3.24.28  Campus Quality Assurance Program

Manual Transmittal

November 14, 2014

Purpose

(1) This transmits revised IRM 3.24.28, ISRP System, Campus Quality Assurance Program and Other General Processing Programs.

Background

This IRM provides procedures for input of general purpose programs on the Integrated Submission and Remittance Processing (ISRP) system.

Material Changes

(1) Various editorial changes were made throughout.

(2) Title of IRM 3.24.28, Campus Quality Assurance Program and Other General Processing Programs, was updated to reflect other general purpose programs placed in this revision.

(3) Instruction on the following obsolete form types were removed throughout this instruction manual: Form 3926A, Form 3927 and Form 3926B.

(4) IRM 3.24.28.1 Obsolete Form 3926A, Form 3927 and Form 3926B were removed and Form 1042-S, Foreign Person's U.S. Source Income Subject to Withholding, Form 8938, Statement of Specified Foreign Financial Assets, and Obsolete Form 8966, FATCA Report, were added.

(5) IRM 3.24.28.1.1 Form 3893, Re-entry Document Control, was removed from the control documents listing. This re-entry type is not valid for the documents in this instruction manual.

(6) IRM 3.24.28.1.2 Obsolete Form 3926A, Form 3927 and Form 3926B were removed and Form 1042-S, Foreign Person's U.S. Source Income Subject to Withholding, Form 8938, Statement of Specified Foreign Financial Assets and Form 8966, FATCA Report, were added.

(7) IRM 3.24.28.1.3 Form 3926A, Form 3927 and Form 3926B were removed and Form 1042-S, Foreign Person's U.S. Source Income Subject to Withholding, Form 8938, Statement of Specified Foreign Financial Assets, and Form 8966, FATCA Report, were added.

(8) IRM 3.24.28.1.5 Special instructions for obsolete Form 3926A were removed. Special instructions for Form 8966, FATCA Report, were added.

(9) IRM 3.24.28.1.6 Special instructions for obsolete Form 3927 were removed.

(10) IRM 3.24.28.1.6 Added special instructions for Form 8939.

(11) IRM 3.24.28.1.7 Added special instructions for Form 1042-S, Foreign Person’s U.S. Source Income Subject to Withholding, (copy B for recipients), attached to Form 1120-F and Form 1040NR,

(12) Exhibit 3.24.28-1 Form 3893 was removed for a valid entry document for Form 3926, Quality Assurance Review Record. Obsolete Form 3926A, Form 3927 and Form 3926B were removed from the format code listing. Form 1042-S, Foreign Person's U.S. Source Income Subject to Withholding (recipient copies), Form 8938, Statement of Specified Foreign Financial Assets, and Form 8966, FATCA Report, were added to the instruction for format code input.

(13) Exhibit 3.24.28-2 Transcription instruction for Form 1042-S, Foreign Person’s U.S. Source Income Subject to Withholding, (copy B for recipients), attached to Forms 1120-F and 1040NR, new Section 01 replaced transcription instruction for Form 3926 section 01. Section 01 Form 3926, Quality Assurance Review Record.

(14) Exhibit 3.24.28-3 Transcription instruction for Form 1042-S, Foreign Person’s U.S. Source Income Subject to Withholding, (copy B for recipients), attached to Forms 1120-F and 1040NR, new Section 02 replaced transcription instruction for Form 3926 section 02. Section 02-12, Form 3926, Quality Assurance Review Record.

(15) Exhibit 3.24.28-4 Transcription instruction for Form 3926A instruction removed. Transcription instruction for Form 1042-S, Foreign Person’s U.S. Source Income Subject to Withholding, (copy B for recipients), attached to Forms 1120-F and 1040NR, new Section 03 was added.

(16) Exhibit 3.24.28-5 Transcription instruction for obsolete Form 3926B was removed. Transcription instruction for Form 1042-S, Foreign Person’s U.S. Source Income Subject to Withholding, (copy B for recipients), attached to Forms 1120-F and 1040NR, new Section 04 was added.

(17) Exhibit 3.24.28-6 Transcription instruction for section 02-12 of obsolete Form 3926B was removed and transcription instruction for section 01 Form 3926, Quality Assurance Review Record was added.

(18) Exhibit 3.24.28-7 Transcription instruction for Form 3927 section 01 was removed. Transcription for section 02-12 Form 3926, Quality Assurance Review Record was added.

(19) Exhibit 3.24.28-8 Transcription instruction for obsolete Form 3927 section 02-31 was removed.

(20) Exhibit 3.24.28-8 Transcription instruction for Form 8938, Statement of Specified Foreign Financial Assets, section 01 was added.

(21) Exhibit 3.24.28-9 Transcription instruction for Form 8938, Statement of Specified Foreign Financial Assets, section 02 was added.

(22) Exhibit 3.24.28-10 Transcription instruction for Form 8938, Statement of Specified Foreign Financial Assets, section 03 was added.

(23) Exhibit 3.24.28-11 Transcription instruction for Form 8938, Statement of Specified Foreign Financial Assets, section 04 was added.

(24) Exhibit 3.24.28-12 Transcription instruction for Form 8938Continuation Forms, Statement of Specified Foreign Financial Assets, section 05 - 29 was added.

(25) Exhibit 3.24.28-13 Transcription instruction for section 01 of Form 8966, FATCA Report, was added.

(26) Exhibit 3.24.28-14 Transcription instruction for section 02 of Form 8966, FATCA Report, was added.

Effect on Other Documents

IRM 3.24.28 dated November 8, 2013 (effective January 1, 2014) is superseded.

Audience

Wage and Investment Submission Processing Integrated Submission Remittance Processing operators

Effective Date

(01-01-2015)


Paul J. Mamo
Director, Submission Processing
Wage and Investment

3.24.28.1  (01-01-2015)
Introduction

  1. This section provides instructions for the transcription and verification of data from the following:

    • Form 1042-S, Foreign Person’s U.S. Source Income Subject to Withholding, (copy B for recipients)

    • Form 3926, Quality Assurance Review Record (Adjustments)

    • Form 8938, Statement of Specified Foreign Financial Assets

    • Form 8966, FATCA Report

3.24.28.1.1  (01-01-2015)
Control Documents

  1. Control data may be transcribed from the Form 1332, Block and Selection Record.

3.24.28.1.2  (01-01-2015)
Source Documents

  1. Data will be transcribed from the following forms:

    • Form 1042-S, Foreign Person’s U.S. Source Income Subject to Withholding, (copy B for recipients)

    • Form 3926, Quality Assurance Review Record

    • Form 8938, Statement of Specified Foreign Financial Assets

    • Form 8966, FATCA Report

3.24.28.1.3  (01-01-2015)
Forms/Program Numbers/Format Codes

  1. The following table shows the program numbers and format codes for source documents.

    FORM PROGRAM NUMBER FORMAT CODE
    Form 1042-S (copyB) 71710 218
    Form 3926 59702 222
    Form 8938 (attached to Form 1040 ) 43300 201
    Form 8938 (attached to Form 1040-NR) 43310 202
    Form 8966 36500 217

3.24.28.1.4  (01-01-2015)
Special Instructions—Form 3926,Quality Assurance Review Record

  1. There will be only one serial number per page, and it will be written in the upper right hand corner of the form. Section 01 contains header information which is entered only one per page. Sections 02 through 12 must be entered by the operator as needed. Begin a new section after a blank line, or whenever non-blank data are present in Items 10, 11, or 16. On Form 3926, Quality Assurance Review Record, the last position of Items 11, 14, and 16 is always numeric.

