3520-A Annual Return of Foreign Trust with a U.S. Owner

Form

Annual Information Return of Foreign
Trust With a U.S. Owner

3520-A

Department of the Treasury
Internal Revenue Service

OMB No. 1545-0159

2021

(Under section 6048(b))

▶

Go to www.irs.gov/Form3520A for instructions and the latest information.

Note: All information must be in English. Show all amounts in U.S. dollars.
For calendar year 2021, or tax year beginning
Check appropriate boxes:
Initial return

, 2021, ending
Final return
Amended return
Extension filed
Check if any excepted specified foreign financial assets are reported on this form. See instructions . . . . .

Part I
1a

.

, 20
Substitute Form 3520-A
. . . . . . . .

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General Information (see instructions)

Name of foreign trust

b Employer identification number (EIN)

c

Number, street, and room or suite no. If a P.O. box, see instructions.

d Date foreign trust was created

e

City or town

2

f

g ZIP or foreign postal code

State or province

h Country

Did the foreign trust appoint a U.S. agent (defined in the instructions) who can provide the IRS with all the relevant
trust information? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

No

If “Yes,” skip lines 2a through 2e and go to line 3.

a
b
c
d
e
3a

If “No,” you are required to attach a copy of all trust documents as indicated below. If these documents have been attached to a Form 3520-A
filed within the previous 3 years, attach only relevant updates.
Attached
Year
Are you attaching a copy of any of the following?
Yes
No
Previously
Attached
Summary of all written and oral agreements and understandings relating to the trust . . .
The trust instrument . . . . . . . . . . . . . . . . . . . . . .
Memoranda or letters of wishes . . . . . . . . . . . . . . . . . . .
Subsequent variances to original trust documents . . . . . . . . . . . . .
Organizational chart and other trust documents . . . . . . . . . . . . . .
Name of U.S. agent
b Taxpayer identification number (TIN)

c

Number, street, and room or suite no. If a P.O. box, see instructions.

d

City or town

4a

e

f

State or province

ZIP or postal code

g Country

b TIN, if any

Name of trustee

c

Number, street, and room or suite no. If a P.O. box, see instructions.

d

City or town

e

f

State or province

ZIP or postal code

g Country

5

Enter the number of Foreign Grantor Trust Owner Statements (pages 3 and 4) included with this Form 3520-A .

▶

6

Enter the number of Foreign Grantor Trust Beneficiary Statements (page 5) included with this Form 3520-A

▶

Trustee’s (or U.S. owner’s) signature

Print/Type preparer’s name

▲

Paid
Preparer
Use Only

▲

▲

Sign
Here

.

Under penalties of perjury, I declare that I have examined this return, including any accompanying reports, schedules, or statements, and to the best of my
knowledge and belief, it is true, correct, and complete.

Title

Preparer’s signature

Date

Firm’s name ▶

Firm’s EIN ▶

Firm’s address ▶

For Paperwork Reduction Act Notice, see instructions.

Check
if
self-employed

Date

PTIN

Phone no.
Cat. No. 19595G

Form

3520-A (2021)

Form 3520-A (2021)

Expenses

Income

Part II

Page

1
2

Interest
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Dividends .

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1
2

3
4
5

Gross rents and royalties . . . . . . .
Income (loss) from partnerships and fiduciaries .
Capital gains:
Net short-term capital gain (loss) . . . . .

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Net long-term capital gain (loss)
Ordinary gains (losses) . . .

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Other income (attach statement) .
Total income (add lines 1 through 7)

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Interest expense .

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10a
b
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Foreign taxes (attach statement) . . .
State and local taxes
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Amortization and depreciation (depletion)

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10a
10b
11

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13
14
15
16

Trustee and advisor fees
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Charitable contributions . . . . . . .
Other expenses (attach statement)
. . .
Total expenses (add lines 9 through 14) . .
Net income (loss) (subtract line 15 from line 8)

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14

17a

Enter the fair market value (FMV) of total distributions (directly or indirectly) from the trust to all persons,
whether U.S. or foreign. Attach statement. See instructions . . . . . . . . . . . . . . ▶
Distributions to U.S. owners:

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(i) Name of owner

c

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16
17a

(ii) TIN

(iii) Date of distribution

(iv) FMV on date of distribution

(ii) TIN

(iii) Date of distribution

(iv) FMV on date of distribution

Distributions to U.S. beneficiaries:
(i) Name of beneficiary

Part III

2

Foreign Trust Income Statement
Enter totals from books and records of foreign trust. See instructions.

