----12 Field Description ----------------N +0100 I(e) 11 AN - Values: "TRADITIONAL", "CURATIVE", or "REMEDIAL" N +0110 I(f) 12 +0120 I(g) 6 R +0125 0130 I(g) I(a) 1 8 "X" or blank YYYYMMDD | 0140 I(b) 12 N 0150 I(c) 12 N 0160 I(d) 12 N 0170 I(e) 11 AN - Values: "TRADITIONAL", "CURATIVE", or "REMEDIAL" N 0180 I(f) 12 Publication 1346 August 30, 2002 Part II Page 750 Section 4 SCHEDULE O (FORM 8865) Field Identification No. ----- -------------0190 Marketable Securities: % Interest Partnership-2 "See Below" Indicator Marketable Securities: Date Of Transfer - 3 Marketable Securities: No. Items Transferred 3 Marketable Securities: FMV On Date Of Transfer - 3 Marketable Securities: Cost Or Other Basis - 3 Marketable Securities: 704(c) Allocation Method-3 Marketable Securities: Gain Recognized - 3 Marketable Securities: % Interest Partnership-3 "See Below" Indicator Marketable Securities: Date Of Transfer - 4 Transfer of Property To A Foreign Partnership Form Ref. ---I(g) Length -----6 Field Description ----------------R 0195 0200 I(g) I(a) 1 8 "X" or blank YYYYMMDD | 0210 I(b) 12 N 0220 I(c) 12 N 0230 I(d) 12 N 0240 I(e) 11 AN - Values: "TRADITIONAL", "CURATIVE", or "REMEDIAL" N 0250 I(f) 12 0260 I(g) 6 R 0265 0270 I(g) I(a) 1 8 "X" or blank YYYYMMDD | Publication 1346 August 30, 2002 Part II Page 751 Section 4 SCHEDULE O (FORM 8865) Field Identification No. ----- -------------0280 Marketable Securities: No. Items Transferred 4 Marketable Securities: FMV On Date Of Transfer - 4 Marketable Securities: Cost Or Other Basis - 4 Marketable Securities: 704(c) Allocation Method-4 Marketable Securities: Gain Recognized - 4 Marketable Securities: % Interest Partnership-4 "See Below" Indicator Statement Reference - BMF Use Only Inventory: Date Of Transfer Inventory: Number Of Items Transferred Inventory: FMV On Transfer Date Inventory: Cost Or Other Basis Inventory: 704(c) Allocation Method Transfer of Property To A Foreign Partnership Form Ref. ---I(b) Length -----12 Field Description ----------------N 0290 I(c) 12 N 0300 I(d) 12 N 0310 I(e) 11 AN - Values: "TRADITIONAL", "CURATIVE", or "REMEDIAL" N 0320 I(f) 12 0330 I(g) 6 R 0335 0337 *0340 +0350 +0360 +0370 +0380 I(g) I I(a) I(b) I(c) I(d) I(e) 1 6 8 12 12 12 11 "X" or blank Blank | YYYYMMDD or "STMbnn" or | blank N N N AN - Values: "TRADITIONAL", "CURATIVE", or "REMEDIAL" Part II Page 752 Section 4 Publication 1346 August 30, 2002 SCHEDULE O (FORM 8865) Field Identification No. ----- -------------+0390 Inventory: Gain Recognized On Transfer Inventory: % Interest In Partnership "See Below" Indicator Inventory: Date Of Transfer - 2 Inventory: Number Of Items Transferred - 2 Inventory: FMV On Transfer Date - 2 Inventory: Cost Or Other Basis - 2 Inventory: 704(c) Allocation Method 2 Inventory: Gain Recognized On Transfer - 2 Inventory: % Interest In Partnership - 2 "See Below" Indicator Inventory: Date Of Transfer - 3 Inventory: Number Of Items Transferred - 3 Inventory: FMV On Transfer Date - 3 Transfer of Property To A Foreign Partnership Form Ref. ---I(f) Length -----12 Field Description ----------------N +0400 I(g) 6 R +0405 0410 0420 I(g) I(a) I(b) 1 8 12 "X" or blank YYYYMMDD N | 0430 0440 0450 I(c) I(d) I(e) 12 12 11 N N AN - Values: "TRADITIONAL", "CURATIVE", or "REMEDIAL" N 0460 I(f) 12 0470 I(g) 6 R 0475 0480 0490 I(g) I(a) I(b) 1 8 12 "X" or blank YYYYMMDD N | 0500 I(c) August 30, 2002 12 N Part II Page 753 Section 4 Publication 1346 SCHEDULE O (FORM 8865) Field Identification No. ----- -------------0510 0520 Inventory: Cost Or Other Basis - 3 Inventory: 704(c) Allocation Method 3 Inventory: Gain Recognized On Transfer - 3 Inventory: % Interest In Partnership - 3 "See Below" Indicator Inventory: Date Of Transfer - 4 Inventory: Number Of Items Transferred - 4 Inventory: FMV On Transfer Date - 4 Inventory: Cost Or Other Basis - 4 Inventory: 704(c) Allocation Method 4 Inventory: Gain Recognized On Transfer - 4 Inventory: % Interest In Partnership - 4 "See Below" Indicator Transfer of Property To A Foreign Partnership Form Ref. ---I(d) I(e) Length -----12 11 Field Description ----------------N AN - Values: "TRADITIONAL", "CURATIVE", or "REMEDIAL" N 0530 I(f) 12 0540 I(g) 6 R 0545 0550 0560 I(g) I(a) I(b) 1 8 12 "X" or blank YYYYMMDD N | 0570 0580 0590 I(c) I(d) I(e) 12 12 11 N N AN - Values: "TRADITIONAL", "CURATIVE", or "REMEDIAL" N 0600 I(f) 12 0610 I(g) 6 R 0615 I(g) 1 "X" or blank Publication 1346 August 30, 2002 Part II Page 754 Section 4 SCHEDULE O (FORM 8865) Field Identification No. ----- -------------0617 *0620 +0630 Statement Reference - BMF Use Only Tangible Property: Date Of Transfer Tangible Property : Number Of Items Transferred Tangible Property : FMV On Date of Transfer Tangible Property : Cost Or Other Basis Tangible Property: 704(c) Allocation Method Tangible Property : Gain Recognized Tangible Property : % Interest In Parnership "See Below" Indicator Tangible Property: Date Of Transfer - 2 Tangible Property: Number Of Items Transferred-2 Tangible Property: FMV On Date of Transfer - 2 Tangible Property : Cost Or Other Basis - 2 Transfer of Property To A Foreign Partnership Form Ref. ---I I(a) I(b) Length -----6 8 12 Field Description ----------------Blank | YYYYMMDD, "STMbnn" or | blank N +0640 I(c) 12 N +0650 +0660 I(d) I(e) 12 11 N AN - Values: "TRADITIONAL", "CURATIVE", or "REMEDIAL" N R +0670 +0680 I(f) I(g) 12 6 +0685 0690 0700 I(g) I(a) I(b) 1 8 12 "X" or blank YYYYMMDD N | 0710 I(c) 12 N 0720 I(d) 12 N Publication 1346 August 30, 2002 Part II Page 755 Section 4 SCHEDULE O (FORM 8865) Field Identification No. ----- -------------0730 Tangible Property : 704(c) Allocation Method - 2 Tangible Property: Gain Recognized - 2 Tangible Property: % Interest In Partnership - 2 "See Below" Indicator Tangible Property: Date Of Transfer - 3 Tangible Property: Number Of Items Transferred-3 Tangible Property: FMV On Date of Tranfer - 3 Tangible Property: Cost Or Other Basis - 3 Tangible Property: 704(c) Allocation Method - 3 Tangible Property: Gain Recognized - 3 Tangible Property: % Interest In Parnership - 3 "See Below" Indicator Tangible Property: Date Of Transfer - 4 Transfer of Property To A Foreign Partnership Form Ref. ---I(e) Length -----11 Field Description ----------------AN - VALUES: "TRADITIONAL", "CURATIVE", or "REMEDIAL" N R 0740 0750 I(f) I(g) 12 6 0755 0760 0770 I(g) I(a) I(b) 1 8 12 "X" or blank YYYYMMDD N | 0780 I(c) 12 N 0790 I(d) 12 N 0800 I(e) 11 AN - Values: "TRADITIONAL", "CURATIVE", or "REMEDIAL" N R 0810 0820 I(f) I(g) 12 6 0825 0830 I(g) I(a) 1 8 "X" or blank YYYYMMDD | Publication 1346 August 30, 2002 Part II Page 756 Section 4 SCHEDULE O (FORM 8865) Field Identification No. ----- -------------0840 Tangible Property: Number Of Items Transferred-4 Tangible Property: FMV On Date of Transfer - 4 Tangible Property: Cost Or Other Basis - 4 Tangible Property: 704(c) Allocation Method - 4 Tangible Property: Gain Recognized - 4 Tangible Property: % Interest In Partnership - 4 "See Below" Indicator Statement Reference - BMF Use Only Intangible Property: Date Of Transfer Intangible Property: Number Items Transferred Intangible Property: FMV On Date Of Transfer Intangible Property: Cost Or Other Basis Transfer of Property To A Foreign Partnership Form Ref. ---I(b) Length -----12 Field Description ----------------N 0850 I(c) 12 N 0860 I(d) 12 N 0870 I(e) 11 AN - Values: "TRADITIONAL", "CURATIVE", or "REMEDIAL" N R 0890 0900 I(f) I(g) 12 6 0905 0907 *0910 I(g) I I(a) 1 6 8 "X" or blank Blank | YYYYMMDD or "STMbnn" or | blank N +0920 I(b) 12 +0930 I(c) 12 N +0940 I(d) 12 N Publication 1346 August 30, 2002 Part II Page 757 Section 4 SCHEDULE O (FORM 8865) Field Identification No. ----- -------------+0950 Intangible Property: 704(c) Allocation Method Intangible Property: Gain Recognized Intangible Property: % Interest In Partnership "See Below" Indicator Intangible Property: Date Of Transfer - 2 Intangible Property: Number Items Transferred 2 Intangible Property: FMV On Date Of Transfer - 2 Intangible Property: Cost Or Other Basis - 2 Intangible Property: 704(c) Allocation Method 2 Intangible Property: Gain Recognized - 2 Intangible Property: % Interest Partnership - 2 Transfer of Property To A Foreign Partnership Form Ref. ---I(e) Length -----11 Field Description ----------------AN - Values: "TRADITIONAL", "CURATIVE", or "REMEDIAL" N +0960 I(f) 12 +0970 I(g) 6 R +0975 0980 I(g) I(a) 1 8 "X" or blank YYYYMMDD | 0990 I(b) 12 N 1000 I(c) 12 N 1010 I(d) 12 N 1020 I(e) 11 AN - Values "TRADITIONAL", "CURATIVE", or "REMEDIAL" N 1030 I(f) 12 1040 I(g) 6 R Publication 1346 August 30, 2002 Part II Page 758 Section 4 SCHEDULE O (FORM 8865) Field Identification No. ----- -------------1045 1050 "See Below" Indicator Intangible Property: Date Of Transfer - 3 Intangible Property: Number Items Transferred 3 Intangible Property: FMV On Date Of Transfer - 3 Intangible Property: Cost Or Other Basis - 3 Intangible Property: 704(c) Allocation Method 3 Intangible Property: Gain Recognized - 3 Intangible Property: % Interest Partnership - 3 "See Below" Indicator Intangible Property: Date Of Transfer - 4 Intangible Property: Number Items Transferred 4 Intangible Property: FMV On Date Of Transfer - 4 Transfer of Property To A Foreign Partnership Form Ref. ---I(g) I(a) Length -----1 8 Field Description ----------------"X" or blank YYYYMMDD | 1060 I(b) 12 N 1070 I(c) 12 N 1080 I(d) 12 N 1090 I(e) 11 AN - Values: "TRADITIONAL", "CURATIVE", or "REMEDIAL" N 1100 I(f) 12 1110 I(g) 6 R 1115 1120 I(g) I(a) 1 8 "X" or blank YYYYMMDD | 1130 I(b) 12 N 1140 I(c) 12 N Publication 1346 August 30, 2002 Part II Page 759 Section 4 SCHEDULE O (FORM 8865) Field Identification No. ----- -------------1150 Intangible Property: Cost Or Other Basis - 4 Intangible Property: 704(c) Allocation Method 4 Intangible Property: Gain Recognized - 4 Intangible Property: % Interest Partnership - 4 "See Below" Indicator Statement Reference - BMF Use Only Other Property: Date Of Transfer Other Property: Number Of Items Transferred Other Property: FMV On Date Of Transfer Other Property: Cost Or Other Basis Other Property: 704(c) Allocation Method Other Property: Gain Recognized Other Property: % Interest In Partnership Transfer of Property To A Foreign Partnership Form Ref. ---I(d) Length -----12 Field Description ----------------N 1160 I(e) 11 AN - Values "TRADITIONAL", "CURATIVE", or "REMEDIAL" N 1170 I(f) 12 1180 I(g) 6 R 1185 1187 *1190 +1200 I(g) I I(a) I(b) 1 6 8 12 "X" or blank Blank | YYYYMMDD or "STMbnn" or | blank N +1210 +1220 +1230 I(c) I(d) I(e) 12 12 11 N N AN - Values: "TRADITIONAL", "CURATIVE", or "REMEDIAL" N N +1240 +1250 I(f) I(g) 12 6 Publication 1346 August 30, 2002 Part II Page 760 Section 4 SCHEDULE O (FORM 8865) Field Identification No. ----- -------------+1255 1260 1270 "See Below" Indicator Other Property: Date Of Transfer - 2 Other Property: Number Of Items Transferred - 2 Other Property: FMV On Date Of Transfer - 2 Other Property: Cost Or Other Basis - 2 Other Property: 704(c) Allocation Method - 2 Other Property: Gain Recognized - 2 Other Property: % Interest In Partnership - 2 "See Below" Indicator Other Property: Date Of Transfer - 3 Other Property: Number Of Items Transferred - 3 Other Property: FMV On Date Of Transfer - 3 Other Property: Cost Or Other Basis - 3 Transfer of Property To A Foreign Partnership Form Ref. ---I(g) I(a) I(b) Length -----1 8 12 Field Description ----------------"X" or blank DT N 1280 I(c) 12 N 1290 I(d) 12 N 1300 I(e) 11 AN - Values: "TRADITIONAL", "CURATIVE", "REMEDIAL" N N 1310 1320 I(f) I(g) 12 6 1325 1330 1340 I(g) I(a) I(b) 1 8 12 "X" or blank YYYYMMDD N | 1350 I(c) 12 N 1360 I(d) 12 N Publication 1346 August 30, 2002 Part II Page 761 Section 4 SCHEDULE O (FORM 8865) Field Identification No. ----- -------------1370 Other Property: 704(c) Allocation Method - 3 Other Property: Gain Recognized - 3 Other Property: % Interest In Partnership - 3 "See Below" Indicator Other Property: Date Of Transfer - 4 Other Property: Number Of Items Transferred - 4 Other Property: FMV On Date Of Transfer - 4 Other Property: Cost Or Other Basis - 4 Other Property: 704(c) Allocation Method - 4 Other Property: Gain Recognized - 4 Other Property: % Interest In Partnership - 4 "See Below" Indicator Statement Reference - BMF Use Only Transfer of Property To A Foreign Partnership Form Ref. ---I(e) Length -----11 Field Description ----------------AN - Values: "TRADITIONAL", "CURATIVE", or "REMEDIAL" N N 1380 1390 I(f) I(g) 12 6 1395 1400 1410 I(g) I(a) I(b) 1 8 12 "X" or blank YYYYMMDD N | 1420 I(c) 12 N 1430 I(d) 12 N 1440 I(e) 11 AN - Values: "TRADITIONAL", "CURATIVE", or "REMEDIAL" N N 1450 1460 I(f) I(g) 12 6 1465 1467 I(g) I 1 6 "X" or blank Blank | Publication 1346 August 30, 2002 Part II Page 762 Section 4 SCHEDULE O (FORM 8865) Field Identification No. ----- -------------@1470 1480 @1485 1490 @1495 1500 1510 1520 1530 1540 1550 @1555 1560 @1565 1570 @1575 1580 1590 Supplemental Information Type Of Property Attach Schedule of 704(c) Property Date Of Original Transfer Attach Schedule of 704(c) Transfer Date Of Disposition Manner Of Disposition Gain Realized By Partnership Depreciation Recapture Recognized Gain Allocated To Partner Depreciation Recapture Allocated Attach Schedule of Calculated Amount Type Of Property - 2 Attach Schedule of 704(c) Property - 2 Date Of Original Transfer - 2 Attach Schedule of 704(c) Transfer - 2 Date Of Disposition Manner Of Disposition - 2 Transfer of Property To A Foreign Partnership Form Ref. ---I II(a) II(a) II(b) II(b) II(c) II(d) II(e) II(f) II(g) II(h) II(h) II(a) II(a) II(b) II(b) II(c) II(d) August 30, 2002 Length -----6 35 6 8 6 8 35 12 12 12 12 6 35 6 8 6 8 35 Field Description ----------------"STMbnn" or blank AN | "STMbnn" or blank | YYYYMMDD | "STMbnn" or blank | YYYYMMDD AN N N N N | | | | | | "STMbnn" or blank | AN "STMbnn" or blank YYYYMMDD "STMbnn" or blank YYYYMMDD AN Part II Page 763 Section 4 | | Publication 1346 SCHEDULE O (FORM 8865) Field Identification No. ----- -------------1600 1610 Gain Recognized By Partnership - 2 Depreciation Recapture Recognized - 2 Gain Allocated To Partner - 2 Depreciation Recapture Allocated - 2 Attach Schedule of Calculated Amount 2 Type Of Property - 3 Attach Schedule of 704(c) Property - 3 Date Of Original Transfer - 3 Attach Schedule of 704(c) Transfer-3 Date Of Disposition - 3 Manner Of Disposition - 3 Gain Recognized By Partnership - 3 Depreciation Recapture Recognized - 3 Gain Allocated To Partner - 3 Depreciation Recapture Allocated - 3 Transfer of Property To A Foreign Partnership Form Ref. ---II(e) II(f) Length -----12 12 Field Description ----------------N N 1620 1630 II(g) II(h) 12 12 N N @1635 II(h) 6 "STMbnn" or blank 1640 @1645 1650 @1655 1660 1670 1680 1690 II(a) II(a) II(b) II(b) II(c) II(d) II(e) II(f) 35 6 8 6 8 35 12 12 AN "STMbnn" or blank YYYYMMDD "STMbnn" or blank YYYYMMDD AN N N | | 1700 1710 II(g) II(h) 12 12 N N Publication 1346 August 30, 2002 Part II Page 764 Section 4 SCHEDULE O (FORM 8865) Field Identification No. ----- -------------@1715 Attach Schedule of Calculated Amount 3 Type Of Property - 4 Attach Schedule of 704(c) Property - 4 Date Of Original Transfer - 4 Attach Schedule of 704(c) Transfer - 4 Date Of Disposition - 4 Manner Of Disposition - 4 Gain Recognized By Partnership - 4 Depreciation Recapture Recogniized - 4 Gain Allocated To Partner - 4 Depreciation Recapture Allocated - 4 Attach Schedule of Calculated Amount 4 Part II additional Info Transfer Subject To Gain - Yes Transfer Subject To Gain - No Transfer of Property To A Foreign Partnership Form Ref. ---II(h) Length -----6 Field Description ----------------"STMbnn" or blank 1720 @1725 1730 @1735 1740 1750 1760 1770 II(a) II(a) II(b) II(b) II(c) II(d) II(e) II(f) 35 6 8 6 8 35 12 12 AN "STMbnn" or blank YYYYMMDD "STMbnn" or blank YYYYMMDD AN N N | | 1780 1790 II(g) II(h) 12 12 N N @1795 II(h) 6 "STMbnn" or blank @1797 1800 1810 II III III 6 1 1 "STMbnn" or blank | "X" or blank "X" or blank Publication 1346 August 30, 2002 Part II Page 765 Section 4 SCHEDULE O (FORM 8865) Field Identification No. ----- -------------@1813 @1815 Schedule Identifying Transfer Global Schedule O Statement Transfer of Property To A Foreign Partnership Form Ref. ---III Length -----6 6 Field Description ----------------"STMbnn" or blank "STMbnn" or blank Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 766 Section 4 SCHEDULE P (FORM 8865) Field Identification No. ----- -------------Byte