Figure 3.11.25-3 provides an illustration of a completed Form 8831, Excise Taxes on Excess Inclusions of REMIC Residual Interests. In the far right hand corner under the OMB No. is the tax period of 1220.Name control of HICK is underlined.Identifying number shown is 00-2426785.Street address is 43 Aspen Dr.City, state and Zip code are Tampa, Florida 33602.Line 1 is for the date the residual interest was transferred to a disqualified organization. The date shown is 03-30-19.Line 2, the Yes box is checked indicating the taxpayer took a reasonable amount of time to ensure the residual interest that was transferred was no longer held by a disqualified organization.Line 3 shows a date of 09-20-20 when the disqualified organization disposed of the residual interest.On Line 6, an amount of $655.00 is shown as the excess inclusion allocable to the residual interest transferred that accrued during the period the disqualified organization held the interest.Line 7 (amount due) shows an amount of $229.00.In the lower portion of the return is the received date stamp. The receive date shown is 04152021.Line 11 shows an edited amount of $229.00 which was taken from line 7.Line 13 shows an edited amount of $229.00.Signature- The form shows the taxpayer has signed Joyce Balsam and dated the form April 15, 2021, with a title of CEO.