Fillable Form 8300 Report of Cash Payment 2012

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Form 8300 Report of Cash Payment 2012

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IRS
Form
8300
(Rev. July 2012)
OMB No. 1545-0892
Department of the Treasury
Internal Revenue Service
Report of Cash Payments Over $10,000
Received in a Trade or Business
▶
See instructions for definition of cash.
▶
Use this form for transactions occurring after July 8, 2012. Do not use prior versions after this date.
For Privacy Act and Paperwork Reduction Act Notice, see the last page.
FinCEN
Form
8300
(Rev. July 2012)
OMB No. 1506-0018
Department of the Treasury
Financial Crimes
Enforcement Network
1 Check appropriate box(es) if: a
Amends prior report;
b
Suspicious transaction.
Part I Identity of Individual From Whom the Cash Was Received
2 If more than one individual is involved, check here and see instructions . . . . . . . . . . . . . . . . . . . .
▶
3 Last name 4 First name 5 M.I. 6 Taxpayer identification number
7 Address (number, street, and apt. or suite no.)
8 Date of birth . . .
▶
(see instructions)
M M D D Y Y Y Y
9 City 10 State 11 ZIP code 12 Country (if not U.S.) 13
Occupation, profession, or business
14 Identifying
document (ID)
a Describe ID
▶
b Issued by
▶
c Number
▶
Part II Person on Whose Behalf This Transaction Was Conducted
15 If this transaction was conducted on behalf of more than one person, check here and see instructions . . . . . . . . . . .
▶
16 Individual’s last name or organization’s name 17 First name 18 M.I. 19 Taxpayer identification number
20 Doing business as (DBA) name (see instructions) Employer identification number
21 Address (number, street, and apt. or suite no.) 22 Occupation, profession, or business
23 City 24 State 25 ZIP code 26 Country (if not U.S.)
27 Alien
identification (ID)
a Describe ID
▶
b Issued by
▶
c Number
▶
Part III Description of Transaction and Method of Payment
28 Date cash received
M M D D Y Y Y Y
29 Total cash received
$ .00
30
If cash was received in
more than one payment,
check here . . .
▶
31 Total price if different from
item 29
$ .00
32 Amount of cash received (in U.S. dollar equivalent) (must equal item 29) (see instructions):
a U.S. currency
$
.00
(Amount in $100 bills or higher $ .00 )
b Foreign currency
$
.00
(Country
▶
)
c Cashier’s check(s)
$
.00
d Money order(s)
$
.00
e Bank draft(s)
$
.00
f Traveler’s check(s) $
.00
}
Issuer’s name(s) and serial number(s) of the monetary instrument(s)
▶
33 Type of transaction
a
Personal property purchased
b
Real property purchased
c
Personal services provided
d
Business services provided
e
Intangible property purchased
f
Debt obligations paid
g
Exchange of cash
h
Escrow or trust funds
i
Bail received by court clerks
j
Other (specify in item 34)
▶
34 Specific description of property or service shown in
33. Give serial or registration number, address, docket
number, etc.
▶
Part IV Business That Received Cash
35 Name of business that received cash
36 Employer identification number
37 Address (number, street, and apt. or suite no.) Social security number
38 City 39 State 40 ZIP code 41 Nature of your business
42
Under penalties of perjury, I declare that to the best of my knowledge the information I have furnished above is true, correct,
and complete.