Count Acquisitions, Dispositions and Changes in Interest Form Ref. ---Length -----4 Field Description ----------------"1365" for Fixed; "nnnn" for variable format Value "****" "SCHbbP" "8865bb" "PG01b" N (Primary SSN) | Start of Record Sentinel 0000 0001 0002 0003 Record ID Schedule Type Page Number Taxpayer Identification Number Filler Schedule Occurrence Number Identifying Number Name Of Foreign Partnership Acquisitions Name Acquisitions Address Acquisitions City Acquisitions State Acquisitions Zip Code Acquisitions ID Number Date Of Acquisition FMV Of Interest Acquired Basis In Interest Acquired I(a) I(a) I(a) I(a) I(a) I(a) I(b) I(c) I(d) 4 6 6 5 9 0004 0005 0010 0020 *0030 +0040 *+0050 +0060 +0070 +0080 +0090 +0100 +0110 1 7 9 35 35 35 22 2 12 9 8 12 12 Blank N 0000001 - 0000005 N or blank AN AN or "STMbnn" or blank AN AN or "STMbnn" AN N or nnnnnbbbbbbb or nnnnnnnnnbbb N YYYYMMDD N N | | Publication 1346 August 30, 2002 Part II Page 767 Section 4 SCHEDULE P (FORM 8865) Field Identification No. ----- -------------*+0120 +0125 +0130 +0135 0140 0150 0160 0170 0180 % Of Interest Before Acquisition "See Below" Ind. % Of Interest After Acquisition "See Below" Ind. Acquisitions Name 2 Acquisitions Address - 2 Acquisitions City 2 Acquisitions State 2 Acquisitions Zip Code - 2 Acquisition ID Number - 2 Date Of Acquisition - 2 FMV Of Interest Acquired - 2 Basis In Interest Acquired - 2 % Of Interest Before Acquisition 2 "See Below" Ind. % Of Interest After Acquisition - 2 "See Below" Ind. Acquisitions, Dispositions and Changes in Interest Form Ref. ---I(e) I(e) I(f) I(f) I(a) I(a) I(a) I(a) I(a) Length -----6 1 6 1 35 35 22 2 12 Field Description ----------------R or "STMbnn" "X" or blank R "X" or blank AN or blank AN or blank AN or blank AN or blank N or nnnnnbbbbbbb or nnnnnnnnnbbb or blank N or blank YYYYMMDD or blank | N or blank N or blank R or blank 0190 0200 0210 0220 0230 I(a) I(b) I(c) I(d) I(e) 9 8 12 12 6 +0235 0240 0245 I(e) I(f) I(f) August 30, 2002 1 6 1 "X" or blank R or blank "X" or blank Part II Page 768 Section 4 Publication 1346 SCHEDULE P (FORM 8865) Field Identification No. ----- -------------0250 0260 0270 0280 0290 Acquisition Name - 3 Acquisitions Address - 3 Acquisitions City 3 Acquisitions State 3 Acquisitions Zip Code - 3 Acquisition ID Number - 3 Date Of Acquisition - 3 FMV Of Interest Acquired - 3 Basis In Interest Acquired - 3 % Of Interest Before Acquisition 3 "See Below" Ind. % Of Interest After Acquisition - 3 "See Below" Ind. Statement Reference - BMF Use Only Dispositions Name Dispositions Address Dispositions City Dispositions State Acquisitions, Dispositions and Changes in Interest Form Ref. ---I(a) I(a) I(a) I(a) I(a) Length -----35 35 22 2 12 Field Description ----------------AN or blank AN or blank AN or blank AN or blank N or nnnnnbbbbbbb or nnnnnnnnnbbb or blank N or blank YYYYMMDD or blank | N or blank N or blank R or blank 0300 0310 0320 0330 0340 I(a) I(b) I(c) I(d) I(e) 9 8 12 12 6 0345 0350 0355 0357 *0360 +0370 *+0380 +0390 I(e) I(f) I(f) I II(a) II(a) II(a) II(a) August 30, 2002 1 6 1 6 35 35 22 2 "X" or blank R or blank "X" or blank Blank | AN or "STMbnn" or blank AN AN or "STMbnn" AN Part II Page 769 Section 4 Publication 1346 SCHEDULE P (FORM 8865) Field Identification No. ----- -------------+0400 +0410 +0420 +0430 +0440 *+0450 +0455 +0460 +0465 0470 0480 0490 0500 0510 Dispositions Zip Code Dispositions ID Number Date Of Disposition FMV Of Interest Disposed Basis In Interest Disposed % Of Interest Before Disposition "See Below" Ind. % Of Interest After Disposition "See Below" Ind. Dispositions Name 2 Dispositions Address - 2 Dispositions City 2 Dispositions State 2 Dispositions Zip Code - 2 Dispositions ID Number - 2 Date Of Disposition - 2 FMV Or Interest Disposed - 2 Acquisitions, Dispositions and Changes in Interest Form Ref. ---II(a) II(a) II(b) II(c) II(d) II(e) I(e) II(f) II(f) II(a) II(a) II(a) II(a) II(a) Length -----12 9 8 12 12 6 1 6 1 35 35 22 2 12 Field Description ----------------N or nnnnnbbbbbbb or nnnnnnnnnbbb N YYYYMMDD N N R or "STMbnn" "X" or blank R "X" or blank AN or blank AN or blank AN or blank AN or blank N or nnnnnbbbbbbb or nnnnnnnnnbbb or blank N or blank YYYYMMDD or blank | N or blank Part II Page 770 Section 4 | 0520 0530 0540 II(a) II(b) II(c) August 30, 2002 9 8 12 Publication 1346 SCHEDULE P (FORM 8865) Field Identification No. ----- -------------0550 0560 Basis In Interest Disposed - 2 % Of Interest Before Disposition 2 "See Below" Ind. % Of Interest After Disposition - 2 "See Below" Ind. Dipositions Name - 3 Dispositions Address - 3 Dispositions City 3 Dispositions State 3 Dispositions Zip Code - 3 Dispositions ID Number -3 Date Of Disposition - 3 FMV Of Interest Disposed - 3 Basis In Interest Disposed - 3 % Of Interest Before Disposition 3 "See Below" Ind. % Of Interest After Disposition - 3 Acquisitions, Dispositions and Changes in Interest Form Ref. ---II(d) II(e) Length -----12 6 Field Description ----------------N or blank R or blank 0565 0570 +0575 0580 0590 0600 0610 0620 II(e) II(f) I(e) II(a) II(a) II(a) II(a) II(a) 1 6 1 35 35 22 2 12 "X" or blank R or blank "X" or blank AN or blank AN or blank AN or blank AN or blank N or nnnnnbbbbbbb or nnnnnnnnnbbb or blank N or blank YYYYMMDD or blank | N or blank N or blank R or blank 0630 0640 0650 0660 0670 II(a) II(b) II(c) II(d) II(e) 9 8 12 12 6 +0675 0680 I(e) II(f) August 30, 2002 1 6 "X" or blank R or blank Part II Page 771 Section 4 Publication 1346 SCHEDULE P (FORM 8865) Field Identification No. ----- -------------0685 0687 *0690 +0700 +0710 *+0720 +0730 +0735 +0740 +0745 0750 0760 0770 0780 0790 0795 0800 0805 0810 "See Below" Ind. Statement Reference - BMF Use Only Description Of Change Date Of Change FMV Of Interest Changed Basis In Interest Changed % Of Interest Before Change "See Below" Ind. % Of Interest After Change "See Below" Ind. Description Of Change - 2 Date Of Change FMV Of Interest Changed - 2 Basis In Interest Changed - 2 % Of Interest Before Change - 2 "See Below" Ind. % Of Interest After Change - 2 "See Below" Ind. Description Of Change - 3 Acquisitions, Dispositions and Changes in Interest Form Ref. ---II(f) I III(a) III(b) III(c) III(d) III(e) III(e) III(f) III(f) III(a) III(b) III(c) III(d) III(e) III(e) III(f) III(f) III(a) August 30, 2002 Length -----1 6 50 8 12 12 6 1 6 1 50 8 12 12 6 1 6 1 50 Field Description ----------------"X" or blank Blank | AN or "STMbnn" or blank YYYYMMDD N N or "STMbnn" R "X" or blank R "X" or blank AN or blank YYYYMMDD or blank | N or blank N or blank R or blank "X" or blank R or blank "X" or blank AN or blank Part II Page 772 Section 4 | Publication 1346 SCHEDULE P (FORM 8865) Field Identification No. ----- -------------0820 0830 0840 0850 0855 0860 0865 0867 @0870 Date Of Change - 3 FMV Of Interest Changed - 3 Basis In Interest Changed - 3 % Of Interest Before Change - 3 "See Below" Ind. % Of Interest After Change - 3 "See Below" Ind. Statement Reference - BMF Use Only Supplemental Information Acquisitions, Dispositions and Changes in Interest Form Ref. ---III(b) III(c) III(d) III(e) III(e) III(f) III(f) I IV Length -----8 12 12 6 1 6 1 6 6 Field Description ----------------YYYYMMDD or blank | N or blank N or blank R or blank "X" or blank R or blank "X" or blank Blank "STMbnn" or blank | Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 773 Section 4 INTENTIONAL BLANK PAGE Publication 1346 August 30, 2002 Part II Page 774 Section 4 FORM 8866 Field Identification No. ----- -------------Byte Count Interest Computation Under the Look-Back Method Form Ref. ---Length -----4 Field Description ----------------"0495" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" "8866bb" "PG01b" N (Primary SSN) | Start of Record Sentinel 0000 0001 0002 0003 Record ID Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number Filing Year Beginning Filing Year Ending Identifying Number Type of Taxpayer: Corporation Type of Taxpayer: Individual Type of Taxpayer: Estate or Trust Type of Taxpayer: S Corporation Type of Taxpayer: Partnership Name of Entity Schedule of Additional Entity(s) B B B B B C C 4 6 6 5 9 0004 0005 0010 0020 0080 0090 0100 0110 0120 0130 0140 @0145 1 7 8 8 9 1 1 1 1 1 35 6 blank N 0000001 - 0000005 YYYYMMDD or blank | YYYYMMDD or blank | NO ENTRY "X" or blank "X" or blank "X" or blank "X" or blank "X" or blank AN or blank "STMbnn" or blank | Publication 1346 August 30, 2002 Part II Page 775 Section 4 FORM 8866 Field Identification No. ----- -------------0150 Employer Identification Number of Entity Year Ended-1 Taxable Income/Loss for Prior Year(s)-1 Adjustment to Taxable Income-1 Schedule of each Separate Property-1 Adjusted Taxable Income for LookBack Purposes-1 Income Tax Liability on Line 3(a) Amount-1 Income Tax Liability on Prior Year(s) Return-1 Increase/Decrease in Prior Year(s) Tax-1 Interest Due on Increase-1 Interest to be Refunded on Decrease-1 Year Ended-2 Taxable Income/Loss for Prior Year(s)-2 Adjustment to Taxable Income-2 Schedule of each Separate Property-2 Interest Computation Under the Look-Back Method Form Ref. ---C Length -----9 Field Description ----------------N or blank 0160 0170 0180 @0185 0190 (a) 1(a) 2(a) 2(a) 3(a) 6 12 12 6 12 YYYYMM N N "STMbnn" or blank N or blank | 0200 4(a) 12 N or blank 0210 5(a) 12 N or blank 0220 6(a) 12 N 0230 0240 7(a) 8(a) 12 12 N or blank N or blank 0250 0260 0270 @0275 (b) 1(b) 2(b) 2(b) August 30, 2002 6 12 12 6 YYYYMM or blank N or blank N or blank "STMbnn" or blank | Publication 1346 Part II Page 776 Section 4 FORM 8866 Field Identification No. ----- -------------0280 Adjusted Taxable Income for LookBack Purposes-2 Income Tax Liability on Line 3(b) Amount-2 Income Tax Liability on Prior Year(s) Return-2 Increase/Decrease in Prior Year(s) Tax-2 Interest Due on Increase-2 Interest to be Refunded on Decrease-2 Year Ended-3 Taxable Income/Loss for Prior Year(s)-3 Adjustment To Taxable Income-3 Schedule of each Separate Property-3 Adjusted Taxable Income For LookBack Purposes-3 Income Tax Liability on Line 3(c) Amount-3 Income Tax Liability on Prior Year(s) Return-3 Increase/Decrease in Prior Year(s) Tax-3 Interest Computation Under the Look-Back Method Form Ref. ---3(b) Length -----12 Field Description ----------------N or blank 0290 4(b) 12 N or blank 0300 5(b) 12 N or blank 0310 6(b) 12 N or blank 0320 0330 7(b) 8(b) 12 12 N or blank N or blank 0340 0350 0360 @0365 0370 (c) 1(c) 2(c) 2(c) 3(c) 6 12 12 6 12 YYYYMM or blank N or blank N or blank "STMbnn" or blank N or blank | 0380 4(c) 12 N or blank 0390 5(c) 12 N or blank 0400 6(c) 12 N or blank Publication 1346 August 30, 2002 Part II Page 777 Section 4 FORM 8866 Field Identification No. ----- -------------0410 0420 Interest Due on Increase-3 Interest to be Refunded on Decrease-3 Total Interest Due on Increase Total Interest to be Refunded on Decrease Net Amount of Interest to be Refunded Net Amount of Interest You Owe Interest Computation Under the Look-Back Method Form Ref. ---7(c) 8(c) Length -----12 12 Field Description ----------------N or blank N or blank 0430 0440 7(d) 8(d) 12 12 N or blank N or blank 0450 9(d) 12 NO ENTRY 0460 10(d) 12 N or blank Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 778 Section 4 FORM 8880 Field Identification No. ----- -------------Byte Count Credit for Qualified Retirement Savings Contr ... Form Ref. ---Length -----4 Field Description ----------------"0276" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" "8880bb" "PG01b" N (Primary SSN) Start of Record Sentinel 0000 0001 0002 0003 Record ID Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number Primary T/P Roth IRA for 2002 Secondary T/P Roth IRA for 2002 Primary T/P Contributions Secondary T/P Contributions Add Lines 1 and 2 Column (a) Add Lines 1 and 2 Column (b) Primary T/P Taxable Distributions Secondary T/P Taxable Distributions Subtract Line 4 from 3 Column (a) 1a 1b 2a 2b 3a 3b 4a 4b 4 6 6 5 9 0004 0005 0010 0020 0030 0040 0050 0060 0070 0080 1 7 12 12 12 12 12 12 12 12 blank N 0000001 N N N N N N N N 0090 5a August 30, 2002 12 N Part II Page 779 Section 4 Publication 1346 FORM 8880 Field Identification No. ----- -------------0100 0110 0120 Subtract Line 4 from 3 Column (b) Primary T/P Smaller of line 5 or $2000 Secondary T/P Smaller of line 5 or $2000 Total line 6a and 6b Adjusted Gross Income From 1040/ 1040A Decimal Amount Multiply line 7 by line 9 Tax from 1040/1040A Credits from 1040/ 1040A Subtract line 12 from line 11 Credit Contributions Credit for Qualified Retirement Savings Contr ... Form Ref. ---5b 6a 6b Length -----12 12 12 Field Description ----------------N N N 0130 0140 7 8 12 12 N N 0150 0160 0170 0180 0190 0200 9 10 11 12 13 14 5 12 12 12 12 12 N N N N N N Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 780 Section 4 FORM 9465 Field Identification No. ----- -------------Byte Count Installment Agreement Request Form Ref. ---Length -----4 Field Description ----------------"0692" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" "9465bb" "PG01b" N (Primary SSN) Start of Record Sentinel 0000 0001 0002 0003 Record ID Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number Taxpayer's Name 1 4 6 6 5 9 0004 0005 0010 1 7 35 blank N 0000001 AN. Allowable special characters are: hyphen (-), slash(/), comma(,), and space First 4 significant characters of taxpayer's last name, no leading or embedded spaces; allowable characters are alpha, hyphen or space (see special instructions) N AN. Allowable special characters are: hyphen (-), slash (/), comma (,), and space First 4 significant characters of spouse's last name, no leading or embedded spaces; allowable characters are alpha, hyphen or space (see special instructions) Part II Page 781 Section 4 0015 Taxpayer's Name Control 4 0020 0030 Taxpayer's SSN Spouse Name 1 1 9 35 0035 Spouse Name Control 4 Publication 1346 August 30, 2002 FORM 9465 Field Identification No. ----- -------------0040 0050 Spouse SSN Taxpayer's Street Address Installment Agreement Request Form Ref. ---1 1 Length -----9 35 Field Description ----------------N or blank AN. Allowable special characters are: ampersand (&), hyphen (-), slash (/), comma (,), plus (+), percent (%), and space AN or blank A. Allowable special character is space A (Standard Postal State Abbreviations) 0060 0070 0080 0082 0084 0086 0090 0095 0100 0110 0120 0130 0140 0150 0155 0160 Apt. Number City State Abbreviation Reserved Reserved Reserved Zip Code Reserved New Address Taxpayer's Home Phone Number Best Time to Call Taxpayer's Work Phone Number Phone Ext. Best Time to Call Reserved Taxpayer's Bank Name or Financial Inst. Name 1 1 1 5 22 2 35 35 22 1 12 1 N (Left-justified) 2 3 3 4 4 4 1 10 10 10 4 10 20 "X" or blank N AN N N or blank AN N or Blank AN. Allowable special characters are: ampersand (&), hyphen(-), slash(/), comma (,), and space 5 35 Publication 1346 August 30, 2002 Part II Page 782 Section 4 FORM 9465 Field Identification No. ----- -------------0170 Financial Institution Address Installment Agreement Request Form Ref. ---5 Length -----35 Field Description ----------------AN. Allowable special characters are: ampersand (&), hyphen(-), slash(/), comma(,), plus (+), percent (%), and space A. Allowable special character is space A (Standard Postal State Abbreviations) N (Left-justified) AN. Allowable special characters are: ampersand (&), hyphen (-), slash(/) comma (,), plus (+), and space AN. Allowable special characters are: ampersand (&), hyphen (-),slash(/), comma (,), plus (+), percent (%), and space A. Allowable special character is space A (Standard Postal State Abbreviations) N (Left-justificated) AN. "FORMb1040bb" or "FORMb1040Ab" or "FORMb1040EZ" N N N N. Not less than 25.00 N. 01-28 Part II Page 783 Section 4 0180 0190 0200 0210 City State Abbreviation Zip Code Taxpayer's Employer Name 5 5 5 6 22 2 12 35 0220 Employer Address 6 35 0230 0240 0250 0260 Employer City Employer State Employer Zip Code Tax Return for Form 6 6 6 7 22 2 12 11 0270 0280 0290 0300 0310 Tax Year for This Request Amount Owed on Tax Return Payment with Tax Return Monthly Payment Monthly Payment Date 8 9 10 11 12 4 12 12 12 2 Publication 1346 August 30, 2002 FORM 9465 Field Identification No. ----- -------------0330 0340 0350 0360 0380 0390 0400 0410 Routing Transit Number Bank Account Number Checking Account Indicator Savings Account Indicator Reserved Reserved Reserved Reserved Installment Agreement Request Form Ref. ---13a 13b 13c 13c Length -----9 