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Federal Free Printable 2018 Form 4720 for 2019 Federal Return of Certain Excise Taxes Under Chapters 41 and 42 of the Internal Revenue Code

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Return of Certain Excise Taxes Under Chapters 41 and 42 of the Internal Revenue Code
2018 Form 4720

Form 4720 Department of the Treasury Internal Revenue Service Return of Certain Excise Taxes Under Chapters 41 and 42 of the Internal Revenue Code OMB No. 1545-0052 (Sections 170(f)(10), 664(c)(2), 4911, 4912, 4941, 4942, 4943, 4944, 4945, 4955, 4958, 4959, 4960, 4965, 4966, 4967, and 4968) ▶ Go to www.irs.gov/Form4720 for instructions and the latest information. For calendar year 2018 or other tax year beginning Name of organization or entity , 2018, and ending 2018 , 20 Employer identification number Number, street, and room or suite no. (or P.O. box if mail is not delivered to street address) Check box for type of annual return: City or town, state or province, country, and ZIP or foreign postal code Form 990 Form 990-EZ Form 990-PF Other Form 5227 A B Yes No Is the organization a foreign private foundation within the meaning of section 4948(b)? . . . . . . . . . Has corrective action been taken on any taxable event that resulted in Chapter 42 taxes being reported on this form? (Enter “N/A” if not applicable) . . . . . . . . . . . . . . . . . . . . . . . . If “Yes,” attach a detailed description and documentation of the corrective action taken and, if applicable, enter the fair market value of any property recovered as a result of the correction ▶ $ . If “No,” (that is, any uncorrected acts or transactions), attach an explanation (see instructions). Part I 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 Taxes on Organization (Sections 170(f)(10), 664(c)(2), 4911(a), 4912(a), 4942(a), 4943(a), 4944(a)(1), 4945(a)(1), 4955(a)(1), 4959, 4960(a), 4965(a)(1), 4966(a)(1), and 4968(a)) Tax on undistributed income—Schedule B, line 4 . . . . . . . . . . . . . . Tax on excess business holdings—Schedule C, line 7 . . . . . . . . . . . . Tax on investments that jeopardize charitable purpose—Schedule D, Part I, column (e) . Tax on taxable expenditures—Schedule E, Part I, column (g) . . . . . . . . . . Tax on political expenditures—Schedule F, Part I, column (e) . . . . . . . . . . Tax on excess lobbying expenditures—Schedule G, line 4 . . . . . . . . . . . Tax on disqualifying lobbying expenditures—Schedule H, Part I, column (e) . . . . . Tax on premiums paid on personal benefit contracts . . . . . . . . . . . . Tax on being a party to prohibited tax shelter transactions—Schedule J, Part I, column (h) Tax on taxable distributions—Schedule K, Part I, column (f) . . . . . . . . . . Tax on a charitable remainder trust’s unrelated business taxable income. Attach statement Tax on failure to meet the requirements of section 501(r)(3)—Schedule M, Part II, line 2 Tax on excess executive compensation—Schedule N . . . . . . . . . . . . Tax on net investment income of private colleges and universities—Schedule O . . . Total (add lines 1–14) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 Part II-A Taxes on Managers, Self-Dealers, Disqualified Persons, Donors, Donor Advisors, and Related Persons (Sections 4912(b), 4941(a), 4944(a)(2), 4945(a)(2), 4955(a)(2), 4958(a), 4965(a)(2), 4966(a)(2), and 4967(a)) (a) Name and address of person subject to tax. City or town, state or province, country, ZIP or foreign postal code (b) Taxpayer identification number a b c (c) Tax on self-dealing—Schedule A, Part II, col. (d), and Part III, col. (d) (d) Tax on investments that jeopardize charitable purpose—Schedule D, Part II, col. (d) (e) Tax on taxable expenditures— Schedule E, Part II, col. (d) (f) Tax on political expenditures— Schedule F, Part II, col. (d) a b c Total (h) Tax on excess benefit (i) Tax on being a party to prohibited (g) Tax on disqualifying lobbying transactions—Schedule I, Part II, col. tax shelter transactions—Schedule J, expenditures—Schedule H, Part II, col. (d) (d), and Part III, col. (d) Part II, col. (d) (j) Tax on taxable distributions— Schedule K, Part II, col. (d) a b c Total (k) Tax on prohibited benefits—Sch L, Part II, col. (d), and Part III, col. (d) (l) Total—Add cols. (c) through (k) a b c Total For Privacy Act and Paperwork Reduction Act Notice, see the separate instructions. Cat. No. 13021D Form 4720 (2018) Page 2 Form 4720 (2018) Part II-B Summary of Taxes (See Tax Payments in the instructions.) 1 Enter the taxes listed in Part II-A, column (l), that apply to managers, self-dealers, disqualified persons, donors, donor advisors, and related persons who sign this form. If all sign, enter the total amount from Part II-A, column (l) . . . . . . . . . . . . . . . . . . 