Signature
▲
Authorized official
Title
▲
43 Date of
signature
M M D D Y Y Y Y
44 Type or print name of contact person 45 Contact telephone number
IRS Form 8300 (Rev. 7-2012)
Cat. No. 62133S
FinCEN Form 8300 (Rev. 7-2012)
IRS Form 8300 (Rev. 7-2012)
Page 2
FinCEN Form 8300 (Rev. 7-2012)
Multiple Parties
(Complete applicable parts below if box 2 or 15 on page 1 is checked)
Part I
Continued—Complete if box 2 on page 1 is checked
3 Last name 4 First name 5 M.I. 6 Taxpayer identification number
7 Address (number, street, and apt. or suite no.)
8 Date of birth . . .
▶
(see instructions)
M M D D Y Y Y Y
9 City 10 State 11 ZIP code 12 Country (if not U.S.) 13 Occupation, profession, or business
14 Identifying
document (ID)
a Describe ID
▶
b Issued by
▶
c Number
▶
3 Last name
4 First name
5 M.I. 6 Taxpayer identification number
7 Address (number, street, and apt. or suite no.)
8 Date of birth . . .
▶
(see instructions)
M M D D Y Y Y Y
9 City 10 State 11 ZIP code 12 Country (if not U.S.) 13 Occupation, profession, or business
14 Identifying
document (ID)
a Describe ID
▶
b Issued by
▶
c Number
▶
Part II
Continued—Complete if box 15 on page 1 is checked
16 Individual’s last name or organization’s name 17 First name 18 M.I. 19 Taxpayer identification number
20 Doing business as (DBA) name (see instructions) Employer identification number
21 Address (number, street, and apt. or suite no.) 22 Occupation, profession, or business
23 City 24 State 25 ZIP code 26 Country (if not U.S.)
27 Alien
identification (ID)
a Describe ID
▶
b Issued by
▶
c Number
▶
16 Individual’s last name or organization’s name 17 First name 18 M.I. 19 Taxpayer identification number
20 Doing business as (DBA) name (see instructions) Employer identification number
21 Address (number, street, and apt. or suite no.)
22 Occupation, profession, or business
23 City 24 State 25 ZIP code 26 Country (if not U.S.)
27 Alien
identification (ID)
a Describe ID
▶
b Issued by
▶
c Number
▶
Comments – Please use the lines provided below to comment on or clarify any information you entered on any line in Parts I, II, III, and IV
IRS Form 8300 (Rev. 7-2012) FinCEN Form 8300 (Rev. 7-2012)
IRS Form 8300 (Rev. 7-2012)
Page 3
FinCEN Form 8300 (Rev. 7-2012)
Section references are to the Internal
Revenue Code unless otherwise noted.
Future Developments. For the latest
information about developments related
to Form 8300 and its instructions, such
as legislation enacted after they were
published, go to www.irs.gov/form8300.
Important Reminders
• Section 6050I (26 United States Code
(U.S.C.) 6050I) and 31 U.S.C. 5331
require that certain information be
reported to the IRS and the Financial
Crimes Enforcement Network (FinCEN).
This information must be reported on
IRS/FinCEN Form 8300.
• Item 33, box i, is to be checked only by
clerks of the court; box d is to be
checked by bail bondsmen. See Item 33
under Part III, later.
• The meaning of the word “currency”
for purposes of 31 U.S.C. 5331 is the
same as for the word “cash” (See Cash
under Definitions, later).
General Instructions
Who must file. Each person engaged in
a trade or business who, in the course
of that trade or business, receives more
than $10,000 in cash in one transaction
or in two or more related transactions,
must file Form 8300. Any transactions
conducted between a payer (or its
agent) and the recipient in a 24-hour
period are related transactions.
Transactions are considered related
even if they occur over a period of more
than 24 hours if the recipient knows, or
has reason to know, that each
transaction is one of a series of
connected transactions.
Keep a copy of each Form 8300 for 5
years from the date you file it.
Clerks of federal or state courts must
file Form 8300 if more than $10,000 in
cash is received as bail for an
individual(s) charged with certain criminal
offenses. For these purposes, a clerk
includes the clerk’s office or any other
office, department, division, branch, or
unit of the court that is authorized to
receive bail. If a person receives bail on
behalf of a clerk, the clerk is treated as
receiving the bail. See Item 33 under
Part III, later.