17 1 1 5 8 5 8 Field Description ----------------N AN (including hyphens or blank) "X" or blank "X" or blank Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 784 Section 4 FORM PAYMENT Field Identification No. ----- -------------Byte Count Balance Due and Estimated Payments Form Ref. ---Length -----4 Field Description ----------------"0123" for Fixed; "nnnn" for variable format Value "****" "FRMbbb" "PMTbbb" "PG01b" N (Primary SSN) Start of Record Sentinel 0000 0001 0002 0003 Record ID Form Number Page Number Taxpayer Identification Number Filler Form Occurrence Number Primary SSN Secondary SSN Routing Transit Number Bank Account Number Type of Account Amount of Tax Payment Tax Type Code 4 6 6 5 9 0004 0005 0010 0020 0030 0040 0050 0060 0070 1 7 9 9 9 17 1 12 5 blank N 0000001 - 0000002 N N N AN (including hyphens or blank) "1" = Checking "2" = Savings N (positive only) AN, Values: "1040E" = Form 1040, "1040A" = Form 1040A, "1040Z" = Form 1040EZ, "1040T" = Telefile "1040S" = Estimated Payments Publication 1346 August 30, 2002 Part II Page 785 Section 4 FORM PAYMENT Field Identification No. ----- -------------0080 Requested Payment Date Balance Due and Estimated Payments Form Ref. ---Length -----8 Field Description ----------------YYYYMMDD for Balance Due (Form 1040, 1040A, 1040EZ & Telefile) YYYYMMDD for Estimated Payments Values: "20020415", "20020617" or "20020916" N 0090 Taxpayer's Day Time Phone Number 10 Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 786 Section 4 AUTHENTICATION Field Identification No. ----- -------------Byte Count Authentication Record Form Ref. ---Length -----4 Field Description ----------------"0340" for Fixed; "nnnn" for variable format Value "****" "ATHbbb" Blank "PG01b" N (Primary SSN) Start of Record Sentinel 0000 0001 0002 0003 Record ID Reserved Page Number Taxpayer Identification Number Filler Record Occurrence Number PIN Type Code 4 6 6 5 9 0004 0005 0008 1 7 1 Blank N 0000001 P = Practitioner PIN S = Self-Select PIN Practitioner O = Self-Select PIN On Line Blank = No PIN Used F8453/8453-OL Required YYYYMMDD N 0010 0020 Primary Date of Birth Primary Prior Year Adjusted Gross Income Primary Taxpayer Signature Spouse Date of Birth Spouse Prior Year Adjusted Gross Income Spouse Signature August 30, 2002 8 12 0035 0040 0050 5 8 12 N (PIN) YYYYMMDD N 0065 5 N (PIN) Part II Page 787 Section 5 Publication 1346 AUTHENTICATION Field Identification No. ----- -------------0070 0075 Taxpayer Signature Date Jurat/Disclosure Code Authentication Record Form Ref. ---Length -----8 1 Field Description ----------------YYYYMMDD A = On-Line Self Select PIN Form 1040/A/EZ B = Regular On-Line Filing Form 1040/A/EZ C = Self Select PIN by ERO Form 1040/A/EZ D = Practitioner PIN Program Form 1040/A/EZ or Blank (Form 8453 Required) Blank = PIN not used, 1 = Taxpayer Entered PIN 2 = ERO Entered Primary PIN 3 = ERO Entered Spouse PIN 4 = ERO Entered Both PINs AN AN 0080 PIN Authorization Code 1 0090 0100 ERO EFIN/PIN Signature Of Prep Oth Than Taxpayer (F2350 & 2688) Signature Explanation (Forms 2350 & 2688) Fiduciary Name (1) (Form 56) Fiduciary Title (1) (Form 56) Fiduciary Name (2) (Form 56) Fiduciary Title (2) 11 35 0110 80 AN 0120 0130 0140 0150 35 20 35 20 AN AN AN AN Publication 1346 August 30, 2002 Part II Page 788 Section 5 AUTHENTICATION Field Identification No. ----- -------------- Authentication Record Form Ref. ---Length -----Field Description ----------------- Record Terminus Character 1 Value "#" Note: The fields for the Primary and Spouse Self Select PINs, the Jurat Version Indicator and the Paid Preparer Self Select PIN are in in the Return record. Publication 1346 August 30, 2002 Part II Page 789 Section 5 INTENTIONAL BLANK PAGE Publication 1346 August 30, 2002 Part II Page 790 Section 5 SECTION 6 STATEMENT RECORD The statement record can be used only where the Record Layout specifies. Field Identification No. ----- -------------Byte Count Form Ref. ---- Length -----4 4 6 6 5 9 Field Description ----------------"0123" Value "****" "STMbnn" nn = 01-99 Blank "PGnnb" nn = 01-02 N nnnnnnnnn (Primary SSN) Blank "LNnnb" nn = 01-99 Blank Statement Title if "LN01"; column titles or blank if "LN02"; otherwise, left-justified field(s) from form or schedule Start of Record Sentinel 0000 0001 0002 0003 Record ID Reserved Page Number Taxpayer Identification Number Filler Line Number Filler Statement Data 0004 0005 0006 0010 1 5 2 80 Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 791 Section 6 INTENTIONAL BLANK PAGE Publication 1346 August 30, 2002 Part II Page 792 Section 6 LTCGL Field Identification No. ----- -------------Byte Count Long-Term Capital Gains/Loss Transaction Form Ref. ---Length -----4 4 6 6 5 9 Field Description ----------------"0129" Value "****" "LTCGLb" "SCHbbD" or "8865bb" "PG01b" N (Primary SSN) Start of Record Sentinel 0000 0001 0002 0003 Record ID Subpart Type Page Number Taxpayer Identification Number Filler Subpart Occurrence Number Transaction Occurrence Number L-T Description of Property L-T Date Acquired L-T Date Sold L-T Sales Price L-T Cost or Other Basis L-T Gain or (Loss) 28% Rate Gain or Loss 8(a) 8(b) 8(c) 8(d) 8(e) 8(f) 8(g) 0004 0005 1 7 Blank SCH D "0000001" or 8865 "0000001-0000005" 0000001-0005000 AN DT, or "INHERIT" or "VARIOUS" DT N, or "EXPIRED" N N N 0010 0020 0040 0060 0080 0100 0120 0140 7 15 8 8 12 12 12 12 Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 793 Section 6 INTENTIONAL BLANK PAGE Publication 1346 August 30, 2002 Part II Page 794 Section 6 STCGL Field Identification No. ----- -------------Byte Count Short-Term Capital Gain/Loss Transaction Form Ref. ---Length -----4 4 6 6 5 9 Field Description ----------------"0117" Value "****" "STCGLb" "SCHbbD" or "8865bb" "PG01b" N (Primary SSN) Start of Record Sentinel 0000 0001 0002 0003 Record ID Subpart Type Page Number Taxpayer Identification Number Filler Subpart Occurrence Number Transaction Occurrence Number S-T Description of Property S-T Date Acquired S-T Date Sold S-T Sales Price S-T Cost or Other Basis S-T Gain or (Loss) 1(a) 1(b) 1(c) 1(d) 1(e) 1(f) 0004 0005 0010 0020 0040 0060 0080 0100 0120 1 7 7 15 8 8 12 12 12 Blank SCH D "0000001" or 8865 "0000001-0000005" 0000001-0005000 AN DT, or "VARIOUS" DT, or "BANKRUPT" N, or "EXPIRED" N, or "EXPIRED" N Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 795 Section 6 INTENTIONAL BLANK PAGE Publication 1346 August 30, 2002 Part II Page 796 Section 6 SECTION 7 PREPARER NOTE, ELECTION EXPLANATION, REGULATORY EXPLANATION Preparer Note Record PREPARER NOTE The Preparer Note record is a variable length record composed record identifying information (42 positions) and up to 4000 data characters followed by the Record Terminus (#). Begin preparer note data in Field 0010 and enter the record terminus after the last significant position. A maximum of twenty pages is allowed. Embedded blank spaces and blank lines are permitted to accommodate tables and columns or to separate multiple notes. Field Identification No. ----- -------------Byte Count Start of Record Sentinel 0000 0001 0002 0003 Record ID Reserved Page Number Taxpayer Identification Number Filler Text Data Character Count Preparer Note Data Form Ref. ---Length -----4 4 6 6 5 9 Field Description ----------------"nnnn" Value "****" "NTEbbb" Blank "PGnnb" (nn = 01-20) N (Primary SSN) 0004 0005 0010 4 4 1 - 4000 Blank N, Value 0001 - 4000 All characters except for asterisk "*" and brackets "[" or "]" Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 797 Section 7 INTENTIONAL BLANK PAGE Publication 1346 August 30, 2002 Part II Page 798 Section 7 ELECTION EXPLANATION Election Explanation Record The Election Explanation record is a variable length record composed record identifying information (42 positions) and up to 4000 data characters followed by the Record Terminus (#). Begin election explanation data in Field 0010 and enter the record terminus after the last significant position. A maximum of twenty page records is permitted. Embedded blank spaces and blank lines are permitted to accommodate tables and columns or to separate multiple explanations. Field Identification No. ----- -------------Byte Count Start of Record Sentinel 0000 0001 0002 0003 Record ID Reserved Page Number Taxpayer Identification Number Filler Text Data Character Count Elections Data Form Ref. ---Length -----4 4 6 6 5 9 Field Description ----------------"nnnn" Value "****" "ELCbbb" Blank "PGnnb" (nn = 01-20) N (Primary SSN) 0004 0005 0010 4 4 1 - 4000 Blank N, Value 0001 - 4000 All characters except for asterisk "*" and brackets "[" or "]" Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 799 Section 7 INTENTIONAL BLANK PAGE Publication 1346 August 30, 2002 Part II Page 800 Section 7 REGULATORY EXPLANATION Regulatory Explanation Record The Regulatory Explanation record is a variable length record composed record identifying information (42 positions) and up to 4000 data characters followed by the Record Terminus (#). Begin regulatory explanation data in Field 0010 and enter the record terminus after the last significant position. A maximum of twenty page records is permitted. Embedded blank spaces and blank lines are permitted to accommodate tables and columns or to separate multiple explanations. Field Identification No. ----- -------------Byte Count Start of Record Sentinel 0000 0001 0002 0003 Record ID Reserved Page Number Taxpayer Identification Number Filler Text Data Character Count Regulatory Data Form Ref. ---Length -----4 4 6 6 5 9 Field Description ----------------"nnnn" Value "****" "REGbbb" Blank "PGnnb" (nn = 01-20) N (Primary SSN) 0004 0005 0010 4 4 1 - 4000 Blank N, Value 0001 - 4000 All characters except for asterisk "*" and brackets "[" or "]" Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 801 Section 7 INTENTIONAL BLANK PAGE Publication 1346 August 30, 2002 Part II Page 802 Section 7 SECTION 8 STATE RECORDS Generic Record The generic record is used by states for various state income tax forms. In order to program software using the generic record developers must obtain a copy of the states' software specifications. The State Direct Deposit Section should be blank if there is no direct deposit or direct debit at the state level. There is no connection between the federal and state direct deposit or direct debit fields since these can differ. The Consistency Section contains fields which when non-zero are checked against the corresponding 1040 field. If non-equal the taxpayer's returns will be rejected. See Section 12, paragraph .09 item (h) of the IRS File Specifications for additional details. Field # Identification Length Description | ************************* HEADER SECTION *************************** Byte Count 4 "2500" for fixed; "nnnn" for variable format Start of Record Sentinel 4 Value "****" 0000 Record ID Type 6 "STbbbb" 0001 Form Number 6 "0001bb" 0002 Page Number 5 "PG01b" 0003 Taxpayer Identification Number 9 N (Primary SSN) 0004 Filler 1 blank 0005 Form/Schedule Number 7 N Value "0000001" ***************************************** *****************Header ends 0010 State Code 2 A Values: AL AR AZ CO CT DC DE GA HI ID IL IN IA KS KY LA MD MI MO MS MT ND NE NC NJ NM NY OH OK OR PA RI SC UT VA VT WI WV 0011 CITY CODE 2 A Reserved for future use 0019 State-Only-Indicator 2 “SO”(State Only return data) 0020 Declaration Control Number 14 N Assigned by filer a. First Two Positions 2 N Value Always "00" b. EFIN of Originator 6 N c. Batch Number 3 N (000-999) d. Serial Number 2 N (00-99) e. Year Digit 1 N Value "3" ********************************************************************* 0023 Return Sequence Number 16 N Required Entry a. ETIN of transmitter 5 N Must Equal RSN b. Trans Use Field 2 N in 1040, A or EZ c. Julian Date of Tr 3 N d. Trans Seq. Number 2 N (01-99) e. Seq Number of Ret 4 N (0001-9999) | | Publication 1346 August 30, 2002 Part II Page 803 Section 8 Generic Record (Continued) Length Description Field # Identification *********** STATE DIRECT DEPOSIT OR DIRECT DEBIT SECTION *********** 0024 Direct Deposit/Debit Indicator 1 1 = Direct Deposit 2 = If Direct Debit 0025 Reserved-RTN-Flag 1 N For State Use Only 0030 State-Routing Transit 9 N blank if no State DD 0032 State-RTN-Indicator 1 N 0 = No State RTN Present | 1 = State RTN found on FOMF 2 = State RTN not found on FOMF 0035 State-Deposit Acct No 17 AN blank if no State DD 0040 State-Checking-Acct 1 "X" or blank 0048 State-Savings-Acct 1 "X" or blank ************************ INDICATORS ******************************** 0049 On-Line-State-Return 1 A Value "O" = On-Line ************** PARTICIPANT SECTION *********************************** 0050 State Numeric Area 27 N a. Preparer SSN/Preparer TIN 9 N or PNNNNNNNN 1040 Seq 1360 b. Preparer EIN 9 N 1040 Seq 1380 c. Preparer ZIP 5 N 1040 Seq 1410-5 d. Preparer ZIP+4 4 N 1040 Seq 1410-4 0052 State Alphanumeric Area 93 AN a. Mailbox ID 5 AN b. Preparer Firm Name 35 AN 1040 Seq 1370 c. Preparer Address 30 AN d. Preparer City 20 AN 1040 Seq 1390 e. Preparer State 2 AN 1040 Seq 1400 f. Preparer Self-Empl Ind 1 AN 1040 Seq 1350 *********************** ENTITY SECTION *********************************** 0055 Spouse's SSN 9 N 0060 Name Line 1 35 AN Required Entry a. Primary Last Name 32 AN b. Primary Suffix 3 AN 0065 Name Line 2 35 AN a. Secondary Last Name 32 AN b. Secondary Suffix 3 AN 0070 Name Line 3 35 AN a. Primary First Name 16 AN b. Primary Middle Init 1 AN c. Secondary First Name 16 AN d. Secondary Middle Init 1 AN e. Filler 1 AN Blank 0075 Address Line 1 35 AN | 0077 Foreign Street Address 35 AN | 0080 Address Line 2 35 AN 0085 City 22 A | 0087 Foreign City State or Province 35 AN | 0090 City Code 5 N 0095 State Abbreviation 2 A | Publication 1346 August 30, 2002 Part II Page 804 Section 8 Generic Record (Continued) Length Description Field # Identification 0098 Foreign Country 22 A | 0100 Zip Code 12 N | 0105 County 20 A 0110 County Code 5 N 0115 Telephone Number 12 AN *********************** CONSISTENCY SECTION ****************************** 0150 Federal Filing Status 1 N Please see Part I, Sect 12, Para. 09(h) 0155 Total Federal Exemptions 2 N See Seq 0150 Desc. 0160 Wages, Salaries, Tips 12 N See Seq 0150 Desc. 0165 Taxable Interest 12 N See Seq 0150 Desc. 0170 Tax Exempt Interest 12 N See Seq 0150 Desc. 0175 Dividends 12 N See Seq 0150 Desc. 0180 State Refund 12 N See Seq 0150 Desc. 0185 Taxable Social Sec Benefits 12 N See Seq 0150 Desc. 0190 Keogh Plan and SEP 12 N See Seq 0150 Desc. Deductions 0195 Adjusted Gross Income 12 N See Seq 0150 Desc. 0200 Standard/Itemized Deductions 12 N See Seq 0150 Desc. 0205 Earned Income Credit 12 N See Seq 0150 Desc. ********************* ALPHANUMERIC SECTION ****************************** 0300 Alphanumeric Field 1 80 AN a. Software Developer Code 10 AN b. Paid Preparer Name 31 AN 1040 Seq 1340 c. Preparer Phone Number 10 AN d. Non-Paid Preparer 13 AN 1040 Seq 1338 e. Preparer State EIN 16 AN 0305 Alphanumeric Field 2 80 AN 0310 Alphanumeric Field 3 80 AN 0315 Alphanumeric Field 4 80 AN 0320 Alphanumeric Field 5 80 AN ******************** SIGNED NUMERIC SECTION *********************** 0350 Numeric Field 1 12 N 0355 Numeric Field 2 12 N 0360 Numeric Field 3 12 N 0365 Numeric Field 4 12 N 0370 Numeric Field 5 12 N 0375 Numeric Field 6 12 N 0380 Numeric Field 7 12 N 0385 Numeric Field 8 12 N 0390 Numeric Field 9 12 N 0395 Numeric Field 10 12 N 0400 Numeric Field 11 12 N Publication 1346 August 30, 2002 Part II Page 805 Section 8 Generic Record (Continued) Length 12 12 12 12 12 12 12 12 12 12 12 12 12 12 12 12 12 12 12 12 12 12 12 12 12 12 12 12 12 12 12 12 12 12 12 12 12 12 12 12 12 12 12 12 12 12 12 Description N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Field # Identification 0405 0410 0415 0420 0425 0430 0435 0440 0445 0450 0455 0460 0465 0470 0475 0480 0485 0490 0495 0500 0505 0510 0515 0520 0525 0530 0535 0540 0545 0550 0555 0560 0565 0570 0575 0580 0585 0590 0595 0600 0605 0610 0615 0620 0625 0630 0635 Numeric Numeric Numeric Numeric Numeric Numeric Numeric Numeric Numeric Numeric Numeric Numeric Numeric Numeric Numeric Numeric Numeric Numeric Numeric Numeric Numeric Numeric Numeric Numeric Numeric Numeric Numeric Numeric Numeric Numeric Numeric Numeric Numeric Numeric Numeric Numeric Numeric Numeric Numeric Numeric Numeric Numeric Numeric Numeric Numeric Numeric Numeric Field Field Field Field Field Field Field Field Field Field Field Field Field Field Field Field Field Field