SCHEDULE B OMB No.

1545-0074
Interest and Ordinary Dividends
(Form 1040A or 1040)

Department of the Treasury © Attach to Form 1040A or 1040. © See instructions on back.
2009
Attachment
Internal Revenue Service (99) Sequence No. 08
Name(s) shown on return Your social security number

1 List name of payer. If any interest is from a seller-financed mortgage and the Amount
Part I buyer used the property as a personal residence, see instructions on back and list
Interest this interest first. Also, show that buyer’s social security number and address ©
(See instructions
on back and the
instructions for
Form 1040A, or
Form 1040,
line 8a.)
1

Note. If you
received a Form
1099-INT, Form
1099-OID, or
substitute
statement from
a brokerage firm,
list the firm’s
name as the
payer and enter 2 Add the amounts on line 1 . . . . . . . . . . . . . . . . . . 2
the total interest 3 Excludable interest on series EE and I U.S. savings bonds issued after 1989.
shown on that
form. Attach Form 8815 . . . . . . . . . . . . . . . . . . . . . 3
4 Subtract line 3 from line 2. Enter the result here and on Form 1040A, or Form
1040, line 8a . . . . . . . . . . . . . . . . . . . . . . © 4
Note. If line 4 is over $1,500, you must complete Part III. Amount
5 List name of payer ©
Part II
Ordinary
Dividends
(See instructions
on back and the
instructions for
Form 1040A, or
Form 1040,
line 9a.) 5
Note. If you
received a Form
1099-DIV or
substitute
statement from
a brokerage firm,
list the firm’s
name as the
payer and enter
the ordinary
dividends shown
on that form.
6 Add the amounts on line 5. Enter the total here and on Form 1040A, or Form
1040, line 9a . . . . . . . . . . . . . . . . . . . . . . © 6
Note. If line 6 is over $1,500, you must complete Part III.
You must complete this part if you (a) had over $1,500 of taxable interest or ordinary dividends; (b) had a
foreign account; or (c) received a distribution from, or were a grantor of, or a transferor to, a foreign trust. Yes No
Part III
7a At any time during 2009, did you have an interest in or a signature or other authority over a
Foreign
financial account in a foreign country, such as a bank account, securities account, or other
Accounts financial account? See instructions on back for exceptions and filing requirements for Form TD F
and Trusts 90-22.1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(See b If “Yes,” enter the name of the foreign country ©
instructions on 8 During 2009, did you receive a distribution from, or were you the grantor of, or transferor to, a
back.)
foreign trust? If “Yes,” you may have to file Form 3520. See instructions on back . . . . . .
For Paperwork Reduction Act Notice, see Form 1040A or 1040 instructions. Cat. No. 17146N Schedule B (Form 1040A or 1040) 2009
Schedule B (Form 1040A or 1040) 2009 Page 2