3.24.28.1.5  (01-01-2015)
Special Instructions—Form 8966, FATCA Reporting

  1. Each form must contain a Global Intermediary Identification Number (GIIN) on Part I, Box 4 in order to be considered edited for input. If the GIIN is not present remove the return from the block and return it to the Code and Edit function. Remove the serial number from the block entry and continue with the remaining documents in the block.

  2. Name lines will hold up to thirty five characters. If the name line entry exceeds the 35 characters enter the first thirty five characters. Valid characters are alpha, &, -, < or blank. A period (.) should be entered for illegible characters.

  3. Do not use Major City Codes (MCCs).

3.24.28.1.6  (01-01-2015)
Special Instructions—Form 8938, Statement of Specified Foreign Financial Assets

  1. Ignore special characters <, >, and (. Note: An address, “N/A”, “None”, “Same”, or other variation should not be entered.

3.24.28.1.7  (01-01-2015)
Special Instructions—Form 1042-S, Foreign Person's U.S. Source Income Subject to Withholding (Recipient Copy (B)) (Program 71710)

  1. Reserved

3.24.28.1.8  (01-01-2015)
MUST ENTER Fields

  1. Some fields require entry of data. These fields are referred to as MUST ENTER fields. They are indicated in the transcription operation sheets by the presence of stars (★★★★★★). See IRM 3.24.37, General Instructions, for procedures related to <MUST ENTER> fields.

3.24.28.2  (01-01-2015)
ISRP Transcription Operation Sheets

  1. The following exhibits represent specific data entry procedures.

Exhibit 3.24.28-1 
Block Header Data Entry Form 1332, Block and Selection Record, For General Purpose Programming

Block Header Data Entry
Source Document or Record: Form 1332, Block and Selection Record
Elem. No. Data Element Name Prompt Fld. Term. Instructions
(1) Alpha Block Control ABC   The screen displays the ABC that was entered in the EOP Dialog box, as described in IRM 3.24.37.2.6. It cannot be changed.
(2) File Location Code FLC/DO <ENTER> File location code "00" will always be generated. No entry is required.
(3) Format Code FCODE <ENTER> Enter the three digit format from the document locator box on Form 1332:
  1. Form 1042-S = 218

  2. Form 8938 (attached to Form 1040 = 201

  3. Form 8938 (attached to Form 1040-NR = 202

  4. Form 8966 = 36500

  5. Form 3926 = 222

Exhibit 3.24.28-2 
Section 01 Form 1042-S, Foreign Person's U.S. Source Income Subject to Withholding (Recipient Copy) (Program 71710)

Section 01
Source Document or Record: Form 1042-S, Foreign Person's U.S. Source Income Subject to Withholding, Recipient Copy
Elem. No. Data Element Name Prompt Fld. Term. Instructions
(1) Section Number SECT:   Section "01" will always be generated. No entry is required.
(2) Serial Number SER# <Enter> Enter the two digit Sequence number located on Form 1042-S, Recipient copy.
(3) Name Line NAME <Enter>
******
Enter Name Line.

Note:

Enter from parent Form 1120-F or 1040-NR.

(4) Taxpayer Identification Number (TIN) TIN <Enter>
******
Enter the SSN or EIN concurrently, no dashes.

Note:

Enter TIN from parent Form 1120-F or 1040-NR.

(5) TIN Type Indicator TINCKBX <Enter>
******
Required. Enter the recipient’s U.S. TIN type indicator from the following values:
1 = IMF - SSN/ITIN
2 = BMF - EIN
(6) Tax Year YEAR <Enter> Enter the preprinted or edited year from the top of the return in YY format.
This is a MUST ENTER field for the first document of the block.
The tax year will be generated into subsequent documents when <Enter> is pressed unless a different Tax Year is entered. If the Tax Year is different on any subsequent document, it must be entered.
(7) Received Date RDATE <Enter> Enter the date as stamped or edited on the face of the return or in the bottom right corner of the return. The received date will be generated into subsequent documents when <Enter> is pressed unless a different received date is entered. If the received date is different on any subsequent document, it must be entered.

Note:

A received date must be present each time the cross reference DLN changes on Form 1042-S. If missing, take to the lead or manager.

(8) Return Type Indicator (RTI) Amended RTIA <Enter> Enter (1) if the box is checked. If blank, press <Enter>.
(9) Pro Rata RTIPR <Enter> Enter (1) if the box is checked. If blank, press <Enter>.
(10) Income Code BX1 <Enter> Enter the digits shown or edited in box 1.

Note:

If more than one code or code is illegible, press <F12>.

(11) Gross Income BX2 $ <Enter> Enter the amount from box 2.
(12) Chapter 3 Check Box 3CKBX <Enter> Enter a "1" if the box is checked; otherwise, press <Enter>.
(13) Chapter 3 Exemption Code BX3A <Enter> Enter the digits shown or edited from box 3a.

Note:

If more than one code or code is illegible, press <F12>.

(14) Chapter 3 Tax Rate BX3B <Enter> Enter the "4" digits shown or edited from box 3b.

Note:

If less than four digits, press <Enter>.

(15) Chapter 4 Check Box 4CKBX <Enter> Enter a "1" if the box is checked; otherwise, press <Enter>.
(16) Chapter 4 Exemption BX4A <Enter> Enter the digits shown or edited from box 4a.

Note:

If more than one code or code is illegible, press <F12>.

(17) Chapter 4 Tax Rate BX4B <Enter> Enter the "4" digits shown or edited from box 4b.

Note:

If less than four digits, press <Enter>.

(18) Withholding Allowances BX5 $ <Enter> Enter the amount from box 5.
(19) Net Income BX6 $ <Enter> Enter the amount from box 6.
(20) Federal Tax Withheld BX7 $ <Enter> Enter the amount from box 7.
(21) Tax Not Deposited Under Escrow Procedure CKBX <Enter> Enter a "1" if only the Yes box is checked; otherwise, press <Enter>.
(22) Tax Withheld by Other Agents BX8 $ <Enter> Enter the amount from box 8.
(23) Tax Assumed by Withholding Agent BX9 $ <Enter> Enter the amount from box 9.
(24) Tax Withholding Credit BX10 $ <Enter> Enter the amount from box 10.
(25) Amount Repaid to Recipient BX11 $ <Enter> Enter the amount from box 11.
(26) Withholding Agent's EIN 12AEIN <Enter> Enter the withholding agent’s EIN, box 12a.
(27) Withholding Agent's EIN Indicator 12CHBX <Enter> Enter as follows:
0 = EIN
(28) Chapter 3 Status Code 12BSC <Enter> Enter the Chapter 3 status code from box 12b.
(29) Chapter 4 Status Code 12CSC <Enter> Enter the Chapter 4 status code from box 12c.