Field Field Field Field Field Field Field Field Field Field Field Field Field Field Field Field Field Field Field Field Field Field Field Field Field Field Field Field Field 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 Publication 1346 August 30, 2002 Part II Page 806 Section 8 Generic Record (Continued) Length 12 12 12 12 12 12 12 12 12 12 12 12 12 12 12 12 12 12 12 12 12 12 12 12 12 12 12 12 12 12 12 12 12 12 12 12 12 12 12 12 12 12 12 12 12 12 12 Description N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N Field # Identification 0640 0645 0650 0655 0660 0665 0670 0675 0680 0685 0690 0695 0700 0705 0710 0715 0720 0725 0730 0735 0740 0745 0750 0755 0760 0765 0770 0775 0780 0785 0790 0795 0800 0805 0810 0815 0820 0825 0830 0835 0840 0845 0850 0855 0860 0865 0870 Numeric Numeric Numeric Numeric Numeric Numeric Numeric Numeric Numeric Numeric Numeric Numeric Numeric Numeric Numeric Numeric Numeric Numeric Numeric Numeric Numeric Numeric Numeric Numeric Numeric Numeric Numeric Numeric Numeric Numeric Numeric Numeric Numeric Numeric Numeric Numeric Numeric Numeric Numeric Numeric Numeric Numeric Numeric Numeric Numeric Numeric Numeric Field Field Field Field Field Field Field Field Field Field Field Field Field Field Field Field Field Field Field Field Field Field Field Field Field Field Field Field Field Field Field Field Field Field Field Field Field Field Field Field Field Field Field Field Field Field Field 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 102 103 104 105 Publication 1346 August 30, 2002 Part II Page 807 Section 8 Generic Record (Continued) Length 12 12 12 12 12 12 12 12 12 12 12 Description N N N N N N N N N N N Field # Identification 0875 0880 0885 0890 0895 0900 0905 0910 0915 0920 0925 Numeric Numeric Numeric Numeric Numeric Numeric Numeric Numeric Numeric Numeric Numeric Field Field Field Field Field Field Field Field Field Field Field 106 107 108 109 110 111 112 113 114 115 116 Record Terminus 1 Value # Publication 1346 August 30, 2002 Part II Page 808 Section 8 Unformatted Record The unformatted record is used by most states for various state and federal income tax forms. In order to program software using the unformatted record, developers must obtain a copy of the states' software specifications. Field # Identification Length Description ************************* HEADER SECTION *************************** Byte Count 4 "4861" for fixed; "nnnn" for variable format Start of Record Sentinel 4 Value "****" 0000 Record ID Type 6 "STbbbb" 0001 Form Number 6 "0002bb" 0002 Page Number 5 "PG01b" 0003 Taxpayer Identification Number 9 N (Primary SSN) 0004 Filler 1 blank 0005 Form/Schedule Number 7 N "0000001" to "0000009" **********************************************************Header ends 0010 State Code 2 A Values: AL AR AZ CO CT DC DE GA HI ID IL IN IA KS KY LA MD MI MO MS MT ND NE NC NJ NM NY OH OK OR PA RI SC UT VA VT WI WV 0011 CITY CODE 2 A Reserved for future use 0020 Declaration Control Number 14 N Assigned by filer a. First Two Positions 2 N Value Always "00" b. EFIN of Originator 6 N c. Batch Number 3 N (000-999) d. Serial Number 2 N (00-99) e. Year Digit 1 N Value "3” **************************** DATA SECTION ************************** 0050 . . . . . . . . . . . . 0345 Form Data (line 001) 80 AN (See Section 12 of File Specs Paragraph .04 for character restrictions) | (Up to 60 lines of data per page may be entered) Form Data (line 060) 80 AN Record Terminus 1 Value "#" Publication 1346 August 30, 2002 Part II Page 809 Section 8 INTENTIONAL BLANK PAGE Publication 1346 August 30, 2002 Part II Page 810 Section 8 Section 9 SUMMARY RECORD The final record for each tax return is the SUMMARY RECORD. (A "1" in the paper document indicator field shows that the paper document specified is a part of the return, and has been attached to the Taxpayer Declaration Form 8453, else enter "0". When a Paper Document Indicator is used, the Taxpayer cannot use a Self-Select PIN signature on the return.) The format is as follows: Field No. ----Identification -------------Byte Count Start of Record Sentinel 0000 0001 0002 Record ID Filler Taxpayer Identification Number Filler Electronic Return Originator Name Electronic EFIN of ERO Intermediate Service Provider EFIN/SBIN Number of Logical Records in Tax Return Number of Form W-2 Records Number of Form W-2C Records Number of Form W-2G Records Number of Form W2GU Records August 30, 2002 Form Ref. ---Length -----4 4 6 11 9 Field Description ----------------"0244" for Fixed or Variable Format Value "****" Value "SUMbbb" Blank Taxpayer's SSN (Primary Taxpayer's SSN if married filing on joint return) Blank AN N AN or blank 0003 0010 0020 0030 8 35 6 6 0040 6 N (Maximum = 009999) 0050 0055 0060 0063 2 2 2 2 N (00-50) N (00-10) N (00-30) N (00-10) | Publication 1346 Part II Page 811 Section 9 SUM RECORD Field No. ----0065 0070 0075 0080 0090 0100 0110 0120 0130 Identification -------------Number of Form 1099G Records Number of Form 1099R Records Number of FEC Records Number of Schedule Records Number of Form Records Number of Statement Record Lines Number of Preparer Note Records Number of Election Explanation Records Number of Regulatory Explanation Records Number of STCGL Records Number of LTCGL Records Presence of Authentication Record Paper Document Indicator 1 Form Ref. ---Length -----2 2 2 3 4 5 2 2 2 Field Description ----------------N (00-10) N (00-10) N (00-10) | | N (000-099) (Occurrences of "SCHb") N (0000-0999) (Occurrences of "FRMb") N (00000-00999) (Occurrences of "LN") N (00-20) (Occurrences of "NTE") N (00-20) (Occurrences of "ELC") N (00-20) (Occurrences of "REG") N (00000-30000) N (00000-30000) | | 0133 0135 0140 5 5 1 N (0-1) (Occurrence of "ATH") "1" = Form 8283, Section B Appraisal Summary, else "0" --| "1" = Form 8332, Release of Exemption for Child of divorced or Separated Parents, else "0" Part II Page 812 Section 9 0150 1 0170 Paper Document Indicator 3 1 Publication 1346 August 30, 2002 SUM RECORD Field No. ----0180 Identification -------------Paper Document Indicator 4 Form Ref. ---Length -----1 Field Description ----------------"1" = Form 3468, Historic Structure Certificate, else "0" "1" = Form 3115, Change in Accounting Method, else "0" "1" = Form 5713, International Boycott Requests/Clauses, else "0" "1" = Form 8609, Low Income Housing Credit Allocation Certification, else "0" AN, Allowable special characters are: period, or blank (For On-Line Filer) YYYYMMDD or blank (For On-Line Filer) HHMMSS or blank (For | On-Line Filer) "Y", "N" or blank (For On-Line Filer) N AN NO ENTRY YYYYMMDD or blanks (yyyy = 2002) HHMM or blanks (HH = 00-23, MM = 00-59) 0185 Paper Document Indicator 5 Paper Document Indicator 6 1 0188 1 0189 Paper Document Indicator 7 1 0190 IP Address 15 0200 0210 0220 0230 0240 0250 0260 0270 IP Date IP Time E-Mail Indicator Software I.D. Number Software Version Identifier State Abbreviation Electronic Postmark Date Electronic Postmark Time 8 6 1 8 15 2 8 4 Publication 1346 August 30, 2002 Part II Page 813 Section 9 SUM RECORD Field No. ----0280 Identification -------------Electronic Postmark Time Zone Form Ref. ---Length -----1 Field Description ----------------"E" = Eastern Time Zone "C" = Central Time Zone "M" = Mountain Time Zone "P" = Pacific Time Zone "A" = Alaskan Time Zone "H" = Hawaiian Time Zone or blank Blank | 0290 Filler 31 Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 814 Section 9 RECAP Field Identification No. ----- -------------Byte Count Recap Record Form Ref. ---Length -----4 4 6 8 6 6 Field Description ----------------"0120" for Fixed or Variable Format Value "****" "RECAPb" Blank N N RANGE = (000001 999999) N (includes Transmitter's Use Code) N (Must be the same as on the TRANA record) N Start of Record Sentinel 0000 0010 0020 0030 Record ID Filler Total EFT Total Return Count 0040 Electronic Trnsmtr Identification Number (Etin) Julian Day of Transmission Transmission Seq Number for Julian Day in 0050 Total Accepted Returns Total Duplicated Returns Total Rejected Returns Total Duplicated EFT IRS Computed EFT Count Irs Computed Return Count Total State Only Return Count Total Accepted State Only Returns August 30, 2002 7 0050 3 0060 2 0070 0080 0090 0100 0110 0120 0130 0135 6 6 6 6 6 6 6 6 IRS Use IRS Use IRS Use IRS Use IRS Use IRS Use N (000001-999999) | IRS Use | Part II Page 815 Section 10 Publication 1346 RECAP Field Identification No. ----- -------------0137 0140 Filler Reserved for IRS Use Only Recap Record Form Ref. ---Length -----5 20 Field Description ----------------Blank AN | Record Terminus Character 1 Value "#" Publication 1346 August 30, 2002 Part II Page 816 Section 10 INTERNAL REVENUE SERVICE PART III ELECTRONIC TRANSMITTED DOCUMENTS FILE SPECIFICATIONS AND RECORD LAYOUTS FOR INDIVIDUAL INCOME TAX DOCUMENTS TAX YEAR 2002 WAGE AND INVESTMENT & ELF/QUESTIONABLE REFUND PROJECT SECTION August 30, 2002 Table of Contents Highlights Introduction Section 1 Section 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. ii . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 General Information . . . . . . . . . . . . . . . . . . . 2 4 5 6 7 Acknowledgment Format . . . . . . . . . . . . . . . . . . A. Ack Record Layout . . . . . . . . . . . . . . . . . B. Ack Error Record . . . . . . . . . . . . . . . . . . C. Ack Recap Record . . . . . . . . . . . . . . . . . . Section 3 Validation - Transmission and Forms (General). . . . . . . 9 .01 Transmission Rejection Conditions . . . . . . . . 9 .02 Form Rejection - General Conditions . . . . . . . 10 Section 4 Validation - Form Required Field Entries . . . . . . . . .17 .01 Required Conditions for Individual Tax Documents. .17 Section 5 Validation - Specific Forms . . . . . . . . . . . . . . . 18 .01 .02 .03 .04 .05 .06 Form Form Form Form Form Form 56 Specific Values . 2350 Specific Values . 2688 Specific Values . 4868 Specific Values . 9465 Specific Values . Payment Specific Values . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18 21 23 27 30 33 37 37 38 39 40 41 47 48 50 51 52 Section 6 Signature Authorization for ETD Specifications . . . . . .01 .02 .03 .04 .05 Signature Authorization . . . . . . . . . . . . Jurat/Disclosure Guidelines . . . . . . . . . . Jurat/Disclosure Codes . . . . . . . . . . . . . Jurat Language Text Selections . . . . . . . . . Jurat/Disclosure Text . . . . . . . . . . . . . . Section 7 ETD Record Layouts . . . . . . . . . . . . . . . . . . . Transmitter Record A . . . . . . . . . . . . . . . . . Transmitter Record B . . . . . . . . . . . . . . . . . Tax Document Identification . . . . . . . . . . . . . Form 56 . . . . . . . . . . . . . . . . . . . . . . . i Table of Contents (continued) Section 7 ETD Record Layouts (Continued) Form 2350 . . . . . . . . . . . . . . . . . . . . . . Form 2688 . . . . . . . . . . . . . . . . . . . . . . Form 4868 . . . . . . . . . . . . . . . . . . . . . . Form 9465 . . . . . . . . . . . . . . . . . . . . . . Attached Form Identification . . . . . . . . . . . . . Form Payment Record . . . . . . . . . . . . . . . . . Authentication Record . . . . . . . . . . . . . . . . Summary Record . . . . . . . . . . . . . . . . . . . . Recap Record . . . . . . . . . . . . . . . . . . . . . 59 64 69 72 77 78 79 81 84 ATTACHMENT 1 ATTACHMENT 2 ATTACHMENT 3 Error Reject Codes (ERC) Cross References . . . . . . . 87 Form Occurrence Number . . . . . . . . . . . . . . . . .100 Attachment Sequence Number . . . . . . . . . . . . . . .101 ii Highlights Changes made since August 6, 2001 revision are denoted by a single vertical bar in the right margin (|). Deletions are denoted by two hyphens followed by a single vertical bar (--|). 1. Form 8878, of Time to Disclosure Documents. Disclosure IRS e-file Signature Authorization on Application for Extension File was added in the instructions for ETD. The Jurat and Guidelines were added to Part III for the Electronic Transmitted Questions concerning the Signature Authorization, Jurat, and Guidelines can be directed to: Internal Revenue Service Carol Brauzer, W:CAS:SP:IEF:R NCFB C5-121 5000 Ellin Road Lanham, MD 20706 2. Questions regarding Electronic Funds Withdrawals (Direct Debit), Forms 4868 and 2350 can be directed to: Internal Revenue Service Rose Holley, W:E:O:PBR NCFB C4-221 5000 Ellin Road Lanham, MD 20706 3. For those individual who are not enrolled in the Electronic Federal Tax Payment System (EFTPS) for Processing Year 2003, payments can be submitted through Lockbox. The Forms 4868 and 2350 can be transmitted electronically. The check can be sent to the Lockbox Sites (listed on the back of the Forms 4868 and 2350) without the Forms 4868 and 2350 attached. The information must be included on the check. 1. 2. 3. 4. 5. Name (taxpayer) Social Security Number (taxpayer SSN) Tax Period Forms 4868 and 2350 Gift Tax (if any indicate the amount) Note: DO NOT complete the Gift/GST tax return information unless requesting an Extension of time to file a Gift or GST tax return. If you are filing Forms 4868 and 2350 electronically and there is a balance due, please remember that the PAYMENT MUST BE POST MARKED NO LATER THAN 4/15/03. Questions regarding ETD filing can be directed to: Internal Revenue Service Eula James, W:CAS:SP:IEF:R NCFB C4-277 5000 Ellin Road Lanham, MD 20706 iii ELECTRONIC TRANSMITTED DOCUMENTS -- INTRODUCTION The Electronic Transmitted Documents System (ETD) has been created to process electronically filed documents that are not attached to a 1040 tax return and are filed separately from the tax return (i.e., stand-alone documents). To the extent possible, the ETD system functions the same as the Electronic Filing system (ELF). For example, the same data communications subsystem is used to receive transmissions and to send acknowledgments. Documents accepted by the ETD system: Form Form Form Form Form Form 56 2350 2688 4868 9465 Payment Other differences: o The record layouts for the TRANA, Forms 56, 2688, 2350, 4868, 9465, RECAP, and Acknowledgment records have been modified: See Part III, Sections 2 and 6 for more information. To the extent possible, the transmission and error reject codes have been transferred to the ETD system. However, some differences do exist, especially in the codes for the specific tax documents. See Part III, Sections 3, 4, 5 and ATTACHMENT 1 for more information. o Publication 1346 August 30, 2002 Part III Page 1 SECTION .01 1 - GENERAL INFORMATION Data Communications Subsystem The ETD system uses the same Data Communications Subsystem as the ELF System. For information about the DCS, refer to Part I, Section 1. .02 File Format - General Description All transmission data must be in ASCII format. No binary fields may be transmitted. More information on file format can be found in Part I, Section 2. .03 File Format - Fixed and Variable Length Option There are two options for transmitting logical tax document records (excluding "TRANA", "TRANB", "SUM" and "RECAP" records): fixed and variable. See Part I, Section 3 for more information. .04 Types of Records There are five types of record associated with the ETD system; the two Transmitter records, the Document record, the Summary record and the Recap record. Each file must contain all five. Transmitter Records The first two records on each file must be the Transmitter records (TRANA and TRANB), which will contain data entered by the Transmitter (the firm transmitting directly to the IRS). The format of the TRANA and TRANB records for the ETD system are found in the Section 7 of Part III. Document Record The next record will be the document record. If a tax document consists of more than one page, then each page of a document will have a new document record with the page number incremented. Currently, no form accepted by ETD has more than one page. Attached Form Payment Up to three Form Payments and one Authentication record can be filed along with Forms 4868 and 2350. Summary Record The final record for each tax document is the SUMMARY record. This record will contain electronic filer identification data. See Section 7 of Part III for more information. Publication 1346 August 30, 2002 Part III Page 2 | SECTION .04 1 - GENERAL INFORMATION (Continued) Types of Records RECAP Record The final record in each transmitted file is the RECAP record. Section 7 of Part III for more information. .05 Types of Characters See The same chart of characters that are allowed for ELF will be allowed by ETD. Refer to Part