SCHEDULE B (Form 1040A or 1040) Deportment of the Treasury internal Revenue &hence (991 Name(s) shown on return LEON & DEBRA BLACK 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 instructions on back and list Interest this interest first. Also, show that buyers social security number and address ► Interest and Ordinary Dividends ►Attach to Form 1040A or 1040. ► Information about Schedule B (Form 1040A or 1040) and its instructions is at rnswirs.govIscheduleb. plAB No. 1545.0074 2©13 Attachment Sequence No. 08 Your social security number (See instructions on back and the instructions for Form 1040A. or Form 1040. line Ba.) Note. If you received a Form 1099-INT. Form 1099-0ID, or substitute statement from a brokerage firm. list the firm's name as the payer and enter the total interest shown on that form. Part II Ordinary Dividends SEE RIDER ATTACHED - A SEE RIDER ATTACHED - B 2 Add the amounts on line 1 3 Excludable interest on series EE and I U.S. savings bonds issued after 1989. Attach Form 8815 4 Subtract line 3 from line 2. Enter the result here and on Form 1040A, or Form 1040. line 8a ► 1 Amount 369,352 5 121 155 2 3 5,490507 4 5 490 507 Note. If line 4 is over $1.500. you must complete Part III. 5 List name of payer ► (See instructions on back and the instructions for Form 1040k or Form 1040. line 9a.) Note. If you received a Form 1099-DN or substitute statement from a brokerage firm. list the firm's name as the payer and enter the ordinary 6 Add the amounts on line 5. Enter the total here and on Form 1040A. or Form dividends shown on that form. 1040. line 9a ► Part III Foreign Accounts and Trusts (See instructions on back.) Note. If line 6 is over $1.500, you must complete Part Ill. You must complete this part if you (a) had over $1,500 of taxable interest or ordinary div