Foreign Trust Balance Sheet

Beginning of Tax Year

Assets

(a)

1
2
3
4
5
6
7
8a
b
9
10
11

Cash
. . . . . . . . . . . . .
Accounts receivable . . . . . . . . .
Mortgages and notes receivable
. . . . .
Inventories . . . . . . . . . . . .
Government obligations . . . . . . . .
Other marketable securities . . . . . . .
Other nonmarketable securities . . . . . .
Depreciable (depletable) assets . . . . . .
Less: accumulated depreciation (depletion) . .
Real property . . . . . . . . . . .
Other assets (attach statement) . . . . . .
Total assets (add lines 1 through 7 and 8b through 10)

12
13
14
15
16

Accounts payable . . . . . . .
Contributions, gifts, grants, etc., payable
Mortgages and notes payable . . .
Other liabilities (attach statement) . .
Total liabilities (add lines 12 through 15)

17
18
19
20
21

Contributions to trust corpus
. . . . . .
Accumulated trust income . . . . . . .
Other (attach statement) . . . . . . . .
Total net worth (add lines 17 through 19) . . .
Total liabilities and net worth (add lines 16 and 20)

(b)

End of Tax Year
(c)

(d)

Liabilities
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Net Worth

Form

3520-A (2021)

Form 3520-A (2021)

Page

3

2021 Foreign Grantor Trust Owner Statement (see instructions)
Important: Trustee (or U.S. owner if a substitute Form 3520-A) must prepare a separate statement for each U.S. owner and include a copy of each
statement with Form 3520-A. Trustee is also required to send to each U.S. owner a copy of the owner’s statement. U.S. owner must attach
a copy of its statement to Form 3520.
1a

Name of foreign trust

b

EIN

c

Number, street, and room or suite no. If a P.O. box, see instructions.

d

Date foreign trust was created

e

City or town

h

Country

f State or province

g ZIP or foreign postal code

2

Did the foreign trust appoint a U.S. agent (defined in the instructions) who can provide the IRS with all relevant trust
information? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
If “Yes,” complete lines 3a through 3g.

3a

Name of U.S. agent

c

Number, street, and room or suite no. If a P.O. box, see instructions.

d

City or town

4a

e State or province

f ZIP or postal code

Name of trustee

c

Number, street, and room or suite no. If a P.O. box, see instructions.

d

City or town

5
6a

e State or province

f ZIP or postal code

The first and last day of the tax year of the foreign trust to which this statement relates
Name of U.S. owner

c

Number, street, and room or suite no. If a P.O. box, see instructions.

d

City or town

e State or province

b

TIN

g

Country

b

TIN

g

Country

b

TIN

g

Country

Yes

No

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f ZIP or postal code

7

Attach an explanation of the facts and law (including the section of the Internal Revenue Code) that establishes that the foreign trust (or portion
of the foreign trust) is treated for U.S. tax principles as owned by the U.S. person.

8

If the trust did not appoint a U.S. agent, list the trust documents attached to Form 3520-A. See instructions.

9

Gross value of the portion of the trust treated as owned by the U.S. owner .

10

(a)
Date of distribution

Total .

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$

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Cash amounts or FMV of property distributed, directly or indirectly, during the foreign trust’s tax year, from the foreign trust (exclude loans) to
the U.S. owner.

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(c)
(d)
FMV of property distributed
Description of property
(determined on date of distribution)
transferred, if any

(b)
Description of property distributed

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(e)
FMV of property
transferred

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(f)
Excess of column (c)
over column (e)

$
Form

3520-A (2021)

Form 3520-A (2021)

Page

4

2021 Statement of Foreign Trust Income Attributable to U.S. Owner (see instructions)
Report each item on the proper form or schedule of your tax return.

Expenses

Income

1a
b
2a
b
3

Taxable interest .