I, Section 5 for more information. Publication 1346 August 30, 2002 Part III Page 3 SECTION 2 - ACKNOWLEDGMENT FORMAT Every transmission will be acknowledged by the return of an acknowledgment file to the transmitter. The acknowledgment file for the ETD system will be comprised of: the original transmitter records (TRANA and TRANB), an ACK Record Set for each recognizable tax document received and the Recap Acknowledgment Record. The last record includes counts for accepted and rejected documents. If the entire transmission is rejected, the acknowledgment file will contain one ACK Key record with a "T" in the acceptance code field and separate ACK Error records containing each transmission reject error code associated with the transmission. The acknowledgment of an individual document will be an ACK Record Set. This set will always have one ACK Key record and up to 96 ACK Error records associated with it. The ACK Key record will contain all of the identifying information for the document it represents, plus a field to indicate how many, if any, ACK Error records follow. Each ACK Error record will contain data defining the document, page, occurrence and the field sequence number in error and the error code defining the specific error encountered. If an ACK Key record contains an "R" in the acceptance code field, the document has been rejected due to a fatal error involving the format, internal consistency or data errors in a key field. It must be corrected and resubmitted to the IRS to be considered as a filed document. If an ACK KEY record contains a "D" in the acceptance code field, the document has been identified as a duplicate, i.e., a document has been previously transmitted and accepted for that Social Security Number. This acceptance code will be used for duplicate forms 2350 and 4868 only. If an ACK Key record contains an "A" in the acceptance code field, the document has been accepted as a filed tax document and will be processed in the same manner as a document originally submitted on paper. This does not imply that the document will pass all IRS Service Center validity checks or post to the IRS Master File without delays. If an ACK Key record contains the words “Ext Approved” in the Form 2688 Extension field (SEQ 0040), the extension request has been approved. Caution: If we later find that statements made on the extension application are false or misleading, the extension is null and void. Taxpayer will owe a late filing penalty. The reject codes and references to validation criteria that cause the codes to be assigned are listed in Part III, Attachment 1. There are differences between the reject codes in the ETD system and the codes in the ELF system. Minor differences in record layouts exist (see the acknowledgment records on the following page and the TRANA record layout in Part III, Section 7). Publication 1346 August 30, 2002 Part III Page 4 SECTION 2 - ACKNOWLEDGMENT FORMAT (CONTINUED) ACKNOWLEDGMENT RECORD LAYOUT (A) Field No. ----ACK Key Record Identification -------------Byte Count Start of Record Sentinel Length -----4 4 6 2 9 16 Description -----------"0120" "****" Value "ACKbbb" 0000 0010 0020 0030 Record Id Filler Primary SSN Electronic Transmitter Information Numeric Numeric ETIN (5), Transmitter's Use Code (2), Julian Day (3), Trans Sequence Number (2) Sequence Num for Form (4) Ext Approved or blank "A" = Accepted "R" = Rejected "T" = Transmission Rejected "D" = Duplicate blank 0 = No PIN present 1 = Practitioner PIN 2 = Self Select PIN by Practitioner Used 3 = Self-Select PIN On-Line Used “ “ (blank) = Rejected PIN blank YYYYMMDD | 0040 0050 Form 2688 Extension Acceptance Code 12 1 0060 0065 Reserved PIN Presence Indicator 3 1 0070 0080 Reserved Date Accepted 1 8 Publication 1346 August 30, 2002 Part III Page 5 SECTION 2 - ACKNOWLEDGMENT FORMAT (CONTINUED) ACKNOWLEDGMENT RECORD LAYOUT (A) Field No. ----0090 0100 0110 0111 0115 ACK Key Record Identification -------------DCN of Document Number of Error Records Length -----14 2 2 11 15 Description -----------Numeric Numeric, 00-96 (See Attachment 3) blank “PYMNT RQST RECD” or blank | | | | | | | | | | | | Attachment Sequence Number Filler Payment Acknowledgement Literals Date of Birth Validity Code 0117 1 “0” = DOB Validation Not Required “1” = All DOB(s) Valid “2” = Primary DOB Mismatch “3” = Spouse DOB Mismatch “4” = Both DOB(s) Mismatch blank blank blank blank Value "#" 0118 0119 0120 0130 Filler Reserved Reserve Reserve Record Terminus Character 2 2 1 2 1 Publication 1346 August 30, 2002 Part III Page 6 SECTION (B) Field No. ----- 2 - ACKNOWLEDGMENT FORMAT - RECORD LAYOUT (CONTINUED) ACK Error Record Identification -------------Byte Count Start of Record Sentinel Length -----4 4 6 9 Description -----------"0120" "****" Value "ACKRbb" Numeric (Must match ACK Key Record) blank Numeric (01-96) Alphanumeric Alphanumeric Numeric (01) Numeric (0000001-0000050) Numeric Numeric (nnnn) (see Attachment 1) blank Value "#" | 0000 0010 Record Id Primary SSN 0020 0030 0040 0050 0060 0070 0080 0090 Reserved Error Record Sequence Number Error Form Record ID Error Form Record Type Error Form Page Number Error Form Occurrence Error Field Sequence Number Error Reject Code 7 2 6 6 5 7 4 4 0100 Filler Record Terminus Character 55 1 Publication 1346 August 30, 2002 Part III Page 7 SECTION (C) Field No. ----- 2 - ACKNOWLEDGMENT FORMAT - RECORD LAYOUT (CONTINUED) ACK Recap Record Form Ref. ----- Identification -------------Byte Count Length -----4 4 6 8 6 6 7 Field Description ----------------"0120" Value "****" Value "RECAPb" blank N N N Start of Record Sentinel 0000 0010 0020 0030 0040 Record ID Reserve Reserve Total ETD Document Count Electronic Transmitter Identification Number and Transmitter's Use Code Julian Day of Transmission Transmission Sequence Number for Julian Day in (0050) Total ETD Documents Accepted Reserve Total ETD Documents Rejected Reserve Reserve IRS Computed ETD Document Count Reserved 0050 0060 3 2 N N (DDD) 0070 0080 0090 0100 0110 0120 0130 6 6 6 6 6 6 6 IRS Use Only IRS Use Only IRS Use Only IRS Use Only IRS Use Only IRS Use Only Blank | Publication 1346 August 30, 2002 Part III Page 8 SECTION (C) Field No. ----0135 0137 0140 2 - ACKNOWLEDGMENT FORMAT - RECORD LAYOUT (CONTINUED) ACK Recap Record Form Ref. ----- Identification -------------Reserved Filler Acknowledgment File GTX Length -----6 5 20 Field Description ----------------Blank Blank AN | | Record Terminus Character 1 Value "#" RECAP record. Field 0120 is computed by IRS. ETD Document Counts are for Forms 56, 2350, 2688, 4868 and 9465. The Payment Form is considered an attachment as described in Part III, Section 7, Attached Form Identification. Publication 1346 August 30, 2002 Part III Page 9 Section 3 - Validation - Transmission and Forms (General) This section is organized and consolidated in the following manner: Transmission Rejection Criteria then General Rejection Criteria. The underlined numbers in the left margin indicates the Error Reject Code (ERC) in Part III, Attachment 1. .01 TRANSMISSION REJECTION CONDITIONS The following conditions must exist or the entire transmission will be rejected: 0805 0806 The TRANB record must be present. The processing site must be a valid processing site: Valid ETD processing sites are: Andover, Austin, Cincinnati, Memphis, and Ogden campuses. 0822 The Transmission Sequence Number of the TRANA cannot match a previously accepted transmission. If there is any unrecognizable or inconsistent control data, the transmission will be rejected. The EFIN of the Transmitter must be present. The data records of the transmission must be in the following sequence: TRANA, TRANB, Form records and RECAP record. Form record(s) must be present. The Transmission Type Code of TRANA must be "D" or the transmission will be rejected. Program counts will be maintained which correspond to the counts shown in the RECAP record. The Total Form Count (Field 0030) in the RECAP Record must match the IRS computed counts. Records are counted as follows: Total Form Count - a count of forms submitted. This count is incremented each time the Primary SSN within a Record ID changes. 0823 - 0824 0825 - - 0831 - Publication 1346 August 30, 2002 Part III Page 10 Section 3 - Validation - Transmission and Forms (General) .01 0840 TRANSMISSION REJECTION CONDITIONS (CONTINUED) The ETIN and Transmitter's Use Code (Field 0040), Julian Day (Field 0050), and Transmission Sequence Number (Field 0060) of the RECAP record must agree with the corresponding fields of the TRANA record (Fields 0060-0080). .02 0001 0004 FORM REJECTION - GENERAL CONDITIONS The Summary Record must be present. The Primary Social Security Number (P-SSN) (Field 0003 of the Record ID) must be numeric. The Primary Social Security Number (P-SSN) (Field 0003 of the Record ID) must match the Primary SSN. The Social Security Number of the Summary record (Field 0002) must be numeric. The Social Security Number of the Summary record (Field 0002) must match the Primary SSN. All alphanumeric fields must contain the type of data specified under the columnar heading "Field Description" in Record Layouts. Alphanumeric fields must be left-justified and blank-filled unless otherwise specified. Significant money fields must be right-justified and zero filled. Money fields must be all whole dollars (no cents). All other significant numeric fields must be right-justified and zero filled. Significant percentage fields must be left-justified and zero filled. Significant date fields with a length of eight positions must contain eight numeric characters in YYYYMMDD format. Where various dates are allowed, or the date is not known, the date field should contain "00000000". Significant date fields with a length of six positions must contain six numeric characters in YYYYMM format when transmitted in variable or fixed format. - - - 0010 - - - Publication 1346 August 30, 2002 Part III Page 11 Section 3 - Validation - Transmission and Forms (General) .02 0014 FORM REJECTION - GENERAL CONDITIONS - (CONTINUED) All non-significant money fields (NO ENTRY) must be blank. All other non-significant fields must be blank unless otherwise specified in the Record Layouts. The Electronic Document Originator Name (Field 0010) must be present in the Summary Record. The EFIN of the Originator (Field 0020) must be present in the Summary Record AND be equal to the EFIN in the DCN of the ETD Document. 0027 - - 0028 - The District Office Code in the EFIN of Originator in the Document record must be valid. An “out of service center” District Office (DO) is permitted State Data is present; or when Processing Site equals “C” (Andover) and at one of the following is present: Forms 56, 2350, 2688, 4868, 9465, and address indicator of the Form equal to “3”. 0030 - The Form Payment must be accompanied by Forms 4868 or 2350. The Authentication record must be accompanied by form payment. The Document Sequence Number (DSN) must be numeric. The Declaration Control Number (DCN) (Field 0008) in the Tax Document Identification information must be numeric. Fields on a record must not be longer than specified in Record Layouts. For each record, significant data must be present following the Record ID. Field sequence numbers for each record must be in ascending order and valid for that tax document. Invalid Record ID on the incoming record. be caused by one of the following: The error may 0031 0032 - 0033 - 0034 - 0035 - 0044 - Form is not valid for Electronic Transmitted Documents. A page number is incorrect or is a duplicate. Publication 1346 August 30, 2002 Part III Page 12 Section 3 - Validation - Transmission and Forms (General) .02 0305 FORM REJECTION - GENERAL CONDITIONS - (CONTINUED) Agent’s name (if applicable) cannot be used as return label without taxpayer's name for Forms 2350 and 2688. For the foreign address document, address indicator must be set to “3” and domestic address field must be blank and Foreign Address fields must be filled. The format and content of the record identification information (Record ID) which begins each type of record must be exactly as presented in the input specifications. The number of occurrences for forms cannot exceed the number specified in Attachment 2. One One One One One Three Form Form Form Form Form Form 56 for each Primary Taxpayer 4868 for each primary taxpayer 9465 for each primary taxpayer 2350 for each primary taxpayer 2688 for each primary taxpayer PMT for each Form 4868 0306 - 0045 - - 0060 - The DSN must be in ascending numerical sequence within a transmission. However, the DSN does not have to be consecutive. The Declaration Control Number (DCN) (Field 0008) in the Tax Document identification information must be in ascending numerical sequence within the transmission. However, the DCNS do not have to be consecutive. The first two digits of the DCN must be zeros (00). The Year Digit of the DCN for Tax Year 2002 processing must be “3”. The Secondary SSN, if present, must be all numeric, cannot be all zeroes nor all nines AND must be within the valid range of SSN/ITIN. Forms 4868 and 2350 must be received no later than April 15, 2003. In the case of a previously rejected form that has been corrected, the form must be received no later than April 22, 2003. 0061 - 0062 0064 0071 - 0310 - Publication 1346 August 30, 2002 Part III Page 13 Section 3 - Validation - Transmission and Forms (General) .02 FORM REJECTION - GENERAL CONDITIONS (CONTINUED) 0311 - The cutoff date for Form 2688 is August 18, 2003, and for retransmitted forms are August 22, 2003. The Primary SSN and the Name Control for the tax document must match the corresponding data in the IRS Master File. The Secondary SSN and the Name Control for the tax document must match the corresponding data in the IRS Master File. | 0315 0316 - See Part I, Attachment 7 for list of valid District Office Codes. 0323 When Date of Death (SEQ 0250) of Form 56 is present, then year cannot be equal or later than processing year. The Tax Form Number (SEQ 0320) of Form 56 must contain '1040'. The Tax Year One (SEQ 0330), Year Two (SEQ 0332), Year Three (SEQ 0334), Period One (SEQ 0340), Period Two (0342) or Period Three (SEQ 0344) cannot be all blanks. The Jurat/Disclosure Code must be “E” for Form 4868 with Electronic Funds Withdrawal (Direct Debit), “F” for Form 9465, “G” for Form 2350 and 2688, and “H” for Form 56. The Preparer Name (SEQ 0350 for Form 2350 and SEQ 0300 for Form 2688) must match with Signature of Preparer Other Than Taxpayer (SEQ 0100) of Authentication Record. The Fiduciary-1 Name and Fiduciary-2 Name (SEQ 0610 and 0640) for Form 56 must match with Fiduciary Name (1) and Fiduciary Name (2) (SEQ 0120 and 0140) of Authentication Record. The Primary SSN of Form PMT (SEQ 0010) must be same as the Primary SSN of Form 4868 or Form 2350. If the Secondary SSN of Form PMT is present, it must be same as the Spouse SSN of Form 4868 or Form 2350. 0324 0325 - 0326 - 0327 - 0328 - 0395 - - Publication 1346 August 30, 2002 Part III Page 14 Section 3 - Validation - Transmission and Forms (General) .02 0396 FORM REJECTION - GENERAL CONDITIONS (CONTINUED) - The Form 9465 Routing Transit Number (RTN)(SEQ 0330), or the Form 4868 and Form 2350 Form Payment Routing Transit Number (SEQ 0030) must contain nine numeric characters. The first two positions must be 01 through 12, or 21 through 32; The RTN must be present on the Financial Organization Master File (FOMF); and the banking institution must Process Electronic Funds Transfer (EFT). See Part I, Section 7 for optional Routing Transit Number Validation. - The Bank Account Number for Form 9465 (SEQ 0340) or Form Payment (SEQ 0040) must be alphanumeric (i.e., only alpha characters, numeric characters, and hyphens), must be left-justified with trailing blanks if less than 17 positions, and cannot equal all zeros. - Form 9465 if the Routing Transit Number (SEQ 0330) or Bank Account Number (SEQ 0340) is significant then Checking Account Indicator (SEQ 0350) or Savings Account Indicator (SEQ 0360) must equal “X”. Both cannot equal “X”. - The Type of Account for Form 4868 and Form 2350 Form Payment, Payment (SEQ 0050) must contain “1” or “2”. 0397 - The Requested Payment Date for Form Payment (SEQ 0080) must be present and cannot be later than April 15, 2003 when a domestic payment is present. - The Requested Payment Date for Form Payment (SEQ 0080) must Be present and cannot be later than June 16, 2003, when a Foreign payment is present. - The Requested Payment Date for Form PMT (SEQ 0080) must be be a valid date format (YYYYMMDD). 