SCHEDULE B (Form 1040A or 1040) Owattrimfldthermeury Interrkal ROVONJO StvAC0 (99) Ill• Information about Schedule B (Form 1040A or 1040) and its instructions is at „„,„„, °nuk e Name town on naturn Interest and Ordinary Dividends ► Attach to Form 1040A or 1040. BENJAMIN E. BLACK Part I Interest 4, OMB No I ra45•O074 2013 /tOoVonert Sationroa No WA1 a.Gn:v Note. If you received a Form 1093INT. Form 10990ID, or substitute statement from a brokerage firm, list the firm's name as the payer and enter the total interest shown on that form. 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 and list this interest first. Also, show that buyer's social security number and address BB. BEB 2011 TRUST YGGDRASIL TRUST) JPMORGAN A/C# BEB 2011 TRUST (BENJAMIN BLACK 2010 TRUST) FROM K-1 - FARMERSWEB LLC 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 Amount 121,870 3 82,266 21 204,160 3 4 204,160 Note. If line 4 is over 51.500. you must complete Part III Amount Part II Ordinary Dividends Note. If you received a Form 1099DIV or substitute statement from a brokerage firm. list the firm's name as the payer and enter the ordinary dividends shown on that form. Part III Foreign Accounts and Trusts 321501 09-30-13 If "Yes,' you may have to file Form 3520. See instructions 5 List name of payer ► JPMORGAN A/C# THE WALT DISNEY COMPANY 6 Add the amounts on line 5. Enter the total here and on Form 1040A. or Form 1040. line 9a Ie. Note. If line 6 is over $1,500. you must complete Part III. You must complete this part if you (a) had over $1,500 of taxable interest or ordinary dividends: (b) had a foreign account: or (c) received a distribution from. or