Exhibit 3.24.28-3 
Section 02 Form 1042-S, Foreign Person's U.S. Source Income Subject to Withholding (Recipient Copy) (Program 71710)

Section 02
Source Document or Record: Form 1042-S, Foreign Person's U.S. Source Income Subject to Withholding, Recipient Copy
Elem. No. Data Element Name Prompt Fld. Term. Instructions
(1) Section Number SECT   Section "02" will always be generated. No entry is required.
(2) Withholding Agent's Name Line 1 13ANAME1 <Enter> Enter the first name line from box 13a.
(3) Withholding Agent's Name Line 2 13ANAME2 <Enter> Enter the second name line from box 13a.
(4) Withholding Agent's Name Line 3 13ANAME3 <Enter> Enter the third name line from box 13a.
(5) Withholding Agent's GIIN 13BGIIN <Enter> Enter the digits shown or edited from box 13b.
(6) Country Code 13CCC <Enter> Enter the country code from box 13c.
(7) Foreign Taxpayer Identification Number 13DFTIN <Enter> Enter the ID# from box 13d.

Note:

Only letters A-Z, digits 0-9 and blanks are valid in this field.

(8) Withholding Agent’s Street Address 1 13EADD1 <Enter> Enter the first address from box 13e.
(9) Withholding Agent’s Street Address 2 13EADD2 <Enter> Enter the second address from box 13e.
(10) Withholding Agent’s City 13FCITY <Enter> Enter the city shown from box 13f.
(11) Withholding Agent’s State 13FST <Enter> Enter the standard state abbreviation from box 13f.
(12) Withholding Agent’s Province Code 13FPROV <Enter> Enter the province code from box 13f.
(13) Withholding Agent’s Country Code 13FCOUN <Enter> Enter the country code from box 13f.
(14) Withholding Agent’s Postal Zone 13FZONE <Enter> Enter the zip code or foreign postal zone from box 13f.
(15) Recipient's U.S. TIN 13GTIN <Enter> Enter the Recipient’s U.S. TIN from box 13g.
(16) Recipient's U.S. TIN Type 13CKBX <Enter> Enter the recipient’s U.S. TIN type indicator from the following values:
0 = No TIN required
(17) Ch. 3 Status Code 13HSC <Enter> Enter the Ch. 3 Status Code from box 13h.
(18) Ch. 4Status Code 13ISC <Enter> Enter the Ch. 4 Status Code from box 13i.

Exhibit 3.24.28-4 
Section 03 Form 1042-S, Foreign Person's U.S. Source Income Subject to Withholding(Recipient Copy) (Program 71710)

Section 03
Source Document or Record: Form 1042-S, Foreign Person's U.S. Source Income Subject to Withholding, Recipient Copy
Elem. No. Data Element Name Prompt Fld. Term. Instructions
(1) Section Number SECT: <Enter> Press <Enter> if already present on the screen; otherwise, enter "03".
(2) Recipient’s Name Line 1 14ANAME1 <Enter> Enter the first name line from box 14a.
(3) Recipient’s Name Line 2 14ANAME2 <Enter> Enter the second name line from box 14a.
(4) Recipient’s Name Line 3 14ANAME3 <Enter> Enter the third name line from box 14a.
(5) Recipient’s Country Code 14BCOUN <Enter> Enter the Recipient’s Country Code from box 14b.
(6) Recipient's Address 14CADD <Enter> Enter the address from box 14c.
(7) Recipient's City/Town 14DCITY <Enter> Enter the City/Town from box 14d.
(8) Recipient's State 14DST <Enter> Enter the State from box 14d.
(9) Recipient's Province 14DPROV <Enter> Enter the Province from box 14d.
(10) Recipient's Country Code 14DCOUN <Enter> Enter the Country Code from box 14d.
(11) Recipient's Zip or Postal Zone 14DZONE <Enter> Enter the ZIP or Postal Zone from box 14d.
(12) Primary Withholding Agent's Name 14ENAME <Enter> Enter the Primary Withholding Agent’s Name from box 14e.
(13) Primary Withholding Agent's EIN 14FEIN <Enter> Enter the Primary Withholding Agent’s EIN from box 14f.
(14) Intermediary or flow-through EIN 15AEIN <Enter> Enter the Intermediary EIN from box 15a.
(15) Intermediary Ch 3 Status Code 15BSC <Enter> Enter the Intermediary Chapter 3 Status Code from box 15b.
(16) Intermediary Ch 4 Status Code 16CSC <Enter> Enter the Intermediary Chapter 4 Status Code from box 15c.
(17) Intermediary or flow-through entity's name line 1 16ANAME1 <Enter> Enter the Intermediary entity’s name from box 16a.
(18) Intermediary or flow-through entity's name line 2 16ANAME2 <Enter> Enter the Intermediary entity’s name from box 16a.
(19) Intermediary or flow-through entity's name line 3 16ANAME3 <Enter> Enter the Intermediary entity’s name from box 16a.
(20) Intermediary or flow-through entity's GIIN 16BGIIN <Enter> Enter the Intermediary GIIN from box 16b.
(21) Intermediary Country Code 16CCOUN <Enter> Enter the Intermediary Country Code from box 16c.
(22) Intermediary Foreign TIN 16DTIN <Enter> Enter the Intermediary Foreign TIN from box 16d.
(23) Intermediary Address 1 16EADD1 <Enter> Enter the Intermediary Address from box 16e.
(24) Intermediary Address 2 16EADD2 <Enter> Enter the Intermediary Address from box 16e.
(25) Intermediary City/Town 16FCITY <Enter> Enter the Intermediary City or Town from box 16f.
(26) Intermediary State 16FST <Enter> Enter the Intermediary State from box 16f.
(27) Intermediary Province 16FPROV <Enter> Enter the Intermediary Province from box 16f.
(28) Intermediary Country Code 16FCOUN <Enter> Enter the Intermediary Country from box 16f.
(29) Intermediary ZIP or Postal Zone 16FZONE <Enter> Enter the Intermediary ZIP for Postal Zone from box 16f.