0490 - When Electronic Postmark is present, Year of Electronic Postmark Date (SEQ 0260) must equal the current processing year. - When Electronic Postmark is present, the following three fields must be present: Electronic Postmark Date (SEQ 0260), Electronic Postmark Time (SEQ 0270), Electronic Postmark Time Zone (SEQ 0280). (For Authorized Electronic Postmark Transmitters only). 0491 Publication 1346 August 30, 2002 Part III Page 15 Section 3 - Validation - Transmission and Forms (General) .02 0670 FORM REJECTION - GENERAL CONDITIONS (CONTINUED) - When the PIN Type Code (SEQ 0008) of Authentication Record is “S”, then, Primary Date of Birth (SEQ 0010), Primary Prior Year AGI (SEQ 0020), Primary Taxpayer Signature (SEQ 0035), Signature Date (SEQ 0070) and Jurat/Disclosure Code (SEQ 0075) must be present. - When the PIN Type Code (SEQ 0008) of Authentication Record is “S” and Spouse PIN Number is present (SEQ 0340 for Form 2350, SEQ 0290 for Form 2688, SEQ 0400 for Form 9465), then, Spouse Date of Birth (SEQ 0040), Spouse Prior Year AGI (SEQ 0050), and Spouse Signature (SEQ 0065) must be present. - When the PIN Type Code (SEQ 0008) of Authentication Record is “P”, “S” or “O”, then, Taxpayer PIN Number (SEQ 0330 for Form 2350,\ SEQ 0280 for Form 2688, SEQ 0380 for Form 9465) must be (numeric and greater than zeroes) and must equal to Primary Taxpayer Signature (SEQ 0035) of Authentication Record. - When the PIN Type Code (SEQ 0008) of Authentication Record is “P”, “S” or “O”, and Spouse PIN Number (SEQ 0340 for Form 2350, SEQ 0290 for Form 2688, SEQ 0400 for Form 9465) is present, then, Spouse PIN Number must be (numeric and greater than zeroes) and must equal to Spouse Signature (SEQ 0065) of Authentication Record. - The Primary Taxpayer is ineligible to participate in the Self-Select PIN program if under the age of sixteen have not filed previously. - The Secondary Taxpayer is ineligible to participate in the Self-Select PIN program if under the age of sixteen and has not filed in the prior year. - When the PIN Type Code (SEQ 0008) of Authentication Record is “S” or “O”, then, Primary Prior Year AGI (SEQ 0020) of Authentication record must match with IRS Master File. - When the PIN Type Code (SEQ 0008) of Authentication Record is “S” or “O”, then, Spouse Prior Year AGI (SEQ 0050) of Authentication record must match with IRS Master File. | 0671 0674 0675 0677 0678 | 0679 0680 Publication 1346 August 30, 2002 Part III Page 16 Section 3 - Validation - Transmission and Forms (General) .02 FORM REJECTION - GENERAL CONDITIONS (CONTINUED) 0681 - When the PIN Type Code (SEQ 0008) of Authentication Record is “O”, then, Primary Date of Birth (SEQ 0010), Primary Prior Year AGI (SEQ 0020), Primary Taxpayer Signature (SEQ 0035), Signature Date (SEQ 0070) and Jurat/Disclosure Code (SEQ 0075) must be present. - When the PIN Type Code (SEQ 0008) of Authentication Record is “O” and Spouse PIN Number is present (SEQ 0340 for Form 2350, SEQ 0290 for Form 2688, SEQ 0400 for Form 9465), then, Spouse Date of Birth (SEQ 0040), Spouse Prior Year AGI (SEQ 0050), and Spouse Signature (SEQ 0065) must be present. - When the PIN Type Code (SEQ 0008) of Authentication Record is “P”, then, Primary Taxpayer Signature (SEQ 0035), Signature Date (SEQ 0070) and Jurat/Disclosure Code (SEQ 0075) must be present. - When the PIN Type Code (SEQ 0008) of Authentication Record is “P” and Spouse PIN Number (SEQ 0340 for Form 2350, SEQ 0290 for Form 2688, SEQ 0400 for Form 9465) is present, then, Spouse Signature (SEQ 0065) must be present. - If more than 96 reject conditions are identified, the last Reject Code will be "999". Filers should use the information on the acknowledgment file to resolve reject conditions. 0682 0697 0698 0999 Publication 1346 August 30, 2002 Part III Page 17 Section 4 - Validation - Form Required Field Entries .01 (1) 0004 Required Conditions for Individual Tax Documents Primary SSN - The Primary SSN must be numeric, cannot be all blanks nor all zeroes nor all nines, must equal the P-SSN (field 0003) AND must be within the valid range of SSNs/ITINs. - In the Form 9465, the Primary SSN must not equal the Spouse SSN. 0900 - In the Form 4868, the Primary SSN must not duplicate the Primary SSN of an electronic transmitted Form 4868 previously accepted for the current tax year. - In the Form 2350, the Primary SSN must not duplicate the Primary SSN of an electronic transmitted Form 2350 previously accepted for the current tax year. (See Part I, Section 10, SSN Validation for the valid range of SSN and ITIN) (2) Primary Name Control 0006 - Primary Name Control must equal the first four significant characters of the Primary Taxpayer's Last Name. - Primary Name Control and Secondary Name Ctrl may not contain leading or embedded spaces. The two leftmost positions must be alpha. Only alpha, hyphen and space are allowed. Omit punctuation marks, titles and suffixes. For more information regarding name controls, see Part I, Attachment 8. Publication 1346 August 30, 2002 Part III Page 18 Section 5 - Validation - Specific Forms .01 (1) 0003 (2) 0020 Form 56 Record Identification The Tax Period (Field 0005) must be "200212". | Decedent's and Fiduciary's Name Decedent's name (SEQ 0010) and fiduciary's name (SEQ 0130) can have no leading or consecutive embedded spaces. The only characters allowed are alpha, space, hyphen(-), and less-than (<). The leftmost position must be alpha. The less-than sign replaces the intervening space to identify the Taxpayer or spouse's last name. It cannot be preceded or followed by a space. All apostrophes (') and any other punctuation characters, except the hyphen (-), must be omitted from names and the alphabetic characters shifted to the left in their place (e.g., O'Shea = OSHEA). Numeric Characters in name components must be replaced by alphabetic Roman Numerals (e.g., Charles 3rd = CHARLES III) Enter a less-than symbol (<) after the Last Name only if a title suffix follows (e.g., "III", JR). Do not enter a space before or after any less-than; the less-than takes the place of a space. Names CANNOT BE MORE THAN 35 CHARACTERS. - - - 0033 (3) 0007 - Street Address Decedent's Street Address (SEQ 0050) for the document filed from U.S. possessions or Foreign Street Address (SEQ 0090) and Foreign City State or Province, Postal Code (SEQ 0100) for the document filed from foreign address must be alphanumeric and can have no leading or consecutive embedded spaces. The only special characters allowed are space, hyphen(-), slash(\). Fiduciary's Street Address (SEQ 0150) for the document filed from U.S. possessions or Foreign Street Address (SEQ 0190) and Foreign City State or Province, Postal Code (SEQ 0200) for the document filed from foreign address must be alphanumeric and can have no leading or consecutive embedded spaces. The only special characters allowed are space, hyphen(-), slash(\). - Publication 1346 August 30, 2002 Part III Page 19 Section 5 - Validation - Specific Forms .01 Form 56 (Continued) The first position or character entered must be alphabetic or numeric. Enter the house number and street, route number, post office box or box number. Words may be abbreviated, using the standard abbreviations in Part I, Attachment 2 unless the word is a proper name. Enter one-half as 1/2, no spaces. Always add st, nd, rd or th to a numbered street or avenue. Examples: 1 = 1ST; 2 = 2ND; 3 = 3RD, etc. Do not use # symbol, No. or Number" as a prefix to a house, apt., route or PO box. Replace a period with a space. - - - - - For more information on Street Address, see Part I, Attachment 2. (4) 0023 City The Decedent's City (SEQ 0060) for the document filed from U.S. possessions, or foreign Country (SEQ 0110) for the document filed from foreign country must be present, left-justified and contain a minimum of three alpha characters, blank-filled when transmitted in fixed format. The Fiduciary's City (SEQ 0160) for the document filed from possessions, or foreign Country (SEQ 0210) for the document foreign country must be present, left-justified and contain of three alpha characters, blank-filled when transmitted in format. U.S. filed from a minimum fixed - - The City field may not contain consecutive embedded spaces. The only allowable characters are alphabet and spaces. DO NOT abbreviate city names. (5) 0022 State Decedent's State Abbreviation (SEQ 0070) must be alphabetic and consistent with the standard state abbreviations issued by the Postal Service. Publication 1346 August 30, 2002 Part III Page 20 Section 5 - Validation - Specific Forms .01 Form 56 (Continued) Fiduciary's State Abbreviation (SEQ 0070) must be alphabetic and consistent with the standard state abbreviations issued by the Postal Service. These abbreviations must be used for the State Abbreviation field and must correspond with the valid range of the three high order zip code digits for the state. For more information on State Codes, see Part I, Attachment 3. (6) 0016 Zip Code Decedent's Zip Code (SEQ 0080) and Fiduciary's Zip Code (SEQ 0180), for the document filed from U.S. and its possessions must be within the valid range for zip codes listed for that state and must not end in 00" (with the exception of 20500, the White House zip code). For more information on Zip Codes, see Part I, Attachment 3. (7) Foreign Address 0306 If the Address Indicator (SEQ 0120) is set to 3, then Foreign Street (SEQ 0090), Foreign City (SEQ 0100), and Foreign Country (SEQ 0110) must be present and Decedent's Street Address (SEQ 0050), Decedent's City (SEQ 0060), Decedent's State Abbreviation (SEQ 0070) and Decedent's Zip Code (SEQ 0080) must not be present. Zeroes in Decedent's ZIP Code (SEQ 0080) are allowed. If the Address Indicator (SEQ 0220) is set to 3, then Foreign Street (SEQ 0190), Foreign City (SEQ 0200), and Foreign Country (SEQ 0210) must be present and Fiduciary's Street Address (SEQ 0150), Fiduciary 's City (SEQ 0160), Fiduciary 's State Abbreviation (SEQ 0170) and Fiduciary's Zip Code (SEQ 0180) must not be present. Zeroes in Fiduciary's ZIP Code (SEQ 0180) are allowed. - (8) 0318 Phone Number Either the Fiduciary's USA Phone No (SEQ 0225) or Fiduciary's Foreign Phone No (SEQ 0230) must be present and numeric. It cannot be all zeroes. Publication 1346 August 30, 2002 Part III Page 21 Section 5 - Validation - Specific Forms .01 (9) 0323 Form 56 (Continued) Date of Death Year of Date of Death (SEQ 0250) cannot be equal or greater than processing year. (10) 0324 (11) 0325 Tax Form Number Tax Form Number (SEQ 0320) must be '1040'. Tax Years or Periods Ending One or more Tax year (SEQ 0330, 0332, 0334)or Periods ending (SEQ 0340, 0342, 0344) must be present. (12) 0328 Fiduciary-1 and Fiduciary-2 Name When Fiduciary-1 Name (SEQ 0610) and/or Fiduciary-2 Name (SEQ 0640) Present, it must be same as Fiduciary Name (1) (SEQ 0120) and/or Fiduciary Name (2) (SEQ 0140) of Authentication Record. Publication 1346 August 30, 2002 Part III Page 22 Section 5 - Validation - Specific Forms .02 (1) 0003 (2) 0020 Form 2350 Record Identification The Tax Period (Field 0005) must be "200212". | Taxpayer's or Spouse's Name Taxpayer's name (SEQ 0010) or spouse's name (SEQ 0040) can have no leading or consecutive embedded spaces. The only characters allowed are alpha, space, hyphen(-), and less-than (<). The leftmost position must be alpha. The less-than sign replaces the intervening space to identify the Taxpayer or spouse's last name. It cannot be preceded or followed by a space. All apostrophes (') and any other punctuation characters, except the hyphen (-), must be omitted from names and the alphabetic characters shifted to the left in their place (e.g., O'Shea = OSHEA). Numeric Characters in name components must be replaced by alphabetic Roman Numerals (e.g., Charles 3rd = CHARLES III) Enter a less-than symbol (<) after the Last Name only if a title suffix follows (e.g., "III", JR). Do not enter a space before or after any less-than; the less-than takes the place of a space. DO NOT ENTER DECEDENT NAMES IN TAXPAYER'S NAME - DECEDENT FORMS MAY NOT BE FILED ELECTRONICALLY. Names CANNOT BE MORE THAN 35 CHARACTERS. If the Spouse SSN (SEQ 0060) on Form 2350 is significant, the Spouse's Name (SEQ 0040) must be present. If the Spouse SSN (SEQ 0060) on Form 2350 is NOT significant, the Spouse's Name (SEQ 0040) MUST NOT be present. - - - - 0033 0312 - - For more information on Name Line 1, see Part I, Section 7. (3) 0322 Extension Date Extension date (SEQ 0160) must be present and a valid date range. Publication 1346 August 30, 2002 Part III Page 23 Section 5 - Validation - Specific Forms .02 (4) 0314 Form 2350 (continued) Spouse SSN If the Spouse Gift Tax Amount is significant and the Spouse Gift Tax Box contains an "X", the Spouse SSN must be present. (5) 0007 Street Address Street Address (SEQ 0070) for the document filed from U.S. possessions or Foreign Street Address (SEQ 0110) and Foreign City State or Province (SEQ 0120) for the document filed from foreign address must be alphanumeric and can have no leading or consecutive embedded spaces. The only special characters allowed are space, hyphen(-), slash(\). The first position or character entered must be alphabetic or numeric. Enter the house number and street, route number, post office box or box number. Words may be abbreviated, using the standard abbreviations in Part I, Attachment 2 unless the word is a proper name. Enter one-half as 1/2, no spaces. Always add st, nd, rd or th to a numbered street or avenue. Examples: 1 = 1ST; 2 = 2ND; 3 = 3RD, etc. Do not use # symbol, No. or Number" as a prefix to a house, apt., route or PO box. Replace a period with a space. - - - - - - For more information on Street Address, see Part I, Attachment 2. (6) 0023 City The City (SEQ 0080) for the document filed from U.S. possessions, or Foreign Country (SEQ 0130) for the document filed from foreign country must be present, left-justified and contain a minimum of three alpha characters, blank-filled when transmitted in fixed format. The City field may not contain consecutive embedded spaces. The only allowable characters are alphabet and spaces. DO NOT abbreviate city names. Publication 1346 August 30, 2002 Part III Page 24 Section 5 - Validation - Specific Forms .02 (7) 0022 Form 2350 (continued) State State Abbreviation (SEQ 0090) must be alphabetic and consistent with the standard state abbreviations issued by the Postal Service. These abbreviations must be used for the State Abbreviation field and must correspond with the valid range of the three high order zip code digits for the state. For more information on State Codes, see Part I, Attachment 3. (8) 0016 Zip Code Zip Code (SEQ 0100), for the document filed from U.S. possessions must be within the valid range for zip codes listed for that state and must not end in 00" (with the exception of 20500, the White House zip code). For more information on Zip Codes, see Part I, Attachment 3. (9) 0304 Primary PIN Number must be present. (10) Foreign Address 0306 If the Address Indicator (SEQ 0150) is set to 3, then Foreign Street (SEQ 0110), Foreign City (SEQ 0120), Foreign Country (SEQ 0130), Postal Code (SEQ 0120) must be present and Street Address (SEQ 0070), City (SEQ 0080), State Abbreviation (SEQ 0090) and ZIP Code (SEQ 0100) must not be present. Zeroes in ZIP Code (SEQ 0100) are allowed). (11) Foreign Residence Qualification 0321 Date First Arrived in Foreign Country (SEQ 0220), Date Qualifying Period Begins (SEQ 0230), Date Qualifying Period Ends (SEQ 0240), Foreign Home Address (SEQ 0250), Return to US Date (SEQ 0260) must be present and valid. Publication 1346 August 30, 2002 Part III Page 25 Section 5 - Validation - Specific Forms .03 (1) 0003 (2) 0020 Form 2688 Record Identification The Tax Period (Field 0005) must be "200212". Taxpayer's or Spouse's Name Taxpayer's name (SEQ 0010) or spouse's name (SEQ 0040) can have no leading or consecutive embedded spaces. The only characters allowed are alpha, space, hyphen(-), and less-than (<). The leftmost position must be alpha. The less-than sign replaces the intervening space to identify the Taxpayer's or spouses last name. It cannot be preceded or followed by a space. All apostrophes (') and any other punctuation characters, except the hyphen (-), must be omitted from names and