2 3 4 5 Total tax. Add Part I, line 15, and Part II-B, line 1 . . . . . . . . . . . . Total payments including amount paid with Form 8868 (see instructions) . . . . Tax due. If line 2 is larger than line 3, enter amount owed (see instructions) . . . Overpayment. If line 2 is smaller than line 3, enter the difference. This is your refund Part I (a) Act number . . . . . . . . 1 2 3 4 5 . . ▶ ▶ SCHEDULE A—Initial Taxes on Self-Dealing (Section 4941) Acts of Self-Dealing and Tax Computation (b) Date of act (c) Description of act 1 2 3 4 5 (d) Question number from Form 990-PF, Part VII-B, or Form 5227, Part VI-B, applicable to the act Part II (e) Amount involved in act (g) Tax on foundation managers (if applicable) (lesser of $20,000 or 5% of col. (e)) Summary of Tax Liability of Self-Dealers and Proration of Payments (a) Names of self-dealers liable for tax Part III (f) Initial tax on self-dealer (10% of col. (e)) (b) Act no. from Part I, col. (a) (d) Self-dealer’s total tax liability (add amounts in col. (c)) (see instructions) (c) Tax from Part I, col. (f), or prorated amount Summary of Tax Liability of Foundation Managers and Proration of Payments (a) Names of foundation managers liable for tax (b) Act no. from Part I, col. (a) (d) Manager’s total tax liability (add amounts in col. (c)) (see instructions) (c) Tax from Part I, col. (g), or prorated amount SCHEDULE B—Initial Tax on Undistributed Income (Section 4942) 1 2 3 4 Undistributed income for years before 2017 (from Form 990-PF for 2018, Part XIII, line 6d) . Undistributed income for 2017 (from Form 990-PF for 2018, Part XIII, line 6e) . . . . . Total undistributed income at end of current tax year beginning in 2018 and subject to tax under section 4942 (add lines 1 and 2) . . . . . . . . . . . . . . . . . . Tax—Enter 30% of line 3 here and on Part I, line 1 . . . . . . . . . . . . . . 1 2 3 4 Form 4720 (2018) Page 3 Form 4720 (2018) SCHEDULE C—Initial Tax on Excess Business Holdings (Section 4943) Business Holdings and Computation of Tax If you have taxable excess holdings in more than one business enterprise, attach a separate schedule for each enterprise. Refer to the instructions for each line item before making any entries. Name and address of business enterprise Employer identification number . . . . . . . . . . . . . . . . . . . . ▶ Form of enterprise (corporation, partnership, trust, joint venture, sole proprietorship, etc.) . ▶ (a) Voting stock (profits interest or beneficial interest) (b) Value (c) Nonvoting stock (capital interest) 1 Foundation holdings in business enterprise . . 1 % % 2 Permitted holdings in business enterprise . 2 % % 3 4 Value of excess holdings in business enterprise Value of excess holdings disposed of within 90 days; or, other value of excess holdings not subject to section 4943 tax (attach statement) Taxable excess holdings in business enterpriseline 3 minus line 4 . . . . . . . . . . 3 Tax—Enter 10% of line 5 . . . . . . . Total tax—Add amounts on line 6, columns (a), (b), and (c); enter total here and on Part I, line 2 6 5 6 7 Part I . 4 5 7 SCHEDULE D—Initial Taxes on Investments That Jeopardize Charitable Purpose (Section 4944) Investments and Tax Computation (a) Investment number (b) Date of investment (c) Description of investment (d) Amount of investment 1 2 3 4 5 Total—Column (e). Enter here and on Part I, line 3 . . . . . . . . . . . . . Total—Column (f). Enter total (or prorated amount) here and in Part II, column (c), below . Part II (e) Initial tax on foundation (10% of col. (d)) . . . . (f) Initial tax on foundation managers (if applicable)— (lesser of $10,000 or 10% of col. (d)) . Summary of Tax Liability of Foundation Managers and Proration of Payments (a) Names of foundation managers liable for tax (b) Investment no. from Part I, col. (a) (c) Tax from Part I, col. (f), or prorated amount (d) Manager’s total tax liability (add amounts in col. (c)) (see instructions) Form 4720 (2018) Page 4 Form 4720 (2018) Part I (a) Item number SCHEDULE E—Initial Taxes on Taxable Expenditures (Section 4945) Expenditures and Computation of Tax (b) Amount (c) Date paid or incurred (d) Name and address of recipient (e) Description of expenditure and purposes for which made (g) Initial tax imposed on foundation (20% of col. (b)) (h) Initial tax imposed on foundation managers (if applicable)—(lesser of $10,000 or 5% of col. (b)) 1 2 3 4 5 (f) Question number from Form 990-PF, Part VII-B, or Form 5227, Part VI-B, applicable to the expenditure Total—Column (g). Enter here and on Part I, line 4 . . . . . . . . . . Total—Column (h). Enter total (or prorated amount) here and in Part II, column (c), below . . . . . . . . . . . . . . . . . . . . . . . . . Part II Summary of Tax Liability of Foundation Managers and Proration of Payments (b) Item no. from Part I, col. (a) (a) Names of foundation managers liable for tax Part I (a) Item number (d) Manager’s total tax liability (add amounts in col. (c)) (see