Exhibit 3.24.28-5 
Section 04 Form 1042-S, Foreign Person's U.S. Source Income Subject to Withholding, (Recipient Copy) (Program 71710)

Section 04
Source Document or Record: Form 1042-S, Foreign Person's U.S. Source Income Subject to Withholding, Recipient Copy
Elem. No. Data Element Name Prompt Fld. Term. Instructions
(30) Recipient's GIIN 17GIIN <Enter> Enter the Recipient’s GIIN from box 17.
(31) Recipient's Foreign TIN 18TIN <Enter> Enter the Recipient’s Foreign TIN from box 18.
(32) Recipient's Account Number 19ACCT <Enter> Enter the Recipient’s account number from box 19.
(33) Recipient's Date of Birth 20DOB <Enter> Enter the Recipient’s date of birth from box 20.
(34) Payer's Name 21NAME <Enter> Enter the Payer’s name from box 21.
(35) Payer's TIN 22TIN <Enter> Enter the Payer’s TIN from box 22.
(36) Payer's GIIN 23GIIN <Enter> Enter the Payer’s GIIN from box 23.
(37) State Income Tax Withheld 24SITW $ <Enter> Enter the State Income Tax Withheld from box 24.
(38) Payer's State Tax No. 25ST# <Enter> Enter the Payer’s State Tax number from box 25.
(39) Name of State 26ST <Enter> Enter the Name of state from box 26.

Exhibit 3.24.28-6 
Section 01 Form 3926, Quality Assurance Review Record (Program 59702)

SECTION 01
Source Document or Record: Form 3926, Quality Assurance Review Record
Elem. No. Data Element Name Prompt Fld. Term. Instructions
(1) Section Number SECT:   Section "01" will always be generated. No entry is required.
(2) Serial Number SER# <ENTER> Press <ENTER> if the correct number appears automatically; otherwise enter the two digit number from the upper right hand corner of the Form 3926. If the serial number has been generated by the system (see IRM 3.24.37.5.5, Sequential Document Entry) verify that it matches the document being entered.
(3) Campus Code SC <ENTER> ★★★★★★ Enter the edited code from the top margin of the Form 3926 or Form 1332.

Note:

This field is very important for Cincinnati when entering Brookhaven Code "19" it is a MUST ENTER field for Document "00" and will be generated into remaining documents until changed.

(4) Defect List Number ITEM5 <ENTER> Enter the number from Item 5.
(a) If only zeros (0) are present, press <ENTER>.
(5) Organization Code ITEM6 <ENTER> Enter the number from Item 6.

Note:

This element should never be blank.

(6) Function Code ITEM7 <ENTER> Enter the number from Item 7.

Note:

This element should never be blank.

(7) Program Code ITEM8 <ENTER> Enter the number from Item 8.

Note:

This element should never be blank.

(8) Control Number CTL# <ENTER> ★★★★★★ Enter the third position of the alpha control number from Form 1332, followed by the Serial Number used in Elem. No. (2).

Exhibit 3.24.28-7 
Sections 02–12 Form 3926,Quality Assurance Review Record, (Program 59706)

SECTION 02-12
Source Document or Record: Form 3926 , Quality Assurance Review Record

Note:

OnForm 3926 , Quality Assurance Review Record Elements 4, 5, and 6 are numeric only.
A maximum of 10 combinations of Items 12 and 14 may be entered in a section.

Elem. No. Data Element Name Prompt Fld. Term. Instructions
       

Note:

Begin a new section after a blank line, or whenever there are non-blank data in Item 11 or Item 16.

(1) Section Number SECT: <ENTER> Press <ENTER> if already present on the screen; otherwise, enter the appropriate section number (must be between 02 and 12, inclusive). Note: On-line help is only available on the Section 02 input screen. If you are in a subsequent section and require on-line help, go back to Section 02, position your cursor in the appropriate input field, and press <Shift-H>.
(2) Social Security Number SSN <ENTER> Enter the number from Item 10, if present.
(3) Number of Records (or Documents, Cases Sampled) ITEM11 <ENTER> Enter the alpha/numeric information from Item 11, if present.
(4) Defect Code 1 ITEM12 <ENTER> Enter the number from Item 12, if present.
(5) Number of Defects ITEM14 <ENTER> Enter the number from Item 14, if present.
(6) Number of Defective Records (Documents) ITEM16 <ENTER> Enter the number from Item 16, if present.
(7) Defect Code 2 2ND I12 <ENTER> Enter the number from the 2nd row of Item 12, if present.
(8) Number of Defects 2ND I14 <ENTER> Enter the number from the 2nd row of Item 14, if present.
(9) Defect Code 3 3RD I12 <ENTER> Enter the number from the 3rd row of Item 12, if present.
(10) Number of Defects 3RD I14 <ENTER> Enter the number from the 3rd row of Item 14, if present.
(11) Defect Code 4 4TH I12 <ENTER> Enter the number from the 4th row of Item 12, if present.
(12) Number of Defects 4TH I14 <ENTER> Enter the number from the 4th row of Item 14, if present.
(13) Defect Code 5 5TH I12 <ENTER> Enter the number from the 5th row of Item 12, if present.
(14) Number of Defects 5TH I14 <ENTER> Enter the number from the 5th row of Item 14, if present.
(15) Defect Code 6 6TH I12 <ENTER> Enter the number from the 6th row of Item 12, if present.
(16) Number of Defects 6TH I14 <ENTER> Enter the number from the 6th row of Item 14, if present.
(17) Defect Code 7 7TH I12 <ENTER> Enter the number from the 7th row of Item 12, if present.
(18) Number of Defects 7TH I14 <ENTER> Enter the number from the 7th row of Item 14, if present.
(19) Defect Code 8 8TH I12 <ENTER> Enter the number from the 8th row of Item 12, if present.
(20) Number of Defects 8TH I14 <ENTER> Enter the number from the 8th row of Item 14, if present.
(21) Defect Code 9 9TH I12 <ENTER> Enter the number from the 9th row of Item 12, if present.
(22) Number of Defects 9TH I14 <ENTER> Enter the number from the 9th row of Item 14, if present.
(23) Defect Code 10 10TH I12 <ENTER> Enter the number from the 10th row of Item 12, if present.
(24) Number of Defects 10TH I14 <ENTER> Enter the number from the 10th row of Item 14, if present.

Exhibit 3.24.28-8 
Section 01 Form 8938, Statement of Specified Foreign Financial Assets, (Attached To Form 1040 (Program 43300) Or Form 1040-NR (Program 43310))

SECTION 01
Source Document or Record: Form 8938, Statement of Specified Foreign Financial Assets, (Attached to Form 1040 or Form 1040 NR)
Elem. No. Data Element Name Prompt Fld. Term. Instructions
(1) Section Number SECT:   Section "01" will always be generated. No entry is required.
(2) Serial Number SER# <ENTER> Press <ENTER> if the correct number appears automatically; otherwise enter the two digit number from the upper right hand corner of the Form 8938.
(3) Continuation Form Indicator CFIND <ENTER> If CFIND is = 1 go directly to Section 05.
(4) TIN/SSN TIN/SSN <ENTER> Enter the SSN/TIN as shown in the “Your social security number” box on the parent form.
(a) If missing, illegible, incomplete, more than 9 digits, multiple SSNs on the same line/box, or is a TIN that begins with a red edited “9”, enter as Long Entity.
(b) See IRM 3.24.37.6.8, ISRP System, General Instructions, for procedures.
The data for the three following fields will be taken from the parent form that Form 8938 is attached to.
(5) Name NAME <ENTER>
★★★★★★
Enter up to 35 characters as shown on the Name Line. The operator has the option of whether or not to enter special characters, punctuation, and/or approved abbreviations.

