Federal Free Printable 2016 Form 8938 for 2017 Federal Statement of Foreign Financial Assets

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Statement of Foreign Financial Assets
2016 Form 8938

Form 8938 Department of the Treasury Internal Revenue Service Statement of Specified Foreign Financial Assets ▶ OMB No. 1545-2195 2016 Information about Form 8938 and its separate instructions is at www.irs.gov/form8938. ▶ Attach to your tax return. For calendar year 20 , 20 or tax year beginning If you have attached continuation statements, check here and ending Attachment Sequence No. 175 , 20 Number of continuation statements 1 Name(s) shown on return 3 Type of filer Specified individual b Partnership c a Corporation d Trust If you checked box 3a, skip this line 4. If you checked box 3b or 3c, enter the name and TIN of the specified individual who closely holds the partnership or corporation. If you checked box 3d, enter the name and TIN of the specified person who is a current beneficiary of the trust. (See instructions for definitions and what to do if you have more than one specified individual or specified person to list.) 4 a Part I 1 2 3 4 5 b TIN Name Foreign Deposit and Custodial Accounts Summary Number of Deposit Accounts (reported in Part V) . . . . . . . . . Maximum Value of All Deposit Accounts . . . . . . . . . . . Number of Custodial Accounts (reported in Part V) . . . . . . . . Maximum Value of All Custodial Accounts . . . . . . . . . . . Were any foreign deposit or custodial accounts closed during the tax year? Part II 1 2 3 2 TIN . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ▶ . . . . . . . . . . . . . . . . . . . . . . . . . . . ▶ . $ ▶ . . $ . . . . . . . . . . . . . . 2 Other Foreign Assets 1a 1b 1c 1d 1e 1f 1g 2a 2b 2c 2d 2e 2f 2g (b) Tax item Interest Dividends Royalties Other income Gains (losses) Deductions Credits Interest Dividends Royalties Other income Gains (losses) Deductions Credits (c) Amount reported on form or schedule Yes No Yes No $ Summary of Tax Items Attributable to Specified Foreign Financial Assets (see instructions) (a) Asset Category 1 Foreign Deposit and Custodial Accounts Part IV . . . . . Other Foreign Assets Summary Number of Foreign Assets (reported in Part Vl) . . . . . Maximum Value of All Assets (reported in Part Vl) . . . . . Were any foreign assets acquired or sold during the tax year? Part III . . . . . Where reported (d) Form and line (e) Schedule and line $ $ $ $ $ $ $ $ $ $ $ $ $ $ Excepted Specified Foreign Financial Assets (see instructions) If you reported specified foreign financial assets on one or more of the following forms, enter the number of such forms filed. You do not need to include these assets on Form 8938 for the tax year. 1. Number of Forms 3520 2. Number of Forms 3520-A 3. Number of Forms 5471 4. Number of Forms 8621 5. Number of Forms 8865 Part V Detailed Information for Each Foreign Deposit and Custodial Account Included in the Part I Summary (see instructions) If you have more than one account to report in Part V, attach a continuation statement for each additional account (see instructions). Deposit Custodial 2 Account number or other designation Type of account 1 3 4 5 6 Account opened during tax year b Account closed during tax year a c d No tax item reported in Part III with respect to this asset Account jointly owned with spouse Maximum value of account during tax year . . . . . . . . . . . . . . . . . . . . . $ Did you use a foreign currency exchange rate to convert the value of the account into U.S. dollars? . . Yes No If you answered “Yes” to line 5, complete all that apply. (a) Foreign currency in which (b) Foreign currency exchange rate used to (c) Source of exchange rate used if not from U.S. account is maintained convert to U.S. dollars Treasury Department's Bureau of the Fiscal Service Check all that apply For Paperwork Reduction Act Notice, see the separate instructions. Cat. No. 37753A Form 8938 (2016) Page 2 Form 8938 (2016) Part V Detailed Information for Each Foreign Deposit and Custodial Account Included in the Part I Summary (see instructions) (continued) 7a 8 b Global Intermediary Identification Number (GIIN) (Optional) . . . Mailing address of financial institution in which account is maintained. Number, street, and room or suite no. 9 City or town, state or province, and country (including postal code) Name of financial institution in which account is maintained Part VI Detailed Information for Each “Other Foreign Asset” Included in the Part II Summary (see instructions) If you have more than one asset to report in Part VI, attach a continuation statement for each additional asset (see instructions). 1 Description of asset 2 Identifying number or other designation 3 Complete all that apply. See instructions for reporting of multiple acquisition or disposition dates. a Date asset acquired during tax year, if applicable . . . . . . . . . . . . . . . . . . b Date asset disposed of during tax year, if applicable . . . . . . . . . . . . . . . . . c Check if asset jointly owned with spouse d Check if no tax item reported in Part III with respect to this asset 4 Maximum value of asset during tax year (check box that applies) a $0 - $50,000 b $50,001 - $100,000 c $100,001 - $150,000 d $150,001 - $200,000 e If more than $200,000, list value . . . . . . . . . . . . . . . . . . . . . . . . $ 5 Did you use a foreign currency exchange rate to convert the value of the asset into U.S. dollars? . . . Yes No 6 If you answered “Yes” to line 5, complete all that apply. (a) Foreign currency in which asset (b) Foreign currency exchange rate used to (c) Source of exchange rate used if not from U.S. is denominated convert to U.S. dollars Treasury Department's Bureau of the Fiscal Service 7 If asset reported on