IRS 1040 SCHEDULE B Interest and Ordinary Dividends Form

If you have an amount of tax interests or ordinary dividends with a value exceeding $1,500, the following form has to be completed and submitted.

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SCHEDULE B 
(Form 1040A or 1040) 
Department of the Treasury  
Internal Revenue Service (99) 	
Interest and Ordinary Dividends	
▶ Attach to Form 1040A or 1040.	 
  ▶	
 Information about Schedule B (Form 1040A or 1040) and its instructions\
 is at 
www.irs.gov/form1040.	 	
OMB No. 1545-0074
2012Attachment   
Sequence No. 	08 	
Name(s) shown on return	Your social security number	
Part I  
Interest	
 	
(See instructions 
on back and the  
instructions for  
Form 1040A, or 
Form 1040,  
line 8a.)   
  
Note.  If you  
received a Form  
1099-INT, Form  
1099-OID, or  
substitute  
statement from 
a brokerage firm,  
list the firm’s  
name as the 
payer and enter  
the total interest  
shown on that  
form. 	
1 
 
  List 
name  of payer.  If any  interest  is from  a seller-financed  mortgage and the 
buyer  used the property  as a personal  residence,  see instructions  on back  and list 
this interest first. Also, show that buyer’s social security number a\
nd address  	
▶	
1 	
Amount	
2  Add the amounts on line 1 .................. 	2 	
3 
  Excludable 
interest on series  EE and  I U.S.  savings  bonds issued  after 1989. 
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 	
Part II 
Ordinary  
Dividends  
(See instructions 
on back and the 
instructions for 
Form 1040A, or 
Form 1040,  
line 9a.) 
Note. If you 
received a Form 
1099-DIV or 
substitute 
statement from 
a brokerage firm, 
list the firm’s 
name as the 
payer and enter 
the ordinary 
dividends shown 
on that form. 	
5 	List name of payer	  ▶	
5 	
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. 	
Part III  
Foreign  
Accounts  
and Trusts  
(See 
instructions on 
back.) 	
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
7a  At any time during 2012, did you have a financial interest in or signatu\
re authority over a financial 
account (such as a bank account, securities account, or brokerage accou\
nt) located in a foreign 
country? See instructions  ........................	
b  If “Yes,” are you  required to file Form TD F 90-22.1 to report th\
at financial interest or signature 
authority? See Form TD F 90-22.1 and its instructions for filing require\
ments and exceptions to 
those requirements 
..........................	If you are required to file Form TD F 90-22.1, enter the name of the for\
eign country where the 
financial account is located  	▶	
8  During 2012, did you receive a distribution from, or were you the granto\
r of, or transferor to, a 
foreign trust? If “Yes,” you may have to file Form 3520. See instr\
uctions on back  ......	
For Paperwork Reduction Act Notice, see your tax return instructions. 	Cat. No. 17146N 	Schedule B (Form 1040A or 1040) 2012