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Tax-exempt interest . .
Total ordinary dividends .
Qualified dividends ▶

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Gross rents and royalties

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1b
2a

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3

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5
6

Income from partnerships and fiduciaries .
Capital gains (losses)
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Ordinary gains (losses) . . . . . .

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6

7
8
9

Other income (attach statement) . . . . . .
Total income. Add lines 1a, 1b, 2a, and 3 through 7
Interest expense . . . . . . . . . . .

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10a
b
11

Foreign taxes (attach statement) . . .
State and local taxes
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Amortization and depreciation (depletion)

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10a
10b
11

12
13
14
15

Trustee and advisor fees
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Charitable contributions . . . . .
Other expenses (attach statement)
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Total expenses. Add lines 9 through 14

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14

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▶

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7
8
9

15

Under penalties of perjury, I declare that I have examined this return, including any accompanying reports, schedules, or statements, and to the best of my knowledge and
belief, it is true, correct, and complete.
Trustee’s (or
U.S. owner’s)
signature ▶

Title ▶

Date ▶
Form

3520-A (2021)

Form 3520-A (2021)

Page

5

2021 Foreign Grantor Trust Beneficiary Statement
Important: Trustee (or U.S. owner if a substitute Form 3520-A) must prepare a separate statement for each U.S. beneficiary that received a distribution
from the trust during the tax year and include a copy of each statement with Form 3520-A. Trustee is also required to send to each such
beneficiary a copy of the beneficiary’s statement. Each U.S. beneficiary must attach a copy of its statement to its Form 3520.
1a

Name of foreign trust

b

c

Number, street, and room or suite no. If a P.O. box, see instructions.

d Date foreign trust was created

e

City or town

2

3a

f State or province

g ZIP or foreign postal code h

Number, street, and room or suite no. If a P.O. box, see instructions.

d

City or town

e State or province

f ZIP or postal code

Name of trustee

c

Number, street, and room or suite no. If a P.O. box, see instructions.

d

City or town

5
6a

e State or province

f ZIP or postal code

The first and last day of the tax year of the foreign trust to which Form 3520-A applies ▶
Name of U.S. beneficiary

c

Number, street, and room or suite no. If a P.O. box, see instructions.

d

City or town

7

e State or province

f ZIP or postal code

g

Country

b

TIN

g

Country

b

TIN

g

Country

Yes

No

Yes

No

Cash amounts or FMV of property that during the current tax year was (1) distributed directly or indirectly to a U.S. person whether or not the
U.S. person is designated as a beneficiary of the trust, (2) loaned (exclude loans treated as qualified obligations) directly or indirectly to the
U.S. person who is a beneficiary of the trust or a U.S. person related to that U.S. person, or (3) used by the U.S. person who is a beneficiary of
the trust or a U.S. person related to that U.S. person without compensating the trust for the FMV of the use of the property within a reasonable
period of time. (See the instructions for Part III of Form 3520 for U.S. tax treatment of these amounts.)

(a)
Date of distribution

Total .

Country

Did the foreign trust appoint a U.S. agent (defined in the instructions) who can provide the IRS with all relevant trust
information? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
If “Yes,” complete lines 3a through 3g.
If “No,” do you agree that either the IRS or the U.S. beneficiary can inspect and copy the trust’s permanent books of
account, records, and such other documents that are necessary to establish that the trust should be treated for U.S.
tax purposes as owned by another person? . . . . . . . . . . . . . . . . . . . . . .
Name of U.S. agent
b TIN

c

4a

EIN

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(c)
(d)
FMV of property distributed
Description of property
(determined on date of distribution)
transferred, if any

(b)
Description of property distributed

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(e)
FMV of property
transferred

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▶

(f)
Excess of column (c)
over column (e)

$

8

Attach an explanation of the facts and law (including the section of the Internal Revenue Code) that establishes that the foreign trust (or portion
of the foreign trust) is treated for U.S. tax principles as owned by another person.

9

Owner of the foreign trust is (check one):

Individual

Partnership

Corporation

Under penalties of perjury, I declare that I have examined this return, including any accompanying reports, schedules, or statements, and to the best of my knowledge and
belief, it is true, correct, and complete.
Trustee’s (or
U.S. owner’s)
signature ▶

Title ▶

Date ▶
Form

3520-A (2021)