If multiple payments are made in cash
to satisfy bail and the initial payment
does not exceed $10,000, the initial
payment and subsequent payments
must be aggregated and the information
return must be filed by the 15th day after
receipt of the payment that causes the
aggregate amount to exceed $10,000 in
cash. In such cases, the reporting
requirement can be satisfied either by
sending a single written statement with
an aggregate amount listed or by
furnishing a copy of each Form 8300
relating to that payer. Payments made to
satisfy separate bail requirements are
not required to be aggregated. See
Treasury Regulations section 1.6050I-2.
Casinos must file Form 8300 for
nongaming activities (restaurants, shops,
etc.).
Voluntary use of Form 8300. Form
8300 may be filed voluntarily for any
suspicious transaction (see Definitions,
later) for use by FinCEN and the IRS,
even if the total amount does not
exceed $10,000.
Exceptions. Cash is not required to be
reported if it is received:
• By a financial institution required to file
Form 104, Currency Transaction Report;
• By a casino required to file (or exempt
from filing) Form 103, Currency
Transaction Report by Casinos, if the
cash is received as part of its gaming
business;
• By an agent who receives the cash
from a principal, if the agent uses all of
the cash within 15 days in a second
transaction that is reportable on Form
8300 or on Form 104, and discloses all
the information necessary to complete
Part II of Form 8300 or Form 104 to the
recipient of the cash in the second
transaction;
• In a transaction occurring entirely
outside the United States. See
Publication 1544, Reporting Cash
Payments of Over $10,000 (Received in
a Trade or Business), regarding
transactions occurring in Puerto Rico
and territories and possessions of the
United States; or
• In a transaction that is not in the
course of a person’s trade or business.
When to file. File Form 8300 by the
15th day after the date the cash was
received. If that date falls on a Saturday,
Sunday, or legal holiday, file the form on
the next business day.
Where to file. File the form with the
Internal Revenue Service, Detroit
Computing Center, P.O. Box 32621,
Detroit, Ml 48232.
Statement to be provided. You must
give a written or electronic statement to
each person named on a required Form
8300 on or before January 31 of the
year following the calendar year in which
the cash is received. The statement
must show the name, telephone number,
and address of the information contact
for the business, the aggregate amount
of reportable cash received, and that the
information was furnished to the IRS.
Keep a copy of the statement for your
records.
Multiple payments. If you receive more
than one cash payment for a single
transaction or for related transactions,
you must report the multiple payments
any time you receive a total amount that
exceeds $10,000 within any 12-month
period. Submit the report within 15 days
of the date you receive the payment that
causes the total amount to exceed
$10,000. If more than one report is
required within 15 days, you may file a
combined report. File the combined
report no later than the date the earliest
report, if filed separately, would have to
be filed.
Taxpayer identification number (TIN).
You must furnish the correct TIN of the
person or persons from whom you
receive the cash and, if applicable, the
person or persons on whose behalf the
transaction is being conducted. You may
be subject to penalties for an incorrect
or missing TIN.
The TIN for an individual (including a
sole proprietorship) is the individual’s
social security number (SSN). For certain
resident aliens who are not eligible to get
an SSN and nonresident aliens who are
required to file tax returns, it is an IRS
Individual Taxpayer Identification
Number (ITIN). For other persons,
including corporations, partnerships, and
estates, it is the employer identification
number (EIN).
If you have requested but are not able
to get a TIN for one or more of the
parties to a transaction within 15 days
following the transaction, file the report
and attach a statement explaining why
the TIN is not included.
Exception: You are not required to
provide the TIN of a person who is a
nonresident alien individual or a foreign
organization if that person or foreign
organization:
• Does not have income effectively
connected with the conduct of a U.S.
trade or business;
• Does not have an office or place of
business, or a fiscal or paying agent in
the United States;
• Does not furnish a withholding
certificate described in §1.1441-1(e)(2) or
(3) or §1.1441-5(c)(2)(iv) or (3)(iii) to the
extent required under §1.1441-1(e)(4)(vii);
or
• Does not have to furnish a TIN on any
return, statement, or other document as
required by the income tax regulations
under section 897 or 1445.