instructions) (c) Tax from Part I, col. (h), or prorated amount SCHEDULE F—Initial Taxes on Political Expenditures (Section 4955) Expenditures and Computation of Tax (b) Amount (c) Date paid or incurred (e) Initial tax imposed on organization or foundation (10% of col. (b)) (d) Description of political expenditure (f) Initial tax imposed on managers (if applicable) (lesser of $5,000 or 2½% of col. (b)) 1 2 3 4 5 Total—Column (e). Enter here and on Part I, line 5 . . . . . . . . . . Total—Column (f). Enter total (or prorated amount) here and in Part II, column (c), below . Part II . . . . Summary of Tax Liability of Organization Managers or Foundation Managers and Proration of Payments (a) Names of organization managers or foundation managers liable for tax (b) Item no. from Part I, col. (a) (c) Tax from Part I, col. (f), or prorated amount (d) Manager’s total tax liability (add amounts in col. (c)) (see instructions) Form 4720 (2018) Page 5 Form 4720 (2018) SCHEDULE G—Tax on Excess Lobbying Expenditures (Section 4911) 1 Excess of grass roots expenditures over grass roots nontaxable amount (from Schedule C (Form 990 or 990-EZ), Part II-A, column (b), line 1h). (See the instructions before making an entry.) . . 1 Excess of lobbying expenditures over lobbying nontaxable amount (from Schedule C (Form 990 or 990-EZ), Part II-A, column (b), line 1i). (See the instructions before making an entry.) . . . . . 2 3 Excess lobbying expenditures—enter the larger of line 1 or line 2 . . . . . . . . . . . 3 4 Tax—Enter 25% of line 3 here and on Part I, line 6 . . . . . . . . . . . 4 2 Part I (a) Item number . . . . . SCHEDULE H—Taxes on Disqualifying Lobbying Expenditures (Section 4912) Expenditures and Computation of Tax (b) Amount (c) Date paid or incurred (d) Description of lobbying expenditures (e) Tax imposed on organization (5% of col. (b)) (f) Tax imposed on organization managers (if applicable)— (5% of col. (b)) 1 2 3 4 5 Total—Column (e). Enter here and on Part I, line 7 . . . . . . . . . Total—Column (f). Enter total (or prorated amount) here and in Part II, column (c), below . Part II (a) Names of organization managers liable for tax Part I (a) Transaction number . . . . . Summary of Tax Liability of Organization Managers and Proration of Payments (b) Item no. from Part I, col. (a) (c) Tax from Part I, col. (f), or prorated amount (d) Manager’s total tax liability (add amounts in col. (c)) (see instructions) SCHEDULE I—Initial Taxes on Excess Benefit Transactions (Section 4958) Excess Benefit Transactions and Tax Computation (b) Date of transaction (c) Description of transaction 1 2 3 4 5 (d) Amount of excess benefit (e) Initial tax on disqualified persons (25% of col. (d)) (f) Tax on organization managers (if applicable) (lesser of $20,000 or 10% of col. (d)) Form 4720 (2018) Page 6 Form 4720 (2018) Part II SCHEDULE I—Initial Taxes on Excess Benefit Transactions (Section 4958) Continued Summary of Tax Liability of Disqualified Persons and Proration of Payments (b) Trans. no. from Part I, col. (a) (a) Names of disqualified persons liable for tax Part III Summary of Tax Liability of 501(c)(3), (c)(4) & (c)(29) Organization Managers and Proration of Payments (a) Names of 501(c)(3), (c)(4) & (c)(29) organization managers liable for tax Part I (a) Transaction number (d) Disqualified person’s total tax liability (add amounts in col. (c)) (see instructions) (c) Tax from Part I, col. (e), or prorated amount (b) Trans. no. from Part I, col. (a) (d) Manager’s total tax liability (add amounts in col. (c)) (see instructions) (c) Tax from Part I, col. (f), or prorated amount SCHEDULE J—Taxes on Being a Party to Prohibited Tax Shelter Transactions (Section 4965) Prohibited Tax Shelter Transactions (PTST) and Tax Imposed on the Tax-Exempt Entity (see instructions) (b) Transaction date (c) Type of transaction 1 —Listed 2 —Subsequently listed 3 —Confidential 4 —Contractual protection (d) Description of transaction 1 2 3 4 5 (e) Did the tax-exempt entity know or have reason to know this transaction was a PTST when it became a party to the transaction? Answer Yes or No (f) Net income attributable to the PTST Total—Column (h). Enter here and on Part I, line 9 . . . . (g) 75% of proceeds attributable to the PTST . . . . . . . . . . . (h) Tax imposed on the tax-exempt entity (see instructions) . Form 4720 (2018) Page 7 Form 4720 (2018) Part II Tax Imposed on Entity Managers (Section 4965) Continued (a) Name of entity manager Part I (b) Transaction number from Part I, col. (a) (c) Tax—enter $20,000 for each transaction listed in col. (b) for each manager in col. (a) (d) Manager’s total tax liability (add amounts in col. (c)) SCHEDULE K—Taxes on Taxable Distributions of Sponsoring Organizations Maintaining Donor Advised Funds (Section 4966). See the instructions. Taxable Distributions and Tax Computation (a) Item number (b) Name