Sch NEC (1040-NR) Tax on Income Not Effectively Connected With a U.S. Trad

Version A, Cycle 2

Tax on Income Not Effectively Connected With a U.S. Trade or Business

SCHEDULE NEC
(Form 1040-NR)

OMB No. 1545-0074

2022

Go to www.irs.gov/Form1040NR for instructions and the latest information.
Attach to Form 1040-NR.

Department of the Treasury
Internal Revenue Service

Attachment
Sequence No. 7B
Your identifying number

Name shown on Form 1040-NR

Enter amount of income under the appropriate rate of tax. See instructions.

Nature of Income
1

(a) 10%

(b) 15%

(d) Other (specify)

(c) 30%

%

12

Dividends and dividend equivalents:
Dividends paid by U.S. corporations
. . . . . . . . . . . . .
Dividends paid by foreign corporations . . . . . . . . . . . . .
Dividend equivalent payments received with respect to section 871(m) transactions
Interest:
Mortgage . . . . . . . . . . . . . . . . . . . . . .
Paid by foreign corporations . . . . . . . . . . . . . . . .
Other . . . . . . . . . . . . . . . . . . . . . . .
Industrial royalties (patents, trademarks, etc.) . . . . . . . . . . .
Motion picture or TV copyright royalties
. . . . . . . . . . . .
Other royalties (copyrights, recording, publishing, etc.) . . . . . . . .
Real property income and natural resources royalties . . . . . . . .
Pensions and annuities . . . . . . . . . . . . . . . . . .
Social security benefits . . . . . . . . . . . . . . . . . .
Capital gain from line 18 below . . . . . . . . . . . . . . .
Gambling—Residents of Canada only. Enter net income in column (c).
If zero or less, enter -0-.
Winnings
. . . . . . . . . . . . . . .
Losses
Gambling winnings—Residents of countries other than Canada.
Note: Losses not allowed . . . . . . . . . . . . . . . . .
Other (specify):

13
14
15

12
Add lines 1a through 12 in columns (a) through (d) . . . . . . . . .
13
Multiply line 13 by rate of tax at top of each column . . . . . . . .
14
Tax on income not effectively connected with a U.S. trade or business. Add columns (a) through (d) of line 14. Enter the total here and on Form 1040-NR, line 23a

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

%

INTERNAL USE ONLY
DRAFT AS OF
June 29, 2022
1a
1b
1c
2a
2b
2c
3
4
5
6
7
8
9

10c
11

15

Capital Gains and Losses From Sales or Exchanges of Property
Enter only the capital gains and
losses from property sales or
exchanges that are from sources
within the United States and not
effectively connected with a U.S.
business. Do not include a gain
or loss on disposing of a U.S. real
property interest; report these
gains and losses on Schedule D
(Form 1040).
Report property sales or
exchanges that are effectively
connected with a U.S. business
on Schedule D (Form 1040),
Form 4797, or both.

16

(a) Kind of property and description
(if necessary, attach statement of
descriptive details not shown below)

(b) Date acquired
mm/dd/yyyy

(c) Date sold
mm/dd/yyyy

(d) Sales price

(e) Cost or
other basis

(f) LOSS
(g) GAIN
If (e) is more than (d), If (d) is more than (e),
subtract (d) from (e). subtract (e) from (d).

17 Add columns (f) and (g) of line 16
. . . . . . . . . . . . . . . . . . . . . . .
17 (
18 Capital gain. Combine columns (f) and (g) of line 17. Enter the net gain here and on line 9 above. If a loss, enter -0- .

For Paperwork Reduction Act Notice, see the Instructions for Form 1040-NR.

Cat. No. 72752B

)
.

18

Schedule NEC (Form 1040-NR) 2022