Penalties. You may be subject to
penalties if you fail to file a correct and
complete Form 8300 on time and you
cannot show that the failure was due to
reasonable cause. You may also be
subject to penalties if you fail to furnish
timely a correct and complete statement
to each person named in a required
IRS Form 8300 (Rev. 7-2012)
Page 4
FinCEN Form 8300 (Rev. 7-2012)
report. A minimum penalty of $25,000
may be imposed if the failure is due to
an intentional or willful disregard of the
cash reporting requirements.
Penalties may also be imposed for
causing, or attempting to cause, a trade
or business to fail to file a required
report; for causing, or attempting to
cause, a trade or business to file a
required report containing a material
omission or misstatement of fact; or for
structuring, or attempting to structure,
transactions to avoid the reporting
requirements. These violations may also
be subject to criminal prosecution which,
upon conviction, may result in
imprisonment of up to 5 years or fines of
up to $250,000 for individuals and
$500,000 for corporations or both.
Definitions
Cash. The term “cash” means the
following.
• U.S. and foreign coin and currency
received in any transaction; or
• A cashier’s check, money order, bank
draft, or traveler’s check having a face
amount of $10,000 or less that is
received in a designated reporting
transaction (defined below), or that is
received in any transaction in which the
recipient knows that the instrument is
being used in an attempt to avoid the
reporting of the transaction under either
section 6050I or 31 U.S.C. 5331.
Note. Cash does not include a check
drawn on the payer’s own account, such
as a personal check, regardless of the
amount.
Designated reporting transaction. A
retail sale (or the receipt of funds by a
broker or other intermediary in
connection with a retail sale) of a
consumer durable, a collectible, or a
travel or entertainment activity.
Retail sale. Any sale (whether or not
the sale is for resale or for any other
purpose) made in the course of a trade
or business if that trade or business
principally consists of making sales to
ultimate consumers.
Consumer durable. An item of tangible
personal property of a type that, under
ordinary usage, can reasonably be
expected to remain useful for at least 1
year, and that has a sales price of more
than $10,000.
Collectible. Any work of art, rug,
antique, metal, gem, stamp, coin, etc.
Travel or entertainment activity. An
item of travel or entertainment that
pertains to a single trip or event if the
combined sales price of the item and all
other items relating to the same trip or
event that are sold in the same
transaction (or related transactions)
exceeds $10,000.
Exceptions. A cashier’s check, money
order, bank draft, or traveler’s check is
not considered received in a designated
reporting transaction if it constitutes the
proceeds of a bank loan or if it is
received as a payment on certain
promissory notes, installment sales
contracts, or down payment plans. See
Publication 1544 for more information.
Person. An individual, corporation,
partnership, trust, estate, association, or
company.
Recipient. The person receiving the
cash. Each branch or other unit of a
person’s trade or business is considered
a separate recipient unless the branch
receiving the cash (or a central office
linking the branches), knows or has
reason to know the identity of payers
making cash payments to other
branches.
Transaction. Includes the purchase of
property or services, the payment of
debt, the exchange of cash for a
negotiable instrument, and the receipt of
cash to be held in escrow or trust. A
single transaction may not be broken
into multiple transactions to avoid
reporting.
Suspicious transaction. A suspicious
transaction is a transaction in which it
appears that a person is attempting to
cause Form 8300 not to be filed, or to
file a false or incomplete form.
Specific Instructions
You must complete all parts. However,
you may skip Part II if the individual
named in Part I is conducting the
transaction on his or her behalf only. For
voluntary reporting of suspicious
transactions, see Item 1 next.
Item 1. If you are amending a report,
check box 1a. Complete the form in its
entirety (Parts I-IV) and include the
amended information. Do not attach a
copy of the original report.