of sponsoring organization and donor advised fund (c) Description of distribution 1 2 3 4 (d) Date of distribution (f) Tax imposed on organization (20% of col. (e)) (e) Amount of distribution Total—Column (f). Enter here and on Part I, line 10 . . . . . Total—Column (g). Enter total (or prorated amount) here and in Part II, column (c), below . Part II (g) Tax on fund managers (lesser of 5% of col. (e) or $10,000) . Summary of Tax Liability of Fund Managers and Proration of Payments (a) Name of fund managers liable for tax (b) Item no. from Part I, col. (a) (c) Tax from Part I, col. (g) or prorated amount (d) Manager’s total tax liability (add amounts in col. (c)) (see instructions) Form 4720 (2018) Page 8 Form 4720 (2018) SCHEDULE L—Taxes on Prohibited Benefits Distributed From Donor Advised Funds (Section 4967). See the instructions. Part I Prohibited Benefits and Tax Computation (a) Item number (b) Date of prohibited benefit (c) Description of benefit 1 2 3 4 5 (d) Amount of prohibited benefit Part II (f) Tax on fund managers (if applicable) (lesser of 10% of col. (d) or $10,000) (see instructions) Summary of Tax Liability of Donors, Donor Advisors, Related Persons, and Proration of Payments (a) Names of donors, donor advisors, or related persons liable for tax Part III (e) Tax on donors, donor advisors, or related persons (125% of col. (d)) (see instructions) (b) Item no. from Part I, col. (a) (c) Tax from Part I, col. (e) or prorated amount (d) Donor’s, donor advisor’s, or related person’s total tax liability (add amounts in col. (c)) (see instructions) Summary of Tax Liability of Fund Managers and Proration of Payments (a) Names of fund managers liable for tax (b) Item no. from Part I, col. (a) (c) Tax from Part I, col. (f) or prorated amount (d) Fund manager’s total tax liability (add amounts in col. (c)) (see instructions) Form 4720 (2018) Page 9 Form 4720 (2018) Part I (a) Item number 1 2 3 4 5 Part II Schedule M—Tax on Hospital Organization for Failure to Meet the Community Health Needs Assessment Requirements (Sections 4959 and 501(r)(3)). (See instructions.) Failures to Meet Section 501(r)(3) (b) Name of hospital facility (d) Tax year hospital facility last conducted a CHNA (c) Description of the failure (e) Tax year hospital facility last adopted an implementation strategy Computation of Tax 1 Number of hospital facilities operated by the hospital organization that failed to meet the Community Health Needs Assessment requirements of section 501(r)(3) . . . . . . . . . . . . . . 2 Tax—Enter $50,000 multiplied by line 1 here and on Part I, line 12 . . . . . . . . . . . 1 2 . SCHEDULE N—Tax on Excess Executive Compensation (Section 4960). (See instructions.) (a) Item number (b) Name of covered employee (d) Excess parachute payment (c) Excess remuneration 1 2 3 4 5 6 Attachment, if necessary. See instructions . . . . Total (add column (e) items 1–6) . . . . . . . . . . Tax. Enter 21% of the amount above here and on Part I, line 13 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (e) Total. Add column (c) and (d) . . . SCHEDULE O—Excise Tax on Net Investment Income of Private Colleges and Universities (Section 4968) (a) Name 1 2 3 4 (c) Gross investment income (See instructions.) (b) EIN (d) Capital gain net income (e) Administrative expenses allocable to income included in cols. (c) and (d) (f) Net investment income (See instructions.) Filing Organization Related Organization Related Organization Related Organization 5 Total from attachment, if necessary . . . . . 6 Total . . . . . 7 Excise Tax on Net Investment Income. Enter 1.4% of the amount in 6(f) here and on Part I, line 14 . . . . . . . . . . . . . Form 4720 (2018) Page 10 Form 4720 (2018) Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief it is true, correct, and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge. ▲ ▲ ▲ Sign Here Title Signature of officer or trustee ▲ ▲ Signature (and organization or entity name if applicable) of manager, self-dealer, disqualified person, donor, donor advisor, or related person Date Signature (and organization or entity name if applicable) of manager, self-dealer, disqualified person, donor, donor advisor, or related person Date Signature (and organization or entity name if applicable) of manager, self-dealer, disqualified person, donor, donor advisor, or related person Date Signature (and organization or entity name if applicable) of manager, self-dealer, disqualified person, donor, donor advisor, or related person Date May the IRS discuss this return with the preparer shown below? (see instructions) Paid Preparer Use Only Date Print/Type preparer’s name Firm’s name ▶ Firm’s address ▶ Preparer’s signature . . . . . . Date . . . . . No Yes Check if self-employed PTIN Firm’s EIN ▶ Phone no. Form 4720 (2018)
Extracted from PDF file 2018-federal-form-4720.pdf, last modified November 2018