Schedule B (Form 1040A or 1040) 2012	Page 	2 	
General Instructions
Section references are to the Internal Revenue Code 
unless otherwise noted.
Future Developments
For the latest information about developments 
related to Schedule B (Form 1040A or 1040) and its 
instructions, such as legislation enacted after they 
were published, go to www.irs.gov/form1040.
Purpose of Form
Use Schedule B if any of the following applies.
• You had over $1,500 of taxable interest or ordinary 
dividends.
• You received interest from a seller-financed 
mortgage and the buyer used the property as a 
personal residence.
• You have accrued interest from a bond.
• You are reporting original issue discount (OID) in 
an amount less than the amount shown on Form 
1099-OID.
• You are reducing your interest income on a bond 
by the amount of amortizable bond premium.
• You are claiming the exclusion of interest from 
series EE or I U.S. savings bonds issued after 1989. 
• You received interest or ordinary dividends as a 
nominee.
• You had a financial interest in, or signature 
authority over, a financial account in a foreign 
country or you received a distribution from, or were 
a grantor of, or transferor to, a foreign trust. Part III 
of the schedule has questions about foreign 
accounts and trusts.
Specific Instructions
TIP	
You can list more than one payer on 
each entry space for lines 1 and 5, but 
be sure to clearly show the amount paid 
next to the payer's name. Add the 
separate amounts paid by the payers 
listed on an entry space and enter the total in the 
“Amount” column. If you still need more space, attach 
separate statements that are the same size as the 
printed schedule. Use the same format as lines 1 and 
5, but show your totals on Schedule B. Be sure to put 
your name and social security number (SSN) on the 
statements and attach them at the end of your return.  	
Part I. Interest
Line 1. Report on line 1 all of your taxable interest. 
Taxable interest should be shown on your Forms 
1099-INT, Forms 1099-OID, or substitute 
statements. Include interest from series EE, H, HH, 
and I U.S. savings bonds. List each payer’s name 
and show the amount. Do not report on this line any 
tax-exempt interest from box 8 or box 9 of Form 
1099-INT. Instead, report the amount from box 8 on 
line 8b of Form 1040A or 1040. If an amount is 
shown in box 9 of Form 1099-INT, you generally 
must report it on line 12 of Form 6251. See the 
Instructions for Form 6251 for more details.
Seller-financed mortgages. If you sold your 
home or other property and the buyer used the 
property as a personal residence, list first any 
interest the buyer paid you on a mortgage or other 
form of seller financing. Be sure to show the buyer’s 
name, address, and SSN. You must also let the 
buyer know your SSN. If you do not show the 
buyer’s name, address, and SSN, or let the buyer 
know your SSN, you may have to pay a $50 penalty.
Nominees. If you received a Form 1099-INT that 
includes interest you received as a nominee (that is, in 
your name, but the interest actually belongs to 
someone else), report the total on line 1. Do this even 
if you later distributed some or all of this income to 
others. Under your last entry on line 1, put a subtotal 
of all interest listed on line 1. Below this subtotal, enter 
"Nominee  Distribution" and show the total interest 
you received as a nominee. Subtract this amount from 
the subtotal and enter the result on line 2.  	
TIP	
If you received interest as a nominee, 
you must give the actual owner a Form 
1099-INT unless the owner is your 
spouse. You must also file a Form 1096 
and a Form 1099-INT with the IRS. For 
more details, see the General Instructions for Certain 
Information Returns and the Instructions for Forms 
1099-INT and 1099-OID.
Accrued interest. When you buy bonds between 
interest payment dates and pay accrued interest to 
the seller, this interest is taxable to the seller. If you 
received a Form 1099 for interest as a purchaser of a 
bond with accrued interest, follow the rules earlier 
under Nominees to see how to report the accrued 
interest. But identify the amount to be subtracted as 
“Accrued Interest.”
Original issue discount (OID). If you are reporting 
OID in an amount less than the amount shown on 
Form 1099-OID, follow the rules earlier under 
Nominees to see how to report the OID. But identify 
the amount to be subtracted as “OID Adjustment.”	
Amortizable bond premium. If you are reducing your 
interest income on a bond by the amount of amortizable 
bond premium, follow the rules earlier under Nominees 
to see how to report the interest. But identify the amount 
to be subtracted as “ABP Adjustment.”
Line 3. If, during 2012, you cashed series EE or I    
U.S. savings bonds issued after 1989 and you paid 
qualified higher education expenses for yourself, 
your spouse, or your dependents, you may be able 
to exclude part or all of the interest on those bonds. 
See Form 8815 for details.
Part II. Ordinary Dividends
TIP	
You may have to file Form 5471 if, in 
2012, you were an officer or director of 
a foreign corporation. You may also 
have to file Form 5471 if, in 2012, you 
owned 10% or more of the total  
(a) value of a foreign corporation’s stock, or (b) 
combined voting power of all classes of a foreign 
corporation’s stock with voting rights. For details, 
see Form 5471 and its instructions.
Line 5. Report on line 5 all of your ordinary 
dividends. This amount should be shown in box 1a 
