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...... SCHEDULE B (Form 1040A or 1040) Department of the Treasury Internal Revenue Service (99) Interest and Ordinary Dividends a Attach to Form 1040A or 1040. a Information about Schedule B (Form 1040A or 1040) and its instructions is at www.irs.gov/scheduleb . OMB No. 1545-0074 20 13 Attachment 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 and address a 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 ...................... a 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 a 5 6 Add the amounts on line 5. Enter the total here and on Form 1040A, or Form 1040, line 9a ...................... a 6 Note. If line 6 is over $1,500, you must complete Part III. Part III Foreign Accounts and Trusts (See instructions on back.) Yes No 7a At any time during 2013, did you have a financial interest in or signature authority over a financial account (such as a bank account, securities account, or brokerage account) located in a foreign country? See instructions ........................ If “Yes,” are you required to file FinCEN Form 114, Report of Foreign Bank and Financial Accounts (FBAR), formerly TD F 90-22.1, to report that financial interest or signature authority? requirements ............................ See FinCEN Form 114 and its instructions for filing requirements and exceptions to those b If you are required to file FinCEN Form 114, enter the name of the foreign country where the financial account is located a 8 During 2013, did you receive a distribution from, or were you the grantor of, or transferor to, a foreign trust? If “Yes,” you may have to file Form 3520. See instructions on back For Paperwork Reduction Act Notice, see your tax return instructions. Cat. No. 17146N Schedule B (Form 1040A or 1040) 2013 Enter more interest payers Enter more dividend payers foreign account; or (c) received a distribution from, or were a grantor of, or a transferor to, a foreign trust. You must complete this part if you (a) had over $1,500 of taxable interest or ordinary dividends; (b) had a ----------------Page (0) Break----------------