To voluntarily report a suspicious
transaction (see Suspicious transaction
above), check box 1b. You may also
telephone your local IRS Criminal
Investigation Division or call the FinCEN
Financial Institution Hotline at
1-866-556-3974.
Part I
Item 2. If two or more individuals
conducted the transaction you are
reporting, check the box and complete
Part I for any one of the individuals.
Provide the same information for the
other individual(s) on the back of the
form. If more than three individuals are
involved, provide the same information
on additional sheets of paper and attach
them to this form.
Item 6. Enter the taxpayer identification
number (TIN) of the individual named.
See Taxpayer identification number (TIN),
earlier, for more information.
Item 8. Enter eight numerals for the date
of birth of the individual named. For
example, if the individual’s birth date is
July 6, 1960, enter 07 06 1960.
Item 13. Fully describe the nature of the
occupation, profession, or business (for
example, “plumber,” “attorney,” or
“automobile dealer”). Do not use general
or nondescriptive terms such as
“businessman” or “self-employed.”
Item 14. You must verify the name and
address of the named individual(s).
Verification must be made by
examination of a document normally
accepted as a means of identification
when cashing checks (for example, a
driver’s license, passport, alien
registration card, or other official
document). In item 14a, enter the type of
document examined. In item 14b,
identify the issuer of the document. In
item 14c, enter the document’s number.
For example, if the individual has a Utah
driver’s license, enter “driver’s license”
in item 14a, “Utah” in item 14b, and the
number appearing on the license in item
14c.
Note. You must complete all three items
(a, b, and c) in this line to make sure that
Form 8300 will be processed correctly.
Part II
Item 15. If the transaction is being
conducted on behalf of more than one
person (including husband and wife or
parent and child), check the box and
complete Part II for any one of the
persons. Provide the same information
for the other person(s) on the back of
the form. If more than three persons are
involved, provide the same information
on additional sheets of paper and attach
them to this form.
Items 16 through 19. If the person on
whose behalf the transaction is being
conducted is an individual, complete
items 16, 17, and 18. Enter his or her
TIN in item 19. If the individual is a sole
proprietor and has an employer
identification number (EIN), you must
enter both the SSN and EIN in item 19.
If the person is an organization, put its
name as shown on required tax filings in
item 16 and its EIN in item 19.
Item 20. If a sole proprietor or
organization named in items 16 through
18 is doing business under a name other
than that entered in item 16 (for
example, a “trade” or “doing business
as (DBA)” name), enter it here.
Item 27. If the person is not required to
furnish a TIN, complete this item. See
Taxpayer identification number (TIN),
earlier. Enter a description of the type of
official document issued to that person
in item 27a (for example, a “passport”),
the country that issued the document in
item 27b, and the document’s number in
item 27c.
IRS Form 8300 (Rev. 7-2012)
Page 5
FinCEN Form 8300 (Rev. 7-2012)
Note. You must complete all three items
(a, b, and c) in this line to make sure that
Form 8300 will be processed correctly.
Part III
Item 28. Enter the date you received the
cash. If you received the cash in more
than one payment, enter the date you
received the payment that caused the
combined amount to exceed $10,000.
See Multiple payments, earlier, for more
information.
Item 30. Check this box if the amount
shown in item 29 was received in more
than one payment (for example, as
installment payments or payments on
related transactions).
Item 31. Enter the total price of the
property, services, amount of cash
exchanged, etc. (for example, the total
cost of a vehicle purchased, cost of
catering service, exchange of currency) if
different from the amount shown in item
29.
Item 32. Enter the dollar amount of each
form of cash received. Show foreign
currency amounts in U.S. dollar
equivalent at a fair market rate of
exchange available to the public. The
sum of the amounts must equal item 29.
For cashier’s check, money order, bank
draft, or traveler’s check, provide the
name of the issuer and the serial number
of each instrument. Names of all issuers
and all serial numbers involved must be
provided. If necessary, provide this
information on additional sheets of paper
and attach them to this form.
