| SCHEDULE B (Form 1040A or 1040) Department of the Treasury Internal Revenue Service (99) | Interest and Ordinary Dividends Attach to Form 1040A or 1040. Go to www.irs.gov/ScheduleB for instructions and the latest information. | OMB No. 1545-0074 | | 2017 Attachment Sequence No. 08 | | Name(s) shown on return Charles and Sally Heck | Your social security number | | Part I Interest (See instructions 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 the instructions and list this interest first. Also, show that buyer's social security number and address | | Amount | | | | | | | | 1 | | | | | | | | | | | | | | | 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 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. | | | 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 | | Part III Foreign Accounts and Trusts (See instructions.) | 7a | At any time during 2017, 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), to report that financial interest or signature authority? See FinCEN Form 114 and its instructions for filing requirements and exceptions to those requirements . . . . . . . . . . . . . . . | | | | | | | | | b | If you are required to file FinCEN Form 114, enter the name of the foreign country where the financial account is located . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . | | | | 8 | During 2017, 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 . . . . . . . . . . . | | | | For Paperwork Reduction Act Notice, see your tax return instructions. | Cat. No. 17146N | Schedule B (Form 1040A or 1040) 2017 | |
