Form 3520-A Department of the Treasury Internal Revenue Service Annual Information Return of Foreign Trust With a U.S. Owner (Under section 6048(b)) Go to www.irs.gov/Form3520A for instructions and the latest information. OMB No. 1545-0160 2018 Note: All information must be in English. Show all amounts in U.S. dollars. For calendar year 2018, or tax year beginning , 2018, ending , 20 .Check appropriate boxes. Initial return Final return Amended return Check if any excepted specified foreign financial assets are reported on this form (see instructions) .............. Part I General Information (see instructions) 1a Name of foreign trust b(1) Employer identification number b(2) Reference ID number (see instructions) c 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 foreign postal code g Country2 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 NoIf 223Yes,224 skip lines 2a through 2e and go to line 3.If 223No,224 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.Have you attached a copy of: Yes NoAttached PreviouslyYear AttachedaSummary of all written and oral agreements and understandings relating to the trust? ... bThe trust instrument? ...................... cMemoranda or letters of wishes? .................. dSubsequent variances to original trust documents? ............. eOther trust documents? ..................... 3a Name of U.S. agent b Identification number c 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 g Country 4a Name of trustee b Identification number, if any c 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 g Country5 Did the trust transfer any property (including cash) to another person (see instructions for definition) during the tax year? If 223Yes,224 attach statement (see instructions). .................... Yes No6Enter the number of Foreign Grantor Trust Owner Statements (pages 3 and 4) included with this Form 3520-A 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. Trustee222s Signature Title Date Paid Preparer Use Only Print/Type preparer222s name Preparer222s signature Date Check if self-employed PTIN Firm222s name Firm222s address Firm222s EIN Phone no. For Paperwork Reduction Act Notice, see instructions. Cat. No. 19595G Form 3520-A (2018) American LegalNet, Inc. www.FormsWorkFlow.com Form 3520-A (2018) Page 2 Part II Foreign Trust Income Statement Enter totals from books and records of foreign trust (see instructions). Income1Interest................................ 2Dividends ............................... 3Gross rents and royalties .......................... 4Income (loss) from partnerships and fiduciaries .................... 5Capital gains: aNet short-term capital gain (loss) ........................ bNet long-term capital gain (loss) ........................ 6Ordinary gains (losses) ........................... 7Other income (attach statement) ........................ 8Total income (add lines 1 through 7) ....................... Expenses9Interest expense ............................. 10aForeign taxes (attach statement) ........................ bState and local taxes ........................... 11Amortization and depreciation (depletion) ..................... 12Trustee and advisor fees .......................... 13Charitable contributions ........................... 14Other expenses (attach statement) ....................... 15Total expenses (add lines 9 through 14) ...................... 16Net income (loss) (subtract line 15 from line 8) .................... 17aEnter the fair market value (FMV) of total distributions from the trust to all persons, whether U.S. or foreign . bDistributions to U.S. owners: (i) Name of owner (ii) Identification number (iii) Date of distribution (iv) FMV cDistributions to U.S. beneficiaries: (i) Name of beneficiary (ii) Identification number (iii) Date of distribution (iv) FMV Part III Foreign Trust Balance Sheet Beginning of Tax Year End of Tax YearAssets (a) (b) (c) (d)1Cash ............. 2Accounts receivable......... 3Mortgages and notes receivable ..... 4Inventories ............ 5Government obligations ........ 6Other marketable securities ....... 7Other nonmarketable securities...... 8aDepreciable (depletable) assets ...... bLess: accumulated depreciation (depletion) .. 9Real property ........... 10Other assets (attach statement) ...... 11Total assets ........... Liabilities 12Accounts payable .......... 13Contributions, gifts, grants, etc., payable ... 14Mortgages and notes payable ...... 15Other liabilities (attach statement) ..... 16Total liabilities ........... Net Worth 17Contributions to trust corpus ...... 18Accumulated trust income ....... 19Other (attach statement)........ 20Total net worth (add lines 17 through 19) ... 21 Total liabilities and net worth (add lines 16 and 20) Form 3520-A (2018) American LegalNet, Inc. www.FormsWorkFlow.com Form 3520-A (2018) Page 3 2018 Foreign Grantor Trust Owner Statement (see instructions) Important: Trustee 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 owner222s statement. U.S. owner must attach a copy of its statement to Form 3520. 1a Name of foreign trust b(1) Employer identification number b(2) Reference ID number (see instructions) c 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 foreign postal code g Country2Did the foreign trust appoint a U.S. agent (defined in the instructions) who can provide the IRS with all relevant trust information? If 223Yes,224 complete lines 3a through 3g. Yes No 3a Name of U.S. agent b Identification number c 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 g Country 4a Name of trustee b Identification number (if any) c 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 g Country5The tax year of the owner of the foreign trust to which this statement relates 6a Name of U.S. owner b Identification number c 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 g Country h Service Center where U.S. owner files its income tax returns 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. 8If the trust did not appoint a U.S. agent, list the trust documents attached to Form 3520-A (see instructions). 9Gross value of the portion of the trust treated as owned by the U.S. owner ....... $ 10Cash amounts or FMV of property distributed, directly or indirectly, during the current tax year, from the foreign trust (exclude loans) to the U.S. owner. (a) Date of distribution (b) Description of property distributed (c) FMV of property distributed (determined on date of distribution) (d) Description of property transferred, if any (e) FMV of property transferred (f) Excess of column (c) over column (e) Totals.................................. $ Form 3520-A (2018) American LegalNet, Inc. www.FormsWorkFlow.com Form 3520-A (2018) Page 4 2018 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. Income1aTaxable interest ............................. b Tax-exempt interes