Part IV. — Form 1041-A — U.S. Information Return Trust

Complete the balance sheets using the accounting method the trust uses in keeping its books and records. All filers must complete columns (a) and (b).

Assets

When space is provided to the left of column (a) for reporting receivables and the related allowance for doubtful accounts or depreciable assets and accumulated depreciation, enter the end-of-year figures.

Line 25. Cash—non-interest bearing. Enter the amount of cash on deposit in checking accounts, deposits in transit, change funds, petty cash funds, or any other non-interest bearing accounts. Do not include advances to employees or officers or refundable deposits paid to suppliers or others.

Line 26. Savings and temporary cash investments. Enter the total of cash in savings or other interest-bearing accounts and temporary cash investments, such as money market funds, commercial paper, certificates of deposit, and U.S. Treasury bills or other governmental obligations that mature in less than 1 year.

Line 27. Accounts receivable. Enter the total accounts receivable (reduced by the corresponding allowance for doubtful accounts) that arose from the sale of goods and/or the performance of services. Claims against vendors or refundable deposits with suppliers or others may be reported here if not significant in amount. If significant in amount, report them (with any advances to employees or officers) on line 37, Other assets.

Form 1041-A (Rev. 9-2018) Page 4

If you have questions about whether a preparer is required to sign the return, please contact an IRS office.

The person signing the return as the preparer should complete the requested preparer information and do the following.

Sign it in the space provided for the preparer’s signature. (A facsimile signature is acceptable.)
Give the trustee a copy of the return in addition to the copy to be filed with the IRS.

Paperwork Reduction Act Notice. We ask for the information on this form to carry out the Internal Revenue laws of the United States. You are required to give us the information. We need it to ensure that you are complying with these laws and to allow us to figure and collect the right amount of tax.

You aren’t required to provide the information requested on a form that is subject to the Paperwork Reduction Act unless the form displays a valid OMB control number. Books or records relating to a form or its instructions must be retained as long as their contents may become material in the administration of any Internal Revenue law. Generally, tax returns and return information are confidential, as required by Code section 6103.

The time needed to complete and file this form will vary depending on individual circumstances. The estimated average time is:

Recordkeeping . . . 24 hr., 52 min.

Learning about the law or the form . . . . 2 hr., 37 min.

Preparing the form . . 7 hr., 48 min.

Copying, assembling, and sending the form to the IRS . . . . 1 hr., 20 min.

If you have comments concerning the accuracy of these time estimates or suggestions for making this form simpler, we would be happy to hear from you. You can send us comments through www.irs.gov/FormComments . Or you can write to: Internal Revenue Service, Tax Forms and Publications, 1111 Constitution Ave. NW, IR-6526, Washington, DC 20224. Do not send the tax form to this address. Instead, see Where To File, earlier.

Line 28. Notes and loans receivable. Enter the combined total of notes receivable and net loans receivable (including receivables due from officers, directors, trustees, and other disqualified persons). In an attached schedule, show the following information (preferably in columnar format).

Borrower’s name and title.
Original amount.
Balance due.
Date of note.
Maturity date.
Repayment terms.
Interest rate.
Security provided by the borrower.
Purpose of the loan.
Description and fair market value of the consideration furnished by the lender.

Line 29. Inventories for sale or use. Enter the amount of materials, goods, and supplies purchased or manufactured by the trust and held for sale or use in some future period.

Line 30. Prepaid expenses and deferred charges. Enter the amount of short-term and long-term prepayments of future expenses attributable to one or more future accounting periods. Examples include prepayments of rent, insurance, and pension costs.

Lines 31, 32, and 33. Investments— government obligations, corporate stocks, and corporate bonds. Enter the book value (which may be market value) of these investments. Attach a schedule that lists each security held at the end of the year and shows whether the security is listed at cost (including the value recorded at the time of receipt in the case of donated securities) or end-of-year market value. Do not include amounts on line 26. Government obligations reported on line 31 are those that mature in 1 year or more. Debt securities of the U.S. government may be reported as a single total rather than itemized. Obligations of state and municipal governments may also be reported as a lump-sum total. Do not combine U.S. government obligations with state and municipal obligations on the attached schedule.

Line 34. Investments—land, buildings, and equipment. Attach a schedule of all land, buildings, and equipment that are held for investment purposes, such as rental properties. List the cost or other basis of these assets, accumulated depreciation, and end-of-year book value.

Line 35. Investments—other. Enter the amount of all other investment holdings not reported on lines 31 through 34. Attach a schedule describing each of these investments held at the end of the year. List the cost, or other basis, and the end-of-year book value.

Line 36. Land, buildings, and equipment. Attach a schedule of all land, buildings, and equipment that aren’t held for investment purposes, such as the trust’s offices. List the cost or other basis of these assets, accumulated depreciation, and end-ofyear book value.

Line 37. Other assets. Enter the book value of any trust assets that haven’t been reported on lines 25 through 36. If more space is needed, attach a separate schedule with a description of the asset, date acquired, and end-of-year book value.

Liabilities

Line 39. Accounts payable and accrued expenses. Enter the total accounts payable to suppliers and others, and accrued expenses such as salaries payable, accrued payroll taxes, and interest payable.

Line 40. Mortgages and other notes payable. Attach a schedule showing, as of the end of the year, the total amount of all mortgages payable, and for each nonmortgage note payable, the lender’s name and the other information specified in the line 28 instructions.

Line 41. Other liabilities. Enter the book value of any trust liabilities that haven’t been reported on line 39 or 40. If more space is needed, attach a separate schedule with a description of the liability and amount.

Signature

Form 1041-A must be signed by the trustee or by an authorized representative.

If you, as trustee (or an employee or officer of the trust), fill in Form 1041-A, the Paid Preparer space should be left blank. If someone prepares this return without charge, that person shouldn’t sign the return.

Generally, anyone who is paid to prepare a tax return must sign the return and fill in the other blanks in the Paid Preparer Use Only area of the return.