Exception:

Ignore special characters <, >, and (. Note: An address, “N/A”, “None”, “Same”, or other variation should not be entered.
(a) Enter a space for each illegible character.

(6) Document Locator Number DLN <ENTER>
★★★★★★
Enter the DLN from the parent return.

Exhibit 3.24.28-9 
Section 02 Form 8938, Statement of Specified Foreign Financial Assets, (Attached To Form 1040 (Program 43300) Or Form 1040-NR (Program 43310))

Section 02
Source Document or Record: Form 8938, Statement of Specified Foreign Financial Assets, (Attached to Form 1040 or Form 1040 NR)
Elem. No. Data Element Name Prompt Fld. Term. Instructions
(1) Section Number SECT: <ENTER> Press <Enter> if already present on the screen; otherwise enter "02"
(2) Number of Continuous Statements TOPCKBX <ENTER> Enter “1” if the Continuous Statements X
(3) Number of Deposit Accounts TOPRT <ENTER> Enter the amount present in Continuous the Number of Statements box.
(4) Maximum Value of Deposit Accounts PIL1 <ENTER> Enter the amount from Part I, line 1.
(5) Maximum Value of Deposit Accounts PIL2 $ <ENTER> Enter the amount from Part I, line 2.
(6) Number of Custodial Accounts PIL3 <ENTER> Enter the amount from Part I, line 3.
(7) Maximum Value of Custodial Accounts PIL4 $ <ENTER> Enter the amount from Part I, line 4.
(8) Foreign Accounts Closed PIL5 <ENTER> Enter “1” if the Yes box is marked. Enter “2” if the No box is marked. Enter “3” if both boxes are marked.
(9) Number of Foreign Assets PIIL1 <ENTER> Enter the amount from Part II, line 1.
(10) Maximum Value of Assets PIIL2 $ <ENTER> Enter the amount from Part II, line 2.
(11) Foreign Assets Acquired or Sold PIIL3 <ENTER> Enter “1” if the Yes box is marked. Enter “2” if the No box is marked. Enter “3” if both boxes are marked.
(12) Deposit and Custodial Interest PIII1A(C) $ <ENTER> Enter the amount from Part III, line 1a(c).
(13) Deposit and Custodial Interest Form and Line PIIIL1A(D) <ENTER> Enter the form and line entries in Part III, line 1a(d).
(14) Deposit and Custodial Interest Schedule and Line PIIIL1A(E) <ENTER> Enter the schedule and line entries in Part III, line 1a(e).
(15) Deposit and Custodial Dividends PIIIL1B(C) $ <ENTER> Enter the amount from Part III, line 1b(c).
(16) Deposit and Custodial Dividends Form and Line PIIIL1B(D) <ENTER> Enter the form and line entries in Part III, line 1b(d).
(17) Deposit and Custodial Dividends Schedule and Line PIIIL1B(E) <ENTER> Enter the schedule and line entries in Part III, line 1b(e).
(18) Deposit and Custodial Royalties PIIIL1C(C) $ <ENTER> Enter the amount from Part III, line 1c(c).
(19) Deposit and Custodial Royalties Form and Line PIIIL1C(D) <ENTER> Enter the form and line entries in Part III, line 1c(d).
(20) Deposit and Custodial Royalties Schedule and Line PIIIL1C(E) <ENTER> Enter the schedule and line entries in Part III, line 1c(e).
(21) Deposit and Custodial Other Income PIIIL1D(C) $ <ENTER> Enter the amount from Part III, line 1d(c).
(22) Deposit and Custodial Other Income Form and Line PIIIL1D(D) <ENTER> Enter the form and line entries in Part III, line 1d(d).
(23) Deposit and Custodial Other Income Schedule and Line PIIIL1D(E) <ENTER> Enter the schedule and line entries in Part III, line 1d(e).
(24) Deposit and Custodial Gain/Loss PIIIL1E(C) $ <ENTER> Enter the amount from Part III, line 1e(c).
(25) Deposit and Custodial Gain/Loss Form and Line PIIIL1E(D) <ENTER> Enter the form and line entries in Part III, line 1e(d).
(26) Deposit and Custodial Gain/Loss Schedule and Line PIIIL1E(E) <ENTER> Enter the schedule and line entries in Part III, line 1e(e).
(27) Deposit and Custodial Deductions PIIIL1F(C) $ <ENTER> Enter the amount from Part III, line 1f(c).
(28) Deposit and Custodial Deductions Form and Line PIIIL1F(D) <ENTER> Enter the form and line entries in Part III, line 1f(d).
(29) Deposit and Custodial Deductions Schedule and Line PIIIL1F(E) <ENTER> Enter the schedule and line entries in Part III, line 1f(e).
(30) Deposit and Custodial Credits PIIIL1G(C) $ <ENTER> Enter the amount from Part III, line 1g(c).
(31) Deposit and Custodial Credits Form and Line PIIIL1G(D) <ENTER> Enter the form and line entries in Part III, line 1g(d).
(32) Deposit and Custodial Credits Schedule and Line PIIIL1G(E) <ENTER> Enter the schedule and line entries in Part III, line 1g(e).

Exhibit 3.24.28-10 
Section 03 Form 8938, Statement of Specified Foreign Financial Assets, (Attached To Form 1040 (Program 43300) Or Form 1040-NR (Program 43310))