the alphabetic characters shifted to the left in their place (e.g., O'Shea = OSHEA). Numeric Characters in name components must be replaced by alphabetic Roman Numerals (e.g., Charles 3rd = CHARLES III) Enter a less-than symbol (<) after the Last Name only if a title suffix follows (e.g., "III", JR). Do not enter a space before or after any less-than; the less-than takes the place of a space. DO NOT ENTER DECEDENT NAMES IN TAXPAYER'S NAME - DECEDENT FORMS MAY NOT BE FILED ELECTRONICALLY. Names CANNOT BE MORE THAN 35 CHARACTERS. If the Spouse SSN (SEQ 0060) on Form 2688 is significant, the Spouse's Name (SEQ 0040) must be present. If the Spouse SSN (SEQ 0060) on Form 2688 is NOT significant, the Spouse's Name (SEQ 0040) MUST NOT be present. - - - - 0033 0312 - - For more information on Name Line 1, see Part I, Section 7. Publication 1346 August 30, 2002 Part III Page 26 Section 5 - Validation - Specific Forms .03 (3) 0322 0317 Form 2688 (continued) Extension Date and Explanation Extension date (SEQ 0160) must be present and a valid date range. There must be an explanation as to why extension is needed in the Explanation Field (SEQ 0180 through 0220). (4) 0314 Spouse SSN If the Spouse Gift Tax Box contains an "X", the Spouse SSN must be present. (5) 0007 Street Address Street Address (SEQ 0070) for the document filed from U.S. or U.S. possessions, or Foreign Street Address (SEQ 0110) and Foreign City State or Province (SEQ 0120) for the document filed from foreign country must be alphanumeric and can have no leading or consecutive embedded spaces. The only special characters allowed are space, hyphen(-), slash(\). The first position or character entered must be alphabetic or numeric. Enter the house number and street, route number, post office box or box number. Words may be abbreviated, using the standard abbreviations in Part I, Attachment 2 unless the word is a proper name. Enter one-half as 1/2, no spaces. Always add st, nd, rd or th to a numbered street or avenue. Examples: 1 = 1ST; 2 = 2ND; 3 = 3RD, etc. Do not use # symbol, No. or Number" as a prefix to a house, apt., route or PO box. Replace a period with a space. - - - - - - For more information on Street Address, see Part I, Attachment 2. Publication 1346 August 30, 2002 Part III Page 27 Section 5 - Validation - Specific Forms .03 (6) 0023 Form 2688 (continued) City The City (SEQ 0080) for the document filed from U.S. or U.S. possessions or Foreign Country (SEQ 0130) for the document filed from foreign country must be present, left-justified and contain a minimum of three alpha characters, blank-filled when transmitted in fixed format. The City field may not contain consecutive embedded spaces. The only allowable characters are alphabet and spaces. DO NOT abbreviate city names. (7) 0022 State State Abbreviation (SEQ 0090) must be alphabetic and consistent with the standard state abbreviations issued by the Postal Service. These abbreviations must be used for the State Abbreviation field and must correspond with the valid range of the three high order zip code digits for the state. For more information on State Codes, see Part I, Attachment 3. (8) 0016 Zip Code Zip Code (SEQ 0100) must be within the valid range for zip codes listed for that state and must not end in 00" (with the exception of 20500, the White House zip code). For more information on Zip Codes, see Part I, Attachment 3. (9) 0304 Primary PIN must be present. (10) Foreign Address 0306 If the Address Indicator (SEQ 0150) is set to 3, then Foreign Street (SEQ 0110), Foreign City (SEQ 0120), Foreign Country (SEQ 0130), Postal Code (SEQ 130) must be present and Street Address (SEQ 0070), City (SEQ 0080), State Abbreviation (SEQ 0090) and ZIP Code (SEQ 0100) must not be present. Zeroes in ZIP Code (SEQ 0100) are allowed. Publication 1346 August 30, 2002 Part III Page 28 Section 5 - Validation - Specific Forms .03 Form 2688 (continued) (11) Filed Form 4868 For Auto Extension Check Box 0319 .04 (1) 0003 Filed Form 4868 Yes Check Box (SEQ 0230) must be checked. Filed Form 4868 NO Check Box (SEQ 0240) must not be checked. Form 4868 Record Identification The Tax Period (Field 0005) must be "200212". | (2) 0020 Name Line 1 Name Line 1 (SEQ 0030) can have no leading or consecutive embedded spaces. The only characters allowed are alpha, space, ampersand (&), hyphen(-), and less-than (<). The leftmost position must be alpha. The less-than sign replaces the intervening space to identify the Primary Taxpayer's last name. It cannot be preceded or followed by a space. All apostrophes (') and any other punctuation characters, except the hyphen (-), must be omitted from names and the alphabetic characters shifted to the left in their place (e.g., O'Shea = OSHEA). Numeric Characters in name components must be replaced by alphabetic Roman Numerals (e.g., Charles 3rd = CHARLES III) Enter a less-than symbol (<) after the Last Name only if a title suffix follows (e.g., "III", JR). Do not enter a space before or after any less-than; the less-than takes the place of a space. DO NOT ENTER DECEDENT NAMES IN NAME LINE 1 - DECEDENT FORMS MAY NOT BE FILED ELECTRONICALLY. - - - - Publication 1346 August 30, 2002 Part III Page 29 Section 5 - Validation - Specific Forms .04 (2) 0033 0312 Form 4868 (continued) Name Line 1 (Continued) Name Line 1 CANNOT BE MORE THAN 35 CHARACTERS. If the Spouse SSN (SEQ 0100) on Form 4868 is significant, the Name Line 1 (SEQ 0030) must contain an ampersand. If the Spouse SSN (SEQ 0100) on Form 4868 is NOT significant, the Name Line 1 (SEQ 0030) CAN NOT contain an ampersand. - For more information on Name Line 1, see Part I, Section 7. (3) 0314 Spouse SSN If the Spouse Gift Tax Amount is significant and the Spouse Gift Tax Box contains an "X", the Spouse SSN must be present. (4) 0007 Street Address Street Address (SEQ 0040) for the document filed from U.S. or U.S. possessions, or Foreign Street Address (SEQ 0032) and Foreign City State or Province (SEQ 0034) for the document filed from foreign country must be alphanumeric and can have no leading or consecutive embedded spaces. The only special characters allowed are space, hyphen(-), slash(\). The first position or character entered must be alphabetic or numeric. Enter the house number and street, route number, post office box or box number. Words may be abbreviated, using the standard abbreviations in Part I, Attachment 2 unless the word is a proper name. Enter one-half as 1/2, no spaces. Always add st, nd, rd or th to a numbered street or avenue. Examples: 1 = 1ST; 2 = 2ND; 3 = 3RD, etc. Do not use # symbol, No. or Number" as a prefix to a house, apt., route or PO box. Replace a period with a space. - - - - - - For more information on Street Address, see Part I, Attachment 2. Publication 1346 August 30, 2002 Part III Page 30 Section 5 - Validation - Specific Forms .04 (5) 0023 Form 4868 (continued) City The City (SEQ 0050) for the document filed from U.S. or U.S. possessions, or Foreign Country (SEQ 0036) for the document filed from foreign country must be present, left-justified and contain a minimum of three alpha characters, blank-filled when transmitted in fixed format. The City field may not contain consecutive embedded spaces. The only allowable characters are alphabet and spaces. DO NOT abbreviate city names. (6) 0022 State State Abbreviation (SEQ 0060) must be alphabetic and consistent with the standard state abbreviations issued by the Postal Service. These abbreviations must be used for the State Abbreviation field and must correspond with the valid range of the three high order zip code digits for the state. For more information on State Codes, see Part I, Attachment 3. (7) 0016 Zip Code Zip Code (SEQ 0070) must be within the valid range for zip codes listed for that state and must not end in 00" (with the exception of 20500, the White House zip code). For more information on Zip Codes, see Part I, Attachment 3. (8) 0306 Foreign Address If the Address Indicator (SEQ 0080) is set to 3, then Foreign Street (SEQ 0032), Foreign City (SEQ 0034), Foreign Country (SEQ 0036) must be present and Street Address (SEQ 0040), City (SEQ 0050), State Abbreviation (SEQ 0060) and ZIP Code (SEQ 0070) must not be present. (Zeroes in ZIP Code (SEQ 0070) are allowed). Publication 1346 August 30, 2002 Part III Page 31 Section 5 - Validation - Specific Forms .05 (1) Form 9465 Taxpayer's Name or Spouse Name 0020 - Taxpayer's Name (SEQ 0010) can have no leading or consecutive embedded spaces. The only characters allowed are alpha, space, hyphen(-), and less-than (<). The leftmost position must be alpha. The less-than sign replaces the intervening space to identify the Primary Taxpayer's last name. It cannot be preceded or followed by a space. - All apostrophes (') and any other punctuation characters, except the hyphen (-), must be omitted from names and the alphabetic characters shifted to the left in their place (e.g., O'Shea = OSHEA). - Numeric Characters in name components must be replaced by alphabetic Roman Numerals (e.g., Charles 3rd = CHARLES III) - Enter a less-than symbol (<) after the Last Name only if a title suffix follows (e.g., "III", JR). Do not enter a space before or after any less-than; the less-than takes the place of a space. - DO NOT ENTER DECEDENT NAMES IN NAME LINE 1 - DECEDENT FORMS MAY NOT BE FILED ELECTRONICALLY. 0033 - Taxpayer's Name CANNOT BE MORE THAN 35 CHARACTERS. If filing jointly, the Spouse Name (SEQ 0030) of Form 9465 must meet the same criteria. For more information, see Part I, Section 7, Name Line 1. (2) Street Address 0007 - Street Address (SEQ 0050) is alphanumeric and can have no leading or consecutive embedded spaces. The only special characters allowed are space, hyphen(-), slash(\). - The first position or character entered must be alphabetic or numeric. - Enter the house number and street, route number, post office box or box number. - Words may be abbreviated, using the standard abbreviations in Part I, Attachment 2 unless the word is a proper name. Publication 1346 August 30, 2002 Part III Page 32 Section 5 - Validation - Specific Forms .05 (2) Form 9465 (continued) Street Address (Continued) - Enter one-half as 1/2, no spaces. Always add st, nd, rd or th to a numbered street or avenue. Examples: 1 = 1ST; 2 = 2ND; 3 = 3RD, etc. Do not use # symbol, No. or Number" as a prefix to a house, apt., route or PO box. Replace a period with a space. For more information on Street Address, see Part I, Attachment 2. - - (3) 0023 City The City field (SEQ 0070) must be present, left-justified and contain a minimum of three alpha characters, blank-filled when transmitted in fixed format. The City field may not contain consecutive embedded spaces. The only allowable characters are alphabet and spaces. DO NOT abbreviate city names. (4) 0022 State State Abbreviation (SEQ 0080) must be alphabetic and consistent with the standard state abbreviations issued by the Postal Service. These abbreviations must be used for the State Abbreviation field and must correspond with the valid range of the three high order zip code digits for the state. For more information on State Codes, see Part I, Attachment 3. (5) 0016 Zip Code Zip Code (SEQ 0090) must be within the valid range for zip codes listed for that state and must not end in 00" (with the exception of 20500, the White House zip code). For more information on Zip Codes, see Part I, Attachment 3. Publication 1346 August 30, 2002 Part III Page 33 Section 5 - Validation - Specific Forms .05 Form 9465 (continued) (6) Foreign Address 0306 If the Address Indicator (SEQ 0095) is set to 3, then Foreign Street (SEQ 0082), Foreign City (SEQ 0084), Foreign Country (SEQ 0086), Postal Code (SEQ 0086) must be present and Street Address (SEQ 0050), City (SEQ 0070), State Abbreviation (SEQ 0080)and ZIP Code (SEQ 0090) must not be present. Zeroes in ZIP Code (SEQ 0090) are allowed. (7) 0006 Spouse Name Control If Spouse Name (SEQ 0030) is present, the Spouse Name Control (SEQ 0035) must be present and valid. For more information on Name Controls, see Part I, Attachment 8. (8) 0318 Phone Number Either the Taxpayer’s Home Phone Number (SEQ 0110) or Taxpayer’s Work Number (SEQ 0130) must be present, 10 characters long and numeric. (9) 0396 Direct Debit Information The Routing Transit Number (SEQ 0330), Bank Account Number (SEQ 0340), and Checking Account (SEQ 350) or Saving Account (SEQ 360) must be present and valid if taxpayer Chooses monthly payments using the Direct Debit Installment Agreement (DDIA) methods. For more information on Direct Debit Information, see Part III, Attachment 1. 0167 The Monthly Payment Date (SEQ 0310) must be present and in the range of 01 to 28. The Monthly Payment (SEQ 0300) must be a minimum of $25.00. The Amount Owed (SEQ 0280) CANNOT be greater than $25,000. 0168 0172 (10) 0304 - Primary PIN must be present. Publication 1346 August 30, 2002 Part III Page 34 Section 5 - Validation - Specific Forms .06 (1) 0030 Form Payment Record Identification (2) 0395 Form 4868 or Form 2350 must be present when Form Payment is filed. Authentication Form must be present when Form Payment is filed. Primary and Secondary SSN The Primary SSN (SEQ 0010) must match with the Primary SSN (SEQ 0090) of Form 4868 or (SEQ 0030) of Form 2350. If the Secondary SSN (SEQ 0020) is present, it must match with the Spouse SSN (SEQ 0100) of Form 4868 or (SEQ 0060) of Form 2350. - (3) 0396 Routing Information The Routing Transit Number (SEQ 0030) must be numeric, first two characters must be 01 through 12 or 21 through 32 and must be present on the Financial Organization Master File (FOMF). The Bank Account Number (SEQ 0040) must be 17 characters long and contains 0 to 9, A to Z and '-'. The Type of Account (0050) must be “1” for checking or “2” for savings. - - (4) 0320 Amount of Tax Payment Amount of Tax Payment (SEQ 0060) must be greater than zeroes. For extension, the amount of tax payment cannot be greater than (Amount Taxpayer is Paying (SEQ 0210) of Form 4868 less self and/or spouse's gift tax amount) or amount of income tax paid with Form (SEQ 0270) of Form 2350. For Self's Gift Tax Payment, the amount of tax payment cannot be greater than Self Amount of Gift Tax (SEQ 0170) of Form 4868 or amount of Self Gift Tax Paying (SEQ 0300) of Form 2350. For Spouse's Gift Tax Payment, the amount of tax payment cannot be greater than Spouse Gift Tax (SEQ 0180) of Form 4868 or amount of Spouse Gift Tax Paying (SEQ 0310) of Form 2350. - - Publication 1346 August 30, 2002 Part III Page 35 Section 5 - Validation - Specific Forms .06 (5) 0313 Form Payment Tax Type Code (6) For extension payment, the Tax Type Code must be 4868E or 2350E. For gift tax payment, the Tax Type Code must be 0709P or 0709S. (continued) Requested Payment Date Must be present and a valid date range. Request Payment Date (SEQ 0080)cannot be later than April 15, when a domestic payment is present. Requested Payment Date (SEQ 0080) cannot be later than June 16, 2003. | - | (7) 0318 Phone Number The Taxpayer's Day Time Phone Number must be 10 characters long and numeric. It cannot be all zeroes. (8) 0304 Primary or Secondary PIN Number The Primary PIN number must be present if the payment is for extension or Self Gift Tax. The Secondary PIN number must be present if the payment is for Spouse Gift Tax. - Publication 1346 August 30, 2002 Part III Page 36 Section 6 – Self-Select PIN for ETD Specifications .01 IRS e-file Signature Authorization on Application for Extension of Time To File (Form 8878) 1. Form 8878, IRS e-file Signature Authorization on Application for Extension of Time To File, can be used to authorize an Electronic Return Originator to enter the taxpayer’s self-select personal identification number (PIN) as the taxpayer’s signature on electronically filed Forms 4868, 2688, and 2350. Form 8878 is provided as a convenience when the taxpayer is unavailable or unable to return to the office, or it is inconvenient to personally sign the electronically prepared income tax return. The practitioner will provide Form 8878 to the taxpayer along with a copy of the completed extension application personally or by U.S. mail, private delivery service, e-mail, or an Internet web site. Upon review of their extension application, the taxpayer(s) complete Part II of Form 8878 with their PIN, signature and date. The taxpayer must return the form to the ERO either personally, by U.S. mail, private delivery service, or FAX transmission. The ERO must retain the completed Form 8878 as instructed on the form. 2. When finalized, Form 8878 and instructions for use with Tax Year 2002 e-file will be available on the IRS web site, The Digital Daily, at www.irs.gov (click on “Forms and Pubs”, then “Forms and Instructions”). The tax year 2002 form will be posted on the web site as soon as possible; however, it may not be available at the time this document is published. 