More about the Federal Form 4720 Other TY 2018

We last updated the Return of Certain Excise Taxes Under Chapters 41 and 42 of the Internal Revenue Code in December 2018, so this is the latest version of Form 4720, fully updated for tax year 2018. You can download or print current or past-year PDFs of Form 4720 directly from TaxFormFinder. You can print other Federal tax forms here.

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Form Sources:

The Internal Revenue Service usually releases income tax forms for the current tax year between October and January, although changes to some forms can come even later. We last updated Federal Form 4720 from the Internal Revenue Service in December 2018.

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Historical Past-Year Versions of Federal Form 4720

We have a total of eight past-year versions of Form 4720 in the TaxFormFinder archives, including for the previous tax year. Download past year versions of this tax form as PDFs here:


2018 Form 4720

2018 Form 4720

2017 Form 4720

2017 Form 4720

2016 Form 4720

2016 Form 4720

Return of Certain Excise Taxes Under Chapters 41 and 42 of the Internal Revenue Code 2015 Form 4720

2015 Form 4720

Return of Certain Excise Taxes Under Chapters 41 and 42 of the Internal Revenue Code 2014 Form 4720

2014 Form 4720

Return of Certain Excise Taxes Under Chapters 41 and 42 of the Internal Revenue Code 2013 Form 4720

2013 Form 4720

Return of Certain Excise Taxes Under Chapters 41 and 42 of the Internal Revenue Code 2012 Form 4720

2012 Form 4720

Return of Certain Excise Taxes Under Chapters 41 and 42 of the Internal Revenue Code 2011 Form 4720

2011 Form 4720


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