Section 03
Source Document or Record: Form 8938, Statement of Specified Foreign Financial Assets, (Attached to Form 1040 or Form 1040 NR)
Elem. No. Data Element Name Prompt Fld. Term. Instructions
(1) Section Number SECT: <ENTER> Press <Enter> if already present on the screen; otherwise enter "03" always.
(2) Other Assets Interest PIIL2A(C)$ <ENTER> Enter the amount from Part III, Interest $ line 2a(c).
(3) Other Assets Interest Form and Line PIIIL2A(D) <ENTER> Enter the form and line entries in Part III, line 2a(d).
(4) Other Assets Interest Schedule and Line PIIIL2A(E) <ENTER> Enter the form and line entries in Part III, line 2a(d).
(5) Other Assets Dividends PIIIL2B(C) $ <ENTER> Enter the amount from Part III, line 2b(c).
(6) Other Assets Dividends Form and Line PIIIL2B(D) <ENTER> Enter the form and line entries in Part III, line 2b(d).
(7) Other Assets Dividends Schedule and Line PIIIL2B(E) <ENTER> Enter the schedule and line entries in Part III, line 2b(e).
(8) Other Assets Royalties PIIIL2C(C) $ <ENTER> Enter the amount from Part III, line 2c(c).
(9) Other Assets Royalties Form and Line PIIIL2C(D) <ENTER> Enter the form and line entries in Part III, line 2c(d).
(10) Other Assets Royalties Schedule and Line PIIIL2C(E) <ENTER> Enter the schedule and line entries in Part III, line 2c(e).
(11) Other Assets Other Income PIIIL2D(C) $ <ENTER> Enter the amount from Part III, line 2d(c).
(12) Other Assets Other Income Form and Line PIIIL2D(D) <ENTER> Enter the form and line entries in Part III, line 2d(d).
(13) Other Assets Other Income Schedule and Line PIIIL2D(E) <ENTER> Enter the schedule and line entries in Part III, line 2d(e).
(14) Other Assets Gain/Loss PIIIL2E(C) $ <ENTER> Enter the amount from Part III, line 2e(c).
(15) Other Assets Gain/Loss Form and Line PIIIL2E(D) <ENTER> Enter the form and line entries in Part III, line 2e(d).
(16) Other Assets Gain/Loss Schedule and Line PIIIL2E(E) <ENTER> Enter the schedule and line entries in Part III, line 2e(e).
(17) Other Assets Deductions PIIIL2F(C) $ <ENTER> Enter the amount from Part III, line 2f(c).
(18) Other Assets Deductions Form and Line PIIIL2F(D) <ENTER> Enter the form and line entries in Part III, line 2f(d).
(19) Other Assets Deductions Schedule and Line Other Assets Credits PIIIL2F(E) <ENTER> Enter the schedule and line entries in Part III, line 2f(e).
(20) Other Assets Credits PIIIL2G(C) $ <ENTER> Enter the amount from Part III, line 2g(c).
(21) Other Assets Credits Form and Line PIIIL2G(D) <ENTER> Enter the form and line entries in Part III, line 2g(d).
(22) Other Assets Credits Schedule and Line PIIIL2G(E) <ENTER> Enter the schedule and line entries in Part III, line 2g(e).
(23) Number of Forms 3520 PIVL1 <ENTER> Enter the amount from Part IV, line 1.
(24) Number of Forms 3520-A PIVL2 <ENTER> Enter the amount from Part IV, line 2.
(25) Number of Forms 5471 PIVL3 <ENTER> Enter the amount from Part IV, line 3.
(26) Number of Forms 8621 PIVL4 <ENTER> Enter the amount from Part IV, line 4.
(27) Number of Forms 8865 PIVL5 <ENTER> Enter the amount from Part IV, line 5.
(28) Number of Forms 8891 PIVL6 <ENTER> Enter the amount from Part IV, line 6.

Exhibit 3.24.28-11 
Section 04 Form 8938, Statement of Specified Foreign Financial Assets, (Attached To Form 1040 (Program 43300) Or Form 1040-NR (Program 43310))

Section 04
Source Document or Record: Form 8938, Statement of Specified Foreign Financial Assets, (Attached to Form 1040 or Form 1040 NR)
Elem. No. Data Element Name Prompt Fld. Term. Instructions
(1) Section Number SECT: <ENTER> Press <Enter> if already present on the screen; otherwise enter "04" always.
(2) Section Type of Account PVL1 <ENTER> From Part V, line 1:
Enter “1” if the Deposit box is marked.
Enter “2” if the Custodial box is marked.
Enter “3” if both boxes are marked.
(3) Account Number PVL2 <ENTER> Enter up to 20 characters from Part V, line 2.

Note:

The operator has the option of whether or not to enter special characters, punctuation, and/or approved abbreviations.

(4) Account Data PVL3 <ENTER> Enter the alpha character for each box that is marked from Part V, line 3.
(5) Maximum Value of Account PVL4 $ <ENTER> Enter the amount from Part V, line 4.
(6) Foreign Currency Exchange Rate PVL5 <ENTER> From Part V, line 5:
Enter “1” if the Yes box is marked.
Enter “2” if the No box is marked.
Enter “3” if both boxes are marked.
(7) Foreign Currency in Which Account is Maintained PVL6A <ENTER> Enter the first 35 characters from Part V, Line 6a.

Note:

Enter special characters, punctuation, and/or approved abbreviations

(8) Foreign Currency Exchange Rate PVL6B <ENTER> Enter the first 35 characters from Part V, Line 6b.

Note:

Enter special characters, punctuation, and/or approved abbreviations

(9) Source of Exchange Rate PVL6C <ENTER> Enter the first 35 characters from Part V, Line 6c.

Note:

Enter special characters, punctuation, and/or approved abbreviations

(10) Name of Financial Institution PVL7A <ENTER> Enter the first 35 characters from Part V, Line 7a.
(11) Mailing Address of Financial Institutions PVL8 <ENTER> Enter the first 35 characters from Part V, Line 8
(12) Institution Country/City/State PVL9 <ENTER> Enter the first 35 characters from Part V, Line 7.
(13) Description of Asset PVIL1 <ENTER> Enter the first 20 characters from Part VI, Line 1.
(14) Identifying Number PVIL2 <ENTER> Enter the first 20 characters from Part VI, Line 2.
(15) Date Asset Acquired PVIL3A <ENTER> Enter the Date from Part VI, line 3a in MMDDYY format.
(16) Date Asset Disposed PVIL3B <ENTER> Enter the date from Part VI, line 3b in MMDDYY format.
(17) Jointly Owned PVIL3C <ENTER> Enter a “1” if checkbox c, Part VI, line 3, is marked.
(18) No Tax Item Reported PVIL3D <ENTER> Enter a “1” if checkbox d, Part VI, line 3, is marked
(19) Maximum Value of Asset PVIL4 <ENTER> Enter the alpha character from the box marked from Part VI, line 4.
(20) Maximum Value Money Amount PVIL4 $ <ENTER> Enter the amount from Part VI, line 4.
(21) Foreign Currency Rate PVIL5 <ENTER> From Part VI, line 5:
Enter “1” if the Yes box is marked.
Enter “2” if the No box is marked.
Enter “3” if both boxes are marked.
(22) Foreign Currency in which Asset is Denominated PVIL6A <ENTER> Enter the first 35 characters from Part V, Line 6a.
(23) Foreign Currency Exchange Rate Used to Convert PVIL6B <ENTER> Enter the first 35 characters from Part V, Line 6b.
(24) Source of Exchange Rate Used PVIL6C <ENTER> Enter the first 35 characters from Part V, Line 6c
(25) Name of Foreign Entity PVIL7A <ENTER> Enter the first 35 characters from Part VI, Line 7a.
(26) Type of Foreign Entity PVIL7C <ENTER> Enter the number representing the box marked from Part VI, line 7c.
(27) Mailing Address of Financial Institutions PVIL7D <ENTER> Enter the first 35 characters from Part V, Line 7d.
(28) Other Country/City/State PVIL7E <ENTER> Enter the first 35 characters from Part VI, Line 7e.
(29) Name of Insurer or Counterpart PVIL8A <ENTER> Enter the first 35 characters from Part VI, Line 8a
(30) Issuer or Counterparty Checkbox PVIL8A CKBX <ENTER> It will be a checkbox with the valid characters of 0, 1 and 2. The values are as follows:
0 - No boxes Checked
1 – Issuer
2 – Counterparty
(31) Type of Insurer or Counterpart PVIL8B <ENTER> Enter the number representing the box marked from Part VI, line 8b.
(32) Insurer Data PVIL8C <ENTER> From Part VI, line 8c:
Enter “1” if the U.S. Person box is marked.
Enter “2” if the Foreign Person box is marked.
Enter “3” if both boxes are marked.
(33) Mailing Address of Issuer or Counterparty PVIL8D <ENTER> Enter the first 35 characters from Part VI, Line 8d.
(34) Insurer Country/City/State PVIL8E <ENTER> Enter the first 35 characters from Part VI, Line 8e.

