Form 3520 - Page 4Summary: This is an example of page 4 of Form 3520 with field designators, which are represented in braces. The page begins with Part II U.S. Owner of a Foreign Trust (see instructions):Line 20The next fields to be transcribed are five columns identified with a lower case letter. Each column has three lines. The first line is transcribed. If more than one line is present, then a multiple indicator number is entered at the end of the first row. Column (a) Name of foreign trust owners: {Field 12-A}Column (b) Address: {Field 12-B} {Field 12-C} {Field 12-D} {Field 12-E}Column (c) Country of tax residence: {Field 12-F}Column (d) TIN, if any: {Field 12-H} {Field 12-G}Column (e) Relevant code section: {Field 12-I} {Field 12-J}Line 21The next fields to be transcribed are three columns identified with a lower case letter. Each column has one line. The first line is transcribed. The columns for transcription are:Column (a) Country code of country where foreign trust was created: {Field 12-K}Column (b) Country code of country whose law governs the foreign trust: {Field 12-L}Column (c) Date foreign trust was created: {Field 12-M}Line 22Did the foreign trust file Form 3520-A for the current year? checkbox Yes checkbox No {Field 12-N}If Yes, attach the Foreign Grantor Trust Owner Statement you received from the foreign trust. If No, to the best of your ability, complete and attach a substitute Form 3520-A for the foreign trust. See instructions for information on penalties for failing to complete and attach a substitute Form 3520-A.Line 23Enter the gross value of the portion of the foreign trust that you are treated as owning at the end of your tax year. {Field 12-O}Under: Part III Distributions to a U.S. Person From a Foreign Trust During the Current Tax YearLine 24, Enter cash amounts or FMV of property received, directly or indirectly, during your current tax year, from the foreign trust (exclude loans and uncompensated use of trust property included on Line 25).The next fields to be transcribed are six columns identified with a lower case letter. Each column has eight lines. The first two lines are transcribed. If more than two lines are present, then a multiple indicator number is entered at the end of the third row. The columns for transcription are:Column (a) Date of Distribution: {Field 13-A} {Field 13-H} {Field 13-O}Column (b) Description of property received: {Field 13-B} {Field 13-I} {Field 13-P}Column (c) FMV of property received (determined on date of distribution): {Field 13-C} {Field 13-J} {Field 13-Q}Column (d) Description of property transferred, If any: {Field 13-D} {Field 13-K} {Field 13-R}Column (e) FMV of property transferred: {Field 13-E} {Field 13-L} {Field 13-S} Column (f) Excess of column (c) over column (e): {Field 13-F} {Field 13-M} {Field 13-T} {Field 13-V}Totals Line. {Field 13-W}Line 25During the current tax year, did you (or a person related to you) receive a loan or uncompensated use of trust property from a related foreign trust (including an extension of credit upon the purchase property from the trust)? checkbox Yes checkbox No: {Field 14-A}If Yes, complete columns (a) through (g) below for each such loan or use of trust property.NOTE: See instructions for additional information, including how to complete columns (a) through (g) for use of trust property.The next fields to be transcribed are seven columns identified with a lower case letter. Each column has three lines. The first two lines are transcribed. If more than two entries, a multiple indicator number will be edited to the right of the second line. They are:Column (a) FMV of loan proceeds or property: {Field 14-B} {Field 14-I}Column (b) Date of original loan transaction: {Field 14-C} {Field 14-J}Column (c) Maximum term of repayment of obligation: {Field 14-D} {Field 14-K}Column (d) Interest rate of obligation: {Field 14-E} {Field 14-L}Column (e) Is the obligation a qualified obligation?. This column is sub-divided into Yes (on the left) and No (on the right) columns: {Field 14-F} {Field 14-M}Column (f) FMV of qualified obligation: {Field 14-G} {Field 14-N}Column (g) Amount treated as distribution from the trust (subtract column (f) from column (a)): {Field 14-H} {Field 14-O}The multiple indicator is edited at the end of the last column, second row. {Field 14-P}Column (g) Totals field: {Field 14-Q}Line 26With respect to each obligation you reported as a qualified obligation on line 25, do you agree to extend the period of assessment of any income or transfer tax attributable to the transaction, and any consequential income tax changes for each year that the obligation is outstanding, to a date 3 years after the maturity date of the obligation? checkbox Yes checkbox No {Field 14-S}Note: You have the right to refuse to extend the period of limitations or limit this extension to a mutually agreed-upon issue(s) or mutually agreed-upon period of time. Generally, if you refuse to extend the period of limitations with respect to an obligation that you reported as a qualified obligation on line 25, then such obligation is not a qualified obligation and you cannot check Yes in column (e) of Line 25.Line 27Total distributions received during your current tax year. Add Line 24, column (f), and Line 25, column (g): Field contains {Field 14-T}Line 28Did the trust, at any time during the current tax year, hold an outstanding obligation of yours (or a person related to you) that you reported as a qualified obligation? checkbox Yes checkbox No {Field 14-U}If Yes, complete columns (a) through (f) below for each obligation.The next fields to be transcribed are six columns identified with a lower case letter. Each column has four lines. The first two lines are transcribed. If more than two lines are present, then a multiple indicator number is entered at the end of the third row, to the right of the last column, Field 15-K. The columns for transcription are:Column (a) Date of original loan transaction: {Field 15-A} {Field 15-F} Column (b) Tax year qualified obligation first reported: {Field 15-B} {Field 15-G} Column (c) Amount of principal payments made during the tax year: {Field 15-C} {Field 15-H}Column (d) Amount of interest payments made during your tax year: {Field 15-D} {Field 15-I}Column (e) Balance of the outstanding obligation at the end of the tax yearColumn (f) Does the loan still meet the criteria of a qualified obligation: This column is sub-divided into YES (on the left) and NO (on the right) columns: {Field 15-E} {Field 15-J}The multiple indicator is edited at the end of the last column, third row: {Field 15-K}