General Instructions Nominees. If you received a Form 1099-INT that

includes interest you received as a nominee (that is,
Part III. Foreign Accounts and
in your name, but the interest actually belongs to Trusts
Section references are to the Internal Revenue Code
unless otherwise noted. someone else), report the total on line 1. Do this even Line 7a. Check the “Yes” box on line 7a if either (1)
if you later distributed some or all of this income to or (2) below applies.
others. Under your last entry on line 1, put a subtotal
What's New of all interest listed on line 1. Below this subtotal,
1. You own more than 50% of the stock in any
corporation that owns one or more foreign bank
enter "Nominee Distribution" and show the total
Form 1040A. Form 1040A filers will now file accounts.
interest you received as a nominee. Subtract this
Schedule B to report interest and ordinary dividends. amount from the subtotal and enter the result on 2. At any time during 2009 you had an interest in
Schedule 1 (Form 1040A), Interest and Ordinary line 2. or signature or other authority over a financial
Dividends for Form 1040A Filers, is now obsolete. For account in a foreign country (such as a bank account,
any prior year returns (before 2009) that need to be If you received interest as a nominee, securities account, or other financial account).
filed, still use Schedule 1. you must give the actual owner a Form
1099-INT unless the owner is your For line 7a, item (2) does not apply to
Schedule A. Schedule A, Itemized Deductions, is no
spouse. You must also file a Form 1096 foreign securities held in a U.S.
longer associated with Schedule B. Schedules A and
and a Form 1099-INT with the IRS. securities account.
B are now separate schedules. For more details, see the General Instructions for
Forms 1099, 1098, 3921, 3922, 5498, and W-2G and
Purpose of Form the Instructions for Forms 1099-INT and Exceptions. Check the “No” box if any of the
1099-OID. following applies to you.
Use Schedule B if any of the following applies. • The combined value of the accounts was $10,000
Accrued interest. When you buy bonds between
• You had over $1,500 of taxable interest or ordinary or less during the whole year.
interest payment dates and pay accrued interest to
dividends.
the seller, this interest is taxable to the seller. If you • The accounts were with a U.S. military banking
• You received interest from a seller-financed received a Form 1099 for interest as a purchaser of a facility operated by a U.S. financial institution.
mortgage and the buyer used the property as a bond with accrued interest, follow the rules earlier
• You were an officer or employee of a commercial
personal residence. under Nominees to see how to report the accrued
bank that is supervised by the Comptroller of the
• You have accrued interest from a bond. interest. But identify the amount to be subtracted as
Currency, the Board of Governors of the Federal
“Accrued Interest.”
• You are reporting original issue discount (OID) in an Reserve System, or the Federal Deposit Insurance
amount less than the amount shown on Form Original issue discount (OID). If you are reporting Corporation; the account was in your employer’s
1099-OID. OID in an amount less than the amount shown on name; and you did not have a personal financial
Form 1099-OID, follow the rules earlier under interest in the account.
• You are reducing your interest income on a bond
by the amount of amortizable bond premium. Nominees to see how to report the OID. But identify • You were an officer or employee of a domestic
the amount to be subtracted as “OID Adjustment.” corporation with securities listed on national
• You are claiming the exclusion of interest from securities exchanges or with assets of more than $10
series EE or I U.S. savings bonds issued after 1989. Amortizable bond premium. If you are reducing
your interest income on a bond by the amount of million and 500 or more shareholders of record; the
• You received interest or ordinary dividends as a amortizable bond premium, follow the rules earlier account was in your employer’s name; you did not
nominee. under Nominees to see how to report the interest. have a personal financial interest in the account; and
But identify the amount to be subtracted as “ABP the corporation’s chief financial officer has given you
• You had a foreign account or you received a Adjustment.” written notice that the corporation has filed a current
distribution from, or were a grantor of, or transferor report that includes the account.
to, a foreign trust. Part III of the schedule has Line 3. If, during 2009, you cashed series EE or I U.S.
savings bonds issued after 1989 and you paid See Form TD F 90-22.1 to find out if you are
questions about foreign accounts and trusts. considered to have an interest in or signature or other
qualified higher education expenses for yourself, your
spouse, or your dependents, you may be able to authority over a financial account in a foreign country
exclude part or all of the interest on those bonds. See (such as a bank account, securities account, or other
Specific Instructions Form 8815 for details. financial account). You can get Form TD F 90-22.1 by
visiting the IRS website at
You can list more than one payer on Part II. Ordinary Dividends www.irs.gov/pub/irs-pdf/f90221.pdf.
each entry space for lines 1 and 5, but
be sure to clearly show the amount You may have to file Form 5471 if, in If you checked the “Yes” box on line 7a, file Form
paid next to the payer's name. Add the 2009, you were an officer or director of TD F 90-22.1 by June 30, 2010, with the Department
a foreign corporation. You may also of the Treasury at the address shown on that form.
separate amounts paid by the payers listed on an
have to file Form 5471 if, in 2009, you Do not attach it to Form 1040.
entry space and enter the total in the “Amount”
column. If you still need more space, attach separate owned 10% or more of the total (a) value of a foreign
If you are required to file Form TD F
statements that are the same size as the printed corporation’s stock, or (b) combined voting power of
90-22.1 but do not do so, you may
schedule. Use the same format as lines 1 and 5, but all classes of a foreign corporation’s stock with voting
have to pay a penalty of up to $10,000
show your totals on Schedule B. Be sure to put your rights. For details, see Form 5471 and its instructions.
(more in some cases).
name and social security number (SSN) on the Line 5. Report on line 5 all of your ordinary dividends.
statements and attach them at the end of your return. This amount should be shown in box 1a of your Line 7b. If you checked the “Yes” box on line 7a,
Forms 1099-DIV or substitute statements. List each enter the name of the foreign country or countries in
Part I. Interest payer’s name and show the amount. the space provided on line 7b. Attach a separate
Line 1. Report on line 1 all of your taxable interest. Nominees. If you received a Form 1099-DIV that statement if you need more space.
Taxable interest should be shown on your Forms includes ordinary dividends you received as a Line 8. If you received a distribution from a foreign
1099-INT, Forms 1099-OID, or substitute statements. nominee (that is, in your name, but the ordinary trust, you must provide additional information. For
Include interest from series EE, H, HH, and I U.S. dividends actually belong to someone else), report this purpose, a loan of cash or marketable securities
savings bonds. List each payer’s name and show the the total on line 5. Do this even if you later distributed generally is considered to be a distribution. See Form
amount. Do not report on this line any tax-exempt some or all of this income to others. Under your last 3520 for details.
interest from box 8 or box 9 of Form 1099-INT. entry on line 5, put a subtotal of all ordinary dividends
Instead, report the amount from box 8 on line 8b of listed on line 5. Below this subtotal, enter “Nominee If you were the grantor of, or transferor to, a
Form 1040A or 1040. If an amount is shown in box 9 Distribution” and show the total ordinary dividends foreign trust that existed during 2009, you may have
of Form 1099-INT, you generally must report it on line you received as a nominee. Subtract this amount to file Form 3520.
13 of Form 6251. See the Instructions for Form 6251 from the subtotal and enter the result on line 6. Do not attach Form 3520 to Form 1040. Instead,
for more details. file it at the address shown in its instructions.
If you received dividends as a nominee,
Seller-financed mortgages. If you sold your you must give the actual owner a Form If you were treated as the owner of a foreign trust
home or other property and the buyer used the 1099-DIV unless the owner is your under the grantor trust rules, you are also responsible
property as a personal residence, list first any interest spouse. You must also for ensuring that the foreign trust files Form 3520-A.
the buyer paid you on a mortgage or other form of file a Form 1096 and a Form 1099-DIV with the IRS. Form 3520-A is due on March 15, 2010, for a
seller financing. Be sure to show the buyer’s name, For more details, see the General Instructions for calendar year trust. See the instructions for Form
address, and SSN. You must also let the buyer know Forms 1099, 1098, 3921, 3922, 5498, and W-2G and 3520-A for more details.
your SSN. If you do not show the buyer’s name, the Instructions for Form 1099-DIV.
address, and SSN, or let the buyer know your SSN,
you may have to pay a $50 penalty.