line 1 is stock of a foreign entity or an interest in a foreign entity, enter the following information for the asset. a Name of foreign entity b GIIN (Optional) . . . Partnership (2) Corporation (3) Trust (4) Estate c Type of foreign entity (1) d Mailing address of foreign entity. Number, street, and room or suite no. e 8 City or town, state or province, and country (including postal code) If asset reported on line 1 is not stock of a foreign entity or an interest in a foreign entity, enter the following information for the asset. Note: If this asset has more than one issuer or counterparty, attach a continuation statement with the same information for each additional issuer or counterparty (see instructions). a Name of issuer or counterparty Check if information is for b Type of issuer or counterparty (1) Individual Issuer (2) Partnership Counterparty (3) Corporation (4) Trust (5) Estate U.S. person Foreign person c Check if issuer or counterparty is a d Mailing address of issuer or counterparty. Number, street, and room or suite no. e City or town, state or province, and country (including postal code) Form 8938 (2016) Page Form 8938 (2016) (Continuation Statement) Name(s) shown on return Part V TIN Detailed Information for Each Foreign Deposit and Custodial Account Included in the Part I Summary (see instructions) Deposit 2 Account number or other designation Custodial 1 Type of account 3 Account opened during tax year b Account closed during tax year a c d No tax item reported in Part III with respect to this asset Account jointly owned with spouse Maximum value of account during tax year . . . . . . . . . . . . . . . . . . . . . $ Did you use a foreign currency exchange rate to convert the value of the account into U.S. dollars? . . Yes No If you answered “Yes” to line 5, complete all that apply. (a) Foreign currency in which (b) Foreign currency exchange rate used to (c) Source of exchange rate used if not from U.S. account is maintained convert to U.S. dollars Treasury Department's Bureau of the Fiscal Service 4 5 6 Check all that apply 8 b GIIN (Optional) . . . Mailing address of financial institution in which account is maintained. Number, street, and room or suite no. 9 City or town, state or province, and country (including postal code) 7a Name of financial institution in which account is maintained Part VI Detailed Information for Each “Other Foreign Asset” Included in the Part II Summary (see instructions) 2 Identifying number or other designation Description of asset 1 3 Complete all that apply. See instructions for reporting of multiple acquisition or disposition dates. a Date asset acquired during tax year, if applicable . . . . . . . . . . . . . . . . . . b Date asset disposed of during tax year, if applicable . . . . . . . . . . . . . . . . . c Check if asset jointly owned with spouse d Check if no tax item reported in Part III with respect to this asset 4 Maximum value of asset during tax year (check box that applies) a $0 - $50,000 b $50,001 - $100,000 c $100,001 - $150,000 d $150,001 - $200,000 e If more than $200,000, list value . . . . . . . . . . . . . . . . . . . . . . . . $ 5 Did you use a foreign currency exchange rate to convert the value of the asset into U.S. dollars? . . . Yes No 6 If you answered “Yes” to line 5, complete all that apply. (a) Foreign currency in which asset (b) Foreign currency exchange rate used to (c) Source of exchange rate used if not from U.S. is denominated convert to U.S. dollars Treasury Department's Bureau of the Fiscal Service 7 If asset reported on line 1 is stock of a foreign entity or an interest in a foreign entity, enter the following information for the asset. a Name of foreign entity b GIIN (Optional) . . . Partnership (2) Corporation (3) c Type of foreign entity (1) Trust (4) Estate d Mailing address of foreign entity. Number, street, and room or suite no. e 8 City or town, state or province, and country (including postal code) If asset reported on line 1 is not stock of a foreign entity or an interest in a foreign entity, enter the following information for the asset. a Name of issuer or counterparty Check if information is for b Type of issuer or counterparty (1) Individual Issuer (2) Partnership Counterparty (3) Corporation (4) Trust (5) Estate U.S. person Foreign person c Check if issuer or counterparty is a d Mailing address of issuer or counterparty. Number, street, and room or suite no. e City or town, state or province, and country (including postal code) Form 8938 (2016)
Extracted from PDF file 2016-federal-form-8938.pdf, last modified November 2016

More about the Federal Form 8938 Other TY 2016

We last updated the Statement of Foreign Financial Assets in May 2017, so this is the latest version of Form 8938, fully updated for tax year 2016. You can download or print current or past-year PDFs of Form 8938 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 8938 from the Internal Revenue Service in May 2017.

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Historical Past-Year Versions of Federal Form 8938

We have a total of six past-year versions of Form 8938 in the TaxFormFinder archives, including for the previous tax year. Download past year versions of this tax form as PDFs here:


2016 Form 8938

2016 Form 8938

Statement Of Specified Foreign Financial Assets 2015 Form 8938

2015 Form 8938

Statement Of Specified Foreign Financial Assets 2014 Form 8938

Form 8938 (Rev. December 2014)

Statement Of Specified Foreign Financial Assets 2013 Form 8938

Form 8938 (December 2013)

Statement Of Specified Foreign Financial Assets 2012 Form 8938

Form 8938 (November 2012)

Statement Of Specified Foreign Financial Assets 2011 Form 8938

Form 8938 (November 2011)


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