Form 1040 Schedule B
Form 1040 Schedule B
1545-0074
Interest and Ordinary Dividends
2022
(Form 1040)
Department of the Treasury Go to www.irs.gov/ScheduleB for instructions and the latest information.
Attachment
Internal Revenue Service Attach to Form 1040 or 1040-SR. Sequence No. 08
Name(s) shown on return Your social security number
Amount
Part I 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 interest first. Also, show that buyer’s social security number and address:
(See instructions
and the
Instructions for
Form 1040,
line 2b.)
Note: If you
received a
Form 1099-INT, 1
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.
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 1040 or 1040-SR, line 2b 4
Note: If line 4 is over $1,500, you must complete Part III. Amount
Part II 5 List name of payer:
Ordinary
Dividends
(See instructions
and the
Instructions for
Form 1040,
line 3b.) 5
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 6 Add the amounts on line 5. Enter the total here and on Form 1040 or 1040-SR, line 3b 6
on that form. Note: If line 6 is over $1,500, you must complete Part III.
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.
Foreign
Accounts Yes No
and Trusts 7a At any time during 2022, did you have a financial interest in or signature authority over a financial
Caution: If account (such as a bank account, securities account, or brokerage account) located in a foreign
required, failure to country? See instructions . . . . . . . . . . . . . . . . . . . . . . . .
file FinCEN Form
114 may result in If “Yes,” are you required to file FinCEN Form 114, Report of Foreign Bank and Financial
substantial Accounts (FBAR), to report that financial interest or signature authority? See FinCEN Form 114
penalties. and its instructions for filing requirements and exceptions to those requirements . . . . . .
Additionally, you
may be required b If you are required to file FinCEN Form 114, list the name(s) of the foreign country(-ies) where the
to file Form 8938, financial account(s) are located:
Statement of
Specified Foreign
Financial Assets. 8 During 2022, did you receive a distribution from, or were you the grantor of, or transferor to, a
See instructions. 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 1040) 2022