3. An Exhibit of Form 8878 will also be included in Publication 1345A, Filing Supplement for Electronic Return Originators (TY 2002). Publication 1346 August 30, 2002 Part III Page 37 Section 6 – Self-Select PIN for ETD Specifications .02 Jurat/Disclosure Guidelines 1. This section provides guidelines for the jurat/disclosure language that is to be included in software packages for stand-alone documents processed through the Electronic Transmitted Document (ETD) System. 2. In all instances, the appropriate jurat/disclosure text must be provided to taxpayers prior to the presentation of fields used to enter signature(s) (e.g. PIN) and related authentication information (e.g. Date of Birth and Adjusted Gross Income). 3. On-line software products shall provide the capability for taxpayers to view the jurat/disclosure statements on the input screen. 4. Software products intended for use by tax professionals may also provide functionality to print a graphic equivalent of the jurat/disclosure statements for taxpayers to sign as an alternative to viewing and signing the statement on the input screen. A graphic equivalent may be appropriate when the taxpayer will not be present to review the completed return or document in the presence of the ERO, and has elected to authorize the ERO to enter the taxpayer(s) Self Select PIN(s). 5. The jurat/disclosure text selections and samples of the jurat/disclosure text for Codes E – H are included in Part III of this document. 6. Use the guidelines below, and notes on the text selections for jurat entry field format. Field Dates – (e.g. signature dates, Date of Birth) Taxpayer’s PIN ERO or Paid Preparer PIN Length Eight Characters All numeric Format/Notes MMDDYYYY (must convert to YYYYMMDD for record layouts) Cannot be all zeroes First six positions = Electronic Filing Identification Number (EFIN); last five positions = self selected numerics Dollars ONLY, zero fill if no prior year AGI Five Eleven All numeric All numeric Money Fields Twelve maximum All numeric 7. The following table includes the valid Jurat Disclosure Codes for electronically filed Tax Year 2002 documents processed through the Electronic Transmitted Documents (ETD) System. The codes (e.g. C2,D2,T1) in the third column identify the possible selections for each jurat/disclosure version. Publication 1346 August 30, 2002 Part III Page 38 Section 6 – Self-Select PIN for ETD Specifications .03 Jurat/Disclosure Guidelines Tax Year 2002 Jurat Disclosure Codes For Electronic Transmitted Documents (ETD) (Forms 4868, 9465, 2350, 2688, and 56) Required Notes Screen or Graphic Text Selections Prepared by: taxpayer or Preparer/ERO Transmitted by: Transmitter or Preparer/ERO Signatures: - No taxpayer signature or PIN without EFW - Taxpayer Self Select PIN required with EFW Prepared by: taxpayer or Preparer/ERO Transmitted by: Transmitter or Preparer/ERO Signatures: - No taxpayer signature or PIN without EFW - Taxpayer Self Select PIN required with EFW Prepared by: taxpayer or Preparer/ERO Transmitted by: Transmitter or Preparer/ERO Signatures: -Taxpayer(s) – Self Select PIN -Preparer Other Than Taxpayer, up to 35 character name entry. Jurat/ Disclosure Code Title E Form 4868, Application for Automatic Extension of Time To File U.S. Individual Income Tax Return C2 · Without electronic funds withdrawal (EFW) C2,D2,T1 · With electronic funds withdrawal F Form 9465, Installment Agreement Request · Without electronic funds withdrawal (EFW) · With electronic funds withdrawal C2 C2,D3,T1 G Form 2350, Application for Extension of Time To File … or Form 2688, Application for Additional Time To File… P3,C2,T3 · Signed by taxpayer without electronic funds withdrawal (EFW) P3,C2,D2,T1 · Signed by taxpayer with electronic funds withdrawal P3,C2,T4 · Signed by Preparer Other Than Taxpayer without electronic funds withdrawal Not available · Signed by Preparer Other Than Taxpayer with TaxYr 2002 electronic funds withdrawal Form 56, Notice Concerning Fiduciary Relationship · Signed by fiduciary H C2,T7 Prepared by: fiduciary or Preparer/ERO Transmitted by: Transmitter or Preparer/ERO Signatures: -Fiduciary, up to 35 character name entry. Publication 1346 August 30, 2002 Part III Page 39 Section 6 – Self-Select PIN for ETD Specifications .04 Jurat Language Text Selections This section identifies the various Perjury, Consent to Disclosure, and Electronic Funds Withdrawal (EFW) text selections (components) used to develop jurat language statements for electronic filing tax preparation software. The software shall provide the capability to incorporate these statements into the appropriate jurat text for presentation to taxpayer(s) for their review. Use the table above and the displays in this section to determine the appropriate components or building blocks to develop jurat statements for documents processed through the Electronic Transmitted Documents (ETD) system. Perjury Statement Selection P3 (ETD only) Perjury Statement – use this selection when Electronically filing Form 2688 or 2350 Perjury Statement Under penalties of perjury, I declare that, 1) I have examined this form, including any accompanying statements and schedules and, to the best of my knowledge and belief, it is true, correct, and complete; and if prepared by someone other than the taxpayer, 2) I am authorized to prepare this form. Consent to Disclosure Selection C2 (ETD only) Consent to Disclosure – use this selection for forms and documents other than Form 1040 Series returns (e.g. Forms 4868, 2350, 2688, 9465 and 56) Consent to Disclosure I consent to allow my Intermediate Service Provider, transmitter, or Electronic Return Originator (ERO) to send this form to IRS and to receive the following information from IRS: 1) acknowledgment of receipt or reason for rejection of transmission, and 2) if delayed, reason for any delay in processing. Electronic Funds Withdrawal Selections Selection D2 (ETD only) Electronic Funds Withdrawal Consent for Forms 4868 and 2350 (Include statement only with Electronic Funds Withdrawal) Electronic Funds Withdrawal Consent I authorize the U.S. Treasury and its designated Financial Agent to initiate an ACH Electronic Funds Withdrawal (Direct Debit) entry to the financial institution account indicated for payment of my Federal taxes owed, and the financial institution to debit the entry to this account. This authorization is to remain in full force and effect until I notify the U.S. Treasury Financial Agent to terminate the authorization. To revoke a payment, I must contact the U.S. Treasury Financial Agent at 1-888-353-4537 no later than 2 business days prior to the payment (settlement) date. I also authorize the financial institutions involved in the processing of the electronic payment of taxes to receive confidential information necessary to answer inquiries and resolve issues related to the payment. Publication 1346 August 30, 2002 Part III Page 40 Section 6 – Self-Select PIN for ETD Specifications .04 Electronic Funds Withdrawal Selections (continued) Selection D3 (ETD only) Electronic Funds Withdrawal Consent for Forms 9465 (Include statement only with Electronic Funds Withdrawal) Electronic Funds Withdrawal Consent I authorize the U.S. Treasury and its designated Financial Agent to initiate an ACH Electronic Funds Withdrawal (Direct Debit) entry to the financial institution account indicated for payment of my Federal taxes owed, and the financial institution to debit the entry to this account. This authorization is to remain in full force and effect until I notify the U.S. Treasury Financial Agent to terminate the authorization. To revoke a payment, I must contact the U.S. Treasury Financial Agent at 1-888-829-8815 no later than 7 business days prior to the payment (settlement) date. I also authorize the financial institutions involved in the processing of the electronic payment of taxes to receive confidential information necessary to answer inquiries and resolve issues related to the payment. Taxpayer Signature Selections Selection T1 Use this signature selection when filing one of the following: · Form 4868 with an Electronic Funds Withdrawal · Form 2350 signed by the taxpayer with an Electronic Funds Withdrawal I am signing this Tax Return/Form and Electronic Funds Withdrawal Consent, if applicable, by entering my Self Select PIN below. ---------------------------------------------------------------------------------------------------------------------------Taxpayer’s PIN:_ _ _ _ _ Date: _ _ _ _ _ _ _ _ Taxpayer’s Date of Birth: _ _ _ _ _ _ _ _ Taxpayer’s Prior Year Adjusted Gross Income : _ _ _ _ _ _ _ _ _ _ _ Spouse’s PIN: _ _ _ _ _ Spouse’s Date of Birth: _ _ _ _ _ _ _ _ Spouse’s Prior Year Adjusted Gross Income : _ _ _ _ _ _ _ _ _ _ _ Selection T3 (ETD only) Use this signature selection when filing Form 2350 or 2688 without an Electronic Funds Withdrawal signed by the taxpayer using a Self Select PIN I am signing this Form by entering my Self Select PIN below. -----------------------------------------------------------------------------------------------------------------Taxpayer’s PIN: _ _ _ _ _ Date: _ _ _ _ _ _ _ _ Taxpayer’s Date of Birth: _ _ _ _ _ _ _ _ Spouse’s PIN: _ _ _ _ _ Spouse’s Date of Birth: _ _ _ _ _ _ _ _ Publication 1346 August 30, 2002 Part III Page 41 Section 6 – Self-Select PIN for ETD Specifications 04. Taxpayer Signature Selections (continued) Selection T4 (ETD only) Use this signature selection when filing a Form 2350 or 2688 signed by a Preparer Other Than the Taxpayer I am signing this Form by entering my name and date below. -----------------------------------------------------------------------------------------------------------------_______________________________________________ ________ Name of Preparer Other Than Taxpayer (35 character limit) Date Selection T5 (ETD only) Reserved – not available for Tax Year 2002 Selection T7 (ETD only) (Use this signature selection for Form 56 fiduciary certification and signature.) Fiduciary Certification and Signature I certify that I have the authority to execute this notice concerning fiduciary relationship on behalf of the taxpayer identified on this form. I agree to retain a copy of any evidence required authorizing me to serve in this fiduciary capacity and to provide such evidence upon request. I am signing this notice by entering my name and date below. ---------------------------------------------------------------------------------------------------------------------------_______________________________________ ____________________ (Name of Fiduciary) (35 character limit) Title, if applicable (20 character limit) _______________________________________ ____________________ (Name of Fiduciary) (35 character limit) Title, if applicable (20 character limit) ________ Date ________ Date Publication 1346 August 30, 2002 Part III Page 42 Section 6 – Self-Select PIN for ETD Specifications .05 e-file Jurat/Disclosure Text – Codes E - H Tax Year 2002 Jurat/Disclosure – Code E Text Form 4868 (with or without Electronic Funds Withdrawal) Consent to Disclosure I consent to allow my Intermediate Service Provider, transmitter, or Electronic Return Originator (ERO) to send this form to IRS and to receive the following information from IRS: 1) acknowledgment of receipt or reason for rejection of transmission, and 2) if delayed, reason for any delay in processing. If Electronic Funds Withdrawal applies, also include the following Electronic Funds Withdrawal Consent and Signature: Electronic Funds Withdrawal Consent I authorize the U.S. Treasury and its designated Financial Agent to initiate an ACH Electronic Funds Withdrawal (Direct Debit) entry to the financial institution account indicated for payment of my Federal taxes owed, and the financial institution to debit the entry to this account. This authorization is to remain in full force and effect until I notify the U.S. Treasury Financial Agent to terminate the authorization. To revoke a payment, I must contact the U.S. Treasury Financial Agent at 1-888-353-4537 no later than 2 business days prior to the payment (settlement) date. I also authorize the financial institutions involved in the processing of the electronic payment of taxes to receive confidential information necessary to answer inquiries and resolve issues related to the payment. I am signing this Tax Return/Form and Electronic Funds Withdrawal Consent, if applicable, by entering my Self Select PIN below. ---------------------------------------------------------------------------------------------------------------------------Taxpayer’s PIN:_ _ _ _ _ Date: _ _ _ _ _ _ _ _ Taxpayer’s Date of Birth: _ _ _ _ _ _ _ _ Taxpayer’s Prior Year Adjusted Gross Income _ _ _ _ _ _ _ _ Spouse’s PIN: _ _ _ _ _ Spouse’s Date of Birth: _ _ _ _ _ _ _ _ Spouse’s Prior Year Adjusted Gross Income: _ _ _ _ _ _ _ Publication 1346 August 30, 2002 Part III Page 43 Section 6 – Self-Select PIN for ETD Specifications 05. e-file Jurat/Disclosure Text – Codes E - H Tax Year 2002 Jurat/Disclosure – Code F Text Form 9465 (with or without Electronic Funds Withdrawal) Consent to Disclosure I consent to allow my Intermediate Service Provider, transmitter, or Electronic Return Originator (ERO) to send this form to IRS and to receive the following information from IRS: 1) acknowledgment of receipt or reason for rejection of transmission, and 2) if delayed, reason for any delay in processing. If Electronic Funds Withdrawal applies, also include the following Electronic Funds Withdrawal Consent and Signature: Electronic Funds Withdrawal Consent I authorize the U.S. Treasury and its designated Financial Agent to initiate an ACH Electronic Funds Withdrawal (Direct Debit) entry to the financial institution account indicated for payment of my Federal taxes owed, and the financial institution to debit the entry to this account. This authorization is to remain in full force and effect until I notify the U.S. Treasury Financial Agent to terminate the authorization. To revoke a payment, I must contact the U.S. Treasury Financial Agent at 1-888-829-8815 no later than 7 business days prior to the payment (settlement) date. I also authorize the financial institutions involved in the processing of the electronic payment of taxes to receive confidential information necessary to answer inquiries and resolve issues related to the payment. I am signing this Tax Return/Form and Electronic Funds Withdrawal Consent, if applicable, by entering my Self Select PIN below. --------------------------------------------------------------------------------------------------------------------------Taxpayer’s PIN:_ _ _ _ _ Date : _ _ _ _ _ _ _ _ Taxpayer’s Date of Birth: _ _ _ _ _ _ _ _ Taxpayer’s Prior Year Adjusted Gross Income: _ _ _ _ _ _ _ _ Spouse’s PIN: _ _ _ _ _ Spouse’s Date of Birth: _ _ _ _ _ _ _ _ Spouse’s Prior Year Adjusted Gross Income: _ _ _ _ _ _ _ Publication 1346 August 30, 2002 Part III Page 44 Section 6 – Self-Select PIN for ETD Specifications .05 e-file Jurat/Disclosure Text – Codes E - H Tax Year 2002 Jurat/Disclosure – Code G Text Forms 2350 and 2688 (with or without Electronic Funds Withdrawal) Perjury Statement Under penalties of perjury, I declare that, 1) I have examined this return/form, including any accompanying statements and schedules and, to the best of my knowledge and belief, it is true, correct, and complete; and if prepared by someone other than the taxpayer, 2) I am authorized to prepare this form. Consent to Disclosure I consent to allow my Intermediate Service Provider, transmitter, or Electronic Return Originator (ERO) to send this form to IRS and to receive the following information from IRS: 1) acknowledgment of receipt or reason for rejection of transmission, and 2) if delayed, reason for any delay in processing. If application without Electronic Funds Withdrawal signed by taxpayer(s), include the following section: I am signing this Form by entering my Self Select PIN below. -----------------------