Exhibit 3.24.28-12 
Section 05 - 29 Form 8938 Continuation Forms, Statement of Specified Foreign Financial Assets, (Attached To Form 1040 (Program 43300) Or Form 1040-NR (Program 43310))

Section 05 - 29
Source Document or Record: Form 8938, Statement of Specified Foreign Financial Assets, (Attached to Form 1040 or Form 1040 NR)
Elem. No. Data Element Name Prompt Fld. Term. Instructions
(1) Section Number SECT:   Press <Enter> if already present on the screen; otherwise enter "05" - "29" always.
(2) Section Type of Account PVL1 <ENTER> From Part V, line 1:
Enter “1” if the Deposit box is marked.
Enter “2” if the Custodial box is marked.
Enter “3” if both boxes are marked.
(3) Account Number PVL2 <ENTER> Enter up to 20 characters from Part V, line 2.

Note:

The operator has the option of whether or not to enter special characters, punctuation, and/or approved abbreviations.

(4) Account Data PVL3 <ENTER> Enter the alpha character for each box that is marked from Part V, line 3.
(5) Maximum Value of Account PVL4 $ <ENTER> Enter the amount from Part V, line 4.
(6) Foreign Currency Exchange Rate PVL5 <ENTER> From Part V, line 5:
Enter “1” if the Yes box is marked.
Enter “2” if the No box is marked.
Enter “3” if both boxes are marked.
(7) Foreign Currency in Which Account is Maintained PVL6A <ENTER> Enter the first 35 characters from Part V, Line 6a.

Note:

Enter special characters, punctuation, and/or approved abbreviations

(8) Foreign Currency Exchange Rate PVL6B <ENTER> Enter the first 35 characters from Part V, Line 6b.

Note:

Enter special characters, punctuation, and/or approved abbreviations

(9) Source of Exchange Rate PVL6C <ENTER> Enter the first 35 characters from Part V, Line 6c.

Note:

Enter special characters, punctuation, and/or approved abbreviations

(10) Name of Financial Institution PVL7A <ENTER> Enter the first 35 characters from Part V, Line 7a.
(11) Mailing Address of Financial Institutions PVL8 <ENTER> Enter the first 35 characters from Part V, Line 8
(12) Institution Country/City/State PVL9 <ENTER> Enter the first 35 characters from Part V, Line 7.
(13) Description of Asset PVIL1 <ENTER> Enter the first 20 characters from Part VI, Line 1.
(14) Identifying Number PVIL2 <ENTER> Enter the first 20 characters from Part VI, Line 2.
(15) Date Asset Acquired PVIL3A <ENTER> Enter the Date from Part VI, line 3a in MMDDYY format.
(16) Date Asset Disposed PVIL3B <ENTER> Enter the date from Part VI, line 3b in MMDDYY format.
(17) Jointly Owned PVIL3C <ENTER> Enter a “1” if checkbox c, Part VI, line 3, is marked.
(18) No Tax Item Reported PVIL3D <ENTER> Enter a “1” if checkbox d, Part VI, line 3, is marked
(19) Maximum Value of Asset PVIL4 <ENTER> Enter the alpha character from the box marked from Part VI, line 4.
(20) Maximum Value Money Amount PVIL4 $ <ENTER> Enter the amount from Part VI, line 4.
(21) Foreign Currency Rate PVIL5 <ENTER> From Part VI, line 5:
Enter “1” if the Yes box is marked.
Enter “2” if the No box is marked.
Enter “3” if both boxes are marked.
(22) Foreign Currency in which Asset is Denominated PVIL6A <ENTER> Enter the first 35 characters from Part V, Line 6a.
(23) Foreign Currency Exchange Rate Used to Convert PVIL6B <ENTER> Enter the first 35 characters from Part V, Line 6b.
(24) Source of Exchange Rate Used PVIL6C <ENTER> Enter the first 35 characters from Part V, Line 6c
(25) Name of Foreign Entity PVIL7A <ENTER> Enter the first 35 characters from Part VI, Line 7a.
(26) Type of Foreign Entity PVIL7C <ENTER> Enter the number representing the box marked from Part VI, line 7c.
(27) Mailing Address of Financial Institutions PVIL7D <ENTER> Enter the first 35 characters from Part V, Line 7d.
(28) Other Country/City/State PVIL7E <ENTER> Enter the first 35 characters from Part VI, Line 7e.
(29) Name of Insurer or Counterpart PVIL8A <ENTER> Enter the first 35 characters from Part VI, Line 8a
(30) Issuer or Counterparty Checkbox PVIL8ACKBX <ENTER> It will be a checkbox with the valid characters of 0, 1 and 2. The values are as follows:
0 - No boxes Checked
1 – Issuer
2 – Counterparty
(31) Type of Insurer or Counterpart PVIL8B <ENTER> Enter the number representing the box marked from Part VI, line 8b.
(32) Insurer Data PVIL8C <ENTER> From Part VI, line 8c:
Enter “1” if the U.S. Person box is marked.
Enter “2” if the Foreign Person box is marked.
Enter “3” if both boxes are marked.
(33) Mailing Address of Issuer or Counterparty PVIL8D <ENTER> Enter the first 35 characters from Part VI, Line 8d.
(34) Insurer Country/City/State PVIL8E <ENTER> Enter the first 35 characters from Part VI, Line 8e.

Exhibit 3.24.28-13 
Section 01 Form 8966, FATCA Report, (Program 36500)

SECTION 01
Source Document or Record: Form 8966 , FATCA Report
Elem. No. Data Element Name Prompt Fld. Term. Instructions
(1) Section Number SECT:   Section "01" will always be generated. No entry is required.
(2) Serial Number SER# <ENTER> Press <ENTER> if the correct number appears automatically; otherwise enter the two digit number from the upper right hand corner of the Form 8966 . If the serial number has been generated by the system (see IRM 3.24.37.4.5, Sequential Document Entry) verify it matches the document being entered.
(3) Corrected Report Checkbox CORCKBX <ENTER> Check box in located above part I.
Enter "1" if the box is checked.
Enter "0" if the box is not checked.
(4) Amended Report Checkbox AMDCKBX <ENTER> Check box in located above part I.
Enter "1" if the box is checked.
Enter "0" if the box is not checked.
(5) Voided Report Checkbox VOIDCKBX <ENTER> Check box in located above part I.
Enter "1" if the box is checked.
Enter "0" if the box is not checked.
(6) Name of Filer PIL1 <ENTER> Enter the name from part I, box 1.
Alpha characters and "&" are valid.
Enter a period(.) for illegible characters and space for special characters.