of your Forms 1099-DIV or substitute statements. 
List each payer’s name and show the amount.
Nominees. If you received a Form 1099-DIV that 
includes ordinary dividends you received as a 
nominee (that is, in your name, but the ordinary 
dividends actually belong to someone else), report 
the total on line 5. Do this even if you later 
distributed some or all of this income to others. 
Under your last entry on line 5, put a subtotal of all 
ordinary dividends listed on line 5. Below this 
subtotal, enter “Nominee Distribution” and show the 
total ordinary dividends you received as a nominee. 
Subtract this amount from the subtotal and enter the 
result on line 6.	
TIP	
If you received dividends as a nominee,   
you must give the actual owner a Form 
1099-DIV unless the owner is your spouse. 
You must also file a Form 1096 and a Form 
1099-DIV with the IRS. For more 
details, see the General Instructions for Certain 
Information Returns and the Instructions for Form    
1099-DIV.	
Part III. Foreign Accounts and 
Trusts
TIP	
Regardless of whether you are required 
to file Form TD F 90-22.1 (FBAR), you 
may be required to file Form 8938, 
Statement of Specified Foreign 
Financial Assets, with your income tax 
 return. Failure to file Form 8938 may result in 
penalties and extension of the statute of limitations. 
See www.irs.gov/form8938 for more information.  
Line 7a–Question 1. Check the “Yes” box if at any 
time during 2012 you had a financial interest in or 
signature authority over a financial account located 
in a foreign country. See the definitions that follow. 
Check the “Yes” box even if you are not required to 
file Form TD F 90-22.1. Financial account. A financial account includes, 
but is not limited to, a securities, brokerage, savings, 
demand, checking, deposit, time deposit, or other 
account maintained with a financial institution (or 
other person performing the services of a financial 
institution). A financial account also includes a  
commodity futures or options account, an insurance 
policy with a cash value (such as a whole life 
insurance policy), an annuity policy with a cash 
value, and shares in a mutual fund or similar pooled 
fund (that is, a fund that is available to the general 
public with a regular net asset value determination 
and regular redemptions).  
Financial account located in a foreign country. 
A financial account is located in a foreign country if 
the account is physically located outside of the 
United States. For example, an account maintained 
with a branch of a United States bank that is 
physically located outside of the United States is a 
foreign financial account. An account maintained 
with a branch of a foreign bank that is physically 
located in the United States is not a foreign financial 
account.  
Signature authority. Signature authority is the 
authority of an individual (alone or in conjunction 
with another individual) to control the disposition of 
assets held in a foreign financial account by direct 
communication (whether in writing or otherwise) to 
the bank or other financial institution that maintains 
the financial account. See the Instructions for Form 
TD F 90-22.1 (Report of Foreign Bank and Financial 
Accounts) for exceptions. Do not consider the 
exceptions relating to signature authority in 
answering Question 1 on line 7a. 
Other definitions. For definitions of “financial 
interest,” “United States,” and other relevant terms, 
see the instructions for Form TD F 90-22.1.
Note. You can get Form TD F 90-22.1 from the IRS 
website at www.irs.gov/pub/irs-pdf/f90221.pdf. 
Line 7a–Question 2. See Form TD F 90-22.1 and its 
instructions to determine whether you must file the 
form. Check the “Yes” box if you are required to file 
the form; check the "No" box if you are not required 
to file the form. 
If you checked the “Yes” box to Question 2 on line 
7a, file Form TD F 90-22.1 with the Department of 
Treasury at the address shown in the instructions for 
that form. Do not attach Form TD F 90-22.1 to your 
tax return. To be considered timely, Form TD F 
90-22.1 must be received by June 30, 2013. 	
▲	!	CAUTION	
If you are required to file Form TD F 
90-22.1 but do not properly do so, you 
may have to pay a civil penalty up to 
$10,000. A person who willfully fails to 
report an account or provide account 
identifying information may be subject to a civil 
penalty equal to the greater of $100,000 or 50 
percent of the balance in the account at the time of 
the violation. Willful violations may also be subject to 
criminal penalties. 
Line 7b. If you are required to file Form TD F 
90-22.1, enter the name of the foreign country or 
countries in the space provided on line 7b. Attach a 
separate statement if you need more space. 
Line 8. If you received a distribution from a foreign 
trust, you must provide additional information. For 
this purpose, a loan of cash or marketable securities 
generally is considered to be a distribution. See 
Form 3520 for details. 
If you were the grantor of, or transferor to, a 
foreign trust that existed during 2012, you may have 
to file Form 3520. 
Do not attach Form 3520 to Form 1040. Instead, 
file it at the address shown in its instructions.  
If you were treated as the owner of a foreign trust 
under the grantor trust rules, you are also 
responsible for ensuring that the foreign trust files 
Form 3520-A. Form 3520-A is due on March 15, 
2013, for a calendar year trust. See the instructions 
for Form 3520-A for more details.