Item 33. Check the appropriate box(es)
that describe the transaction. If the
transaction is not specified in boxes a–i,
check box j and briefly describe the
transaction (for example, “car lease,”
“boat lease,” “house lease,” or “aircraft
rental”). If the transaction relates to the
receipt of bail by a court clerk, check
box i, “Bail received by court clerks.”
This box is only for use by court clerks.
If the transaction relates to cash
received by a bail bondsman, check box
d, “Business services provided.”
Part IV
Item 36. If you are a sole proprietorship,
you must enter your SSN. If your
business also has an EIN, you must
provide the EIN as well. All other
business entities must enter an EIN.
Item 41. Fully describe the nature of
your business, for example, “attorney” or
“jewelry dealer.” Do not use general or
nondescriptive terms such as “business”
or “store.”
Item 42. This form must be signed by an
individual who has been authorized to
do so for the business that received the
cash.
Comments
Use this section to comment on or
clarify anything you may have entered
on any line in Parts I, II, III, and IV. For
example, if you checked box b
(Suspicious transaction) in line 1 above
Part I, you may want to explain why you
think that the cash transaction you are
reporting on Form 8300 may be
suspicious.
Privacy Act and Paperwork Reduction
Act Notice. Except as otherwise noted,
the information solicited on this form is
required by the IRS and FinCEN in order
to carry out the laws and regulations of
the United States. Trades or businesses
and clerks of federal and state criminal
courts are required to provide the
information to the IRS and FinCEN under
section 6050I and 31 U.S.C. 5331,
respectively. Section 6109 and 31 U.S.C.
5331 require that you provide your
identification number. The principal
purpose for collecting the information on
this form is to maintain reports or
records which have a high degree of
usefulness in criminal, tax, or regulatory
investigations or proceedings, or in the
conduct of intelligence or
counter-intelligence activities, by
directing the federal government’s
attention to unusual or questionable
transactions.
You are not required to provide
information as to whether the reported
transaction is deemed suspicious.
Failure to provide all other requested
information, or providing fraudulent
information, may result in criminal
prosecution and other penalties under
26 U.S.C. and 31 U.S.C.
Generally, tax returns and return
information are confidential, as stated in
section 6103. However, section 6103
allows or requires the IRS to disclose or
give the information requested on this
form to others as described in the
Internal Revenue Code. For example, we
may disclose your tax information to the
Department of Justice, to enforce the tax
laws, both civil and criminal, and to
cities, states, the District of Columbia,
and U.S. commonwealths and
possessions, to carry out their tax laws.
We may disclose this information to
other persons as necessary to obtain
information which we cannot get in any
other way. We may disclose this
information to federal, state, and local
child support agencies; and to other
federal agencies for the purposes of
determining entitlement for benefits or
the eligibility for and the repayment of
loans. We may also provide the records
to appropriate state, local, and foreign
criminal law enforcement and regulatory
personnel in the performance of their
official duties. We may also disclose this
information to other countries under a
tax treaty, or to federal and state
agencies to enforce federal nontax
criminal laws and to combat terrorism. In
addition, FinCEN may provide the
information to those officials if they are
conducting intelligence or
counter-intelligence activities to protect
against international terrorism.
You are not 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 law under 26
U.S.C. or 31 U.S.C.
The time needed to complete this
form will vary depending on individual
circumstances. The estimated average
time is 21 minutes. If you have
comments concerning the accuracy of
this time estimate or suggestions for
making this form simpler, we would be
happy to hear from you. Email us at
taxforms@irs.gov. Enter “Form 8300” on
the subject line. Or you can write to the
Internal Revenue Service, Tax Products
Coordinating Committee,
SE:W:CAR:MP:T:M:S, 1111 Constitution
Ave. NW, IR-6526, Washington, DC
20224. Do not send Form 8300 to this
address. Instead, see Where to file,
earlier.
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Form 8300 Report of Cash Payment 2012

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Completed 31 December 2020

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