Note:

The first position cannot be blank.

(7) Number, Street and Room or Suite PIL2 <ENTER> Enter the street address from part I, box 2.
(8) City or Town PIL3A <ENTER> Enter the city or town listed in part I, box 3a.
(9) State/Province/Region PIL3B <ENTER> Enter the state/province or region listed in part I, box 3b.
(10) Country (including postal code) PIL3C <ENTER> Enter the country including the postal code from part I, box 3c.
(11) Global Intermediary Identification Number PIL4 <ENTER> Enter the 19 character number present in part I box 4.

Caution:

This number should always box should always be populated. If there is no entry remove this document from the block for return to Code and Edit and remove this serial number from the data records.

(12) TIN of Filer PIL5 <ENTER> Enter the TIN from part I, box 5.

Note:

Enter periods (.) for illegible numbers.
Press enter if no entry.

(13) Name of Sponsored Entity PIL6 <ENTER> Enter the name from part I, box 6 if present.

Note:

The first position cannot be blank.
Alpha characters and "&" are valid.
Enter a period(.) for illegible characters and space for special characters.


Press enter if no entry.
(14) Number, Street and Room or Suite PIL7 <ENTER> Enter the street address from part I, box 7, if present.
Press enter if no entry.
(15) City or Town PIL8A <ENTER> Enter the city or town listed in part I, box 8a, if present.
Press enter if no entry.
(16) State/Province/Region PIL8B <ENTER> Enter the state/province or region listed in part I, box 8b, if present.
Press enter if no entry.
(17) Country (including postal code) PIL8C <ENTER> Enter the country including the postal code from part I, box 8c, if present.
Press enter if no entry.
(18) Global Intermediary Identification Number PIL9 <ENTER> Enter the 19 character number present in part I box 9, if present.
Press enter if no entry.
(19) TIN PIL10 <ENTER> Enter the TIN from part I, box 5.

Note:

Enter periods (.) for illegible numbers.
Press enter if no entry.

Exhibit 3.24.28-14 
Sections 02 Form 8966, FATCA Report, (Program 36500)

SECTION 02
Source Document or Record: Form 8966 , FATCA Report
Elem. No. Data Element Name Prompt Fld. Term. Instructions
(1) Section Number SECT: <ENTER> Press <ENTER> if already present on the screen; otherwise, enter 02.
(2) Name of Account Holder PIIL1 <ENTER> Enter the name from part II, box 1.

Note:

The first position cannot be blank.
Alpha characters and "&" are valid.
Enter a period(.) for illegible characters and space for special characters.

(3) Number, Street and Room or Suite PIIL2 <ENTER> Enter the street address from part II, box 2.
Press enter if no entry.
(4) City or Town PIIL3A <ENTER> Enter the city or town listed in part II, box 3a.
Press enter if no entry.
(5) State/Province/Region PIIL3B <ENTER> Enter the state/province or region listed in part II, box 3b.
Press enter if no entry.
(6) Country (including postal code) PIIL3C <ENTER> Enter the country including the postal code from part II, box 3c.
Press enter if no entry.
(7) TIN of Account Holder PIIL4 <ENTER> Enter the TIN from part II, box 4.

Note:

Enter a period (.) for an illegible number.


Press enter if no entry.
(8) If the Account Holder or Payee is an Entity ... PIIL5 <ENTER> Enter up to 5 numbers based on the boxes checked in part II, box 5:
1 = Owner- Documented FI with specified U.S. owner(s)
2 = Non-participating FI
3 = Direct Reporting NFFE
4 = Passive NFFE with substantial U.S. owner(s)
5 = Specified U.S. Person
Press enter if no entry.
(9) Name of Owner PIIIL1 <ENTER> Enter the name from part III, box 1.

Note:

The first position cannot be blank.
Alpha characters and "&" are valid.
Enter a period(.) for illegible characters and space for special characters.

(10) Number, Street and Room or Suite PIIIL2 <ENTER> Enter the street address from part III, box 2.
Press enter if no entry.
(11) City or Town PIIIL3A <ENTER> Enter the city or town listed in part III, box 3a.
Press enter if no entry.
(12) State/Province/Region PIIIL3B <ENTER> Enter the state/province or region listed in part III, box 3b.
Press enter if no entry.
(13) Country (including postal code) PIIIL3C <ENTER> Enter the country including the postal code from part III, box 3c.
Press enter if no entry.
(14) TIN of Owner PIIIL4 <ENTER> Enter the TIN from part III, box 4.

Note:

Enter a period (.) for an illegible number.


Press enter if no entry.
(15) Account Number PIVL1 <ENTER> Enter the account number up to forty characters if present.
Press enter if no entry.
(16) Currency Code PIVL2 <ENTER> Enter the three character alpha code present.
Press enter if no entry.
(17) Account Balance PIVL3 $ <ENTER> Enter the dollar amount in dollars only.

Caution:

DO NOT round for cents if present.


Press enter if no entry.
(18) Interest PIVL4A $ <ENTER> Enter the dollar amount in dollars only.

Caution:

DO NOT round for cents if present.


Press enter if no entry.
(19) Dividends PIVL4B $ <ENTER> Enter the dollar amount in dollars only.

Caution:

DO NOT round for cents if present.


Press enter if no entry.
(20) Gross Proceeds/Redemptions PIVL4C $ <ENTER> Enter the dollar amount in dollars only.

Caution:

DO NOT round for cents if present.


Press enter if no entry.
(21) Other PIVL4D $ <ENTER> Enter the dollar amount in dollars only.

Caution:

DO NOT round for cents if present.


Press enter if no entry.
(22) Check Applicable Pooled Reporting Type PVL1 <ENTER> Enter up to 6 numbers based on the boxes checked in part V, box 1:
1 = Recalcitrant account holders with U.S. Indicia
2 = Dormant Accounts
3 = Recalcitrant account holders that are U.S. persons
4 = Recalcitrant account holders without U.S. Indicia
5 = Non-participating FFI
6 = Recalcitrant account holders that are passive NFFEs
Press enter if no entry.
(23) Number of Accounts PVL2 <ENTER> Enter the number in part V, box 2.
Press enter if no entry.
(24) Aggregated Payment Amount PVL3 $ <ENTER> Enter the dollar amount in dollars only in part V box 3.

Caution:

DO NOT round for cents if present.


Press enter if no entry.
(25) Aggregated Account Balance PVL4 $ <ENTER> Enter the dollar amount in dollars only present in part V box 4.

Caution:

DO NOT round for cents if present.


Press enter if no entry.
(26) Currency Code PVL5 <ENTER> Enter the three character alpha code present in part V box 5.

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