States military banking facility is located in a foreign country.

E. Bank, Securities, or Other Financial Account.-The term "bank account" means a savings, demand, checking, deposit, loan, or any other account maintained with a person engaged in the business of banking. It includes certificates of deposit.

The term "securities account" means an account maintained with a person who buys, sells, holds, or trades stock or other securities for the benefit of another.

The term "other financial account" means any other account maintained with any person who accepts deposits, exchanges or transmits funds, or acts as a broker or dealer for future transactions in any commodity on (or sub. ject to the rules of) a commodity exchange or association.

F. Financial Interest.-A financial interest in a bank, securities, or other financial account in a foreign country means an interest described in either of the following two paragraphs:

(1) A United States person has a financial interest in each account for which such person is the owner of rec. ord or has legal title, whether the account is maintained for his or her own benefit or for the benefit of others in

Signature Authority.-A person has signature authority over an account if such person can control the disposition of money or other property in it by delivery of a document containing his or her signature (or his or her signature and that of one or more other persons) to the bank or other person with whom the account is maintained.

Other authority exists in a person who can exercise comparable power over an account by direct communication to the bank or other person with whom the account is maintained, either orally or by some other means.

H. Account Valuation.-For items 2, 4, and 10, the maximum value of an account is the largest amount of currency and non-monetary assets that appears on any quarterly or more frequent account statement issued for the applicable taxable year. If periodic account statements are not so issued, the maximum account asset value is the largest amount of currency and non. monetary assets in the account at any time during the taxable year. Convert

an account is maintained in the name of two persons jointly, or if several persons each own a partial interest in an account, each of those United States persons has a financial interest in that account.

(2) A United States person has a fi nancial interest in each bank, securi. ties, or other financial account in a foreign country for which the owner of record or holder of legal title is: (a) a person acting as an agent, nominee, attorney, or in some other capacity on behalf of the U.S. person; (b) a corporation in which the United States person owns directly or indirectly more than 50 percent of the voting stock or more than 50 percent of the total value of shares of stock; (c) a partnership in which the United States person owns an interest in more than 50 percent of the profits (distributive share of income); or (d) a trust in which the United States person either has a present beneficial interest

exchange rate at the end of the taxable year. In valuing currency of a country that uses multiple exchange rates, use the rate which would apply if the cur rency in the account were converted into United States dollars at the close of the taxable year.

The value of stock, other securities or other non-monetary assets in an account reported on Form 4683 is the fair market value at the end of the taxable year, or if withdrawn from the account, at the time of withdrawal.

For purposes of items 2 and 4, if you had a financial interest in more than one account, each account is to be valued separately in accordance with the foregoing two paragraphs.

If you had a financial interest in one or more but fewer than 25 accounts, and you are unable to determine whether the maximum value of these accounts exceeded $10,000 at any time during the taxable year, check item 4 (do not

check item 2) and complete Part II for each of these accounts.

1. United States Persons with Only Authority Over but No Interest in an Account.-Except as provided in the following paragraph, you must state t name, address, and tax identity. number (if any) of each owner of an account over which you had authority, but if you check item 1 for more than one account of the same owner, you need identify the owner only once.

If you check item 1 for one or more accounts in which no United States person had a financial interest, you may state on the first line of this item, in lieu of supplying information about the owner, "No U.S. person had any finan. cial interest in the foreign accounts." This statement must be based upon the actual belief of the person filing this form after he or she has taken reasonable measures to ensure its correctness.

If you check item 1 for accounts owned by a domestic corporation and its domestic and/or foreign subsidi. aries, you may treat them as one owner and write in the space provided, the name of the parent corporation, fol. lowed by "and related entities," and the tax identifying number and address of the parent corporation.

J. Avoiding Duplicate Reporting.— If you had a financial interest (as i fined in instruction F(2)(b), (c) or ( in one or more accounts identified in item 4 which are owned by a domestic corporation, partnership or trust which is required to file Form 4683 with respect to these accounts, in lieu of completing items 5 through 10 for each such account you may check the box in the introduction to Part II and fill in the statement below.

K. Providing Additional Information. Any person checking one or more boxes of Part I of this form, when requested by the Internal Revenue Serv. ice, shall provide information concern. ing each account reported in Part I that is necessary to determine such person's Federal income tax liability.

L. Penalties. For criminal penalties for failure to file a return or to supply information, and for filing a false or fraudulent return, see sections 7203 and 7206 of the Internal Revenue Code.

U.S. GOVERNMENT PRINTING OFFICE 1873-0-589-711

EI 430814328

General Instructions

This report is required by Treasury Department regulations (31 Code of Federal Regulations 103).

Who Must File.-Beginning July 1, 1972, each financial Institution (as described in these instructions) shall file a report of each deposit, withdrawal, exchange of currency or other payment or transfer, by, through, or to such financial institution, which involves a transaction in currency of more than $10,000.

Exceptions.-Financial institutions are not required to file Form 4789 for transactions:

(1) with Federal Reserve Banks or Federal Home Loan Banks;

(2) solely with, or originated by, financial institutions or foreign banks; or

(3) between a bank and established customers maintain. ing a deposit relationship with the bank, in amounts which the bank may reasonably conclude do not exceed amounts commensurate with the customary conduct of the customer's business, industry or profession. However, upon request each bank shall submit a report listing those customers who engage in transactions which were not reported because of the exemption in (3).

When and Where to File.-This report shall be filed on or before the 45th day following the date of the transaction with the Internal Revenue Service Center, 11601 Roosevelt Boulevard, Philadelphia, Pennsylvania 19155. Forms may be ob tained from any Internal Revenue Service office.

Identifying Number.-Social security number or employer identification number if other than individual.

Identification Required.-Before any transaction is effected a financial institution shall verify and record the identity, and record the account number on its books or the social security or taxpayer identification number, if any, of a person with whom or for whose account such transaction is to be effected. Verification of identity for a customer of the financial institution depositing or withdrawing funds may be by reference to his account or other number on the books of the institution. Verification of identity in any other case may be by examina. tion, for example, of a driver's license, passport, alien identification card, or other appropriate document normally acceptle as a means of identification.

Penalties. Civil and criminal penalties are provided for failure to file a report or to supply information, and for filing a false or fraudulent report. See sections 103.47 and 103.49 of the regulations.

Specific Instructions

Part 1-(1) In the address block, enter the permanent address of the person conducting the transaction.

(2) In the social security block, enter the social security number of the person conducting the transaction. If the person has no num. ber, write "None" in this block.

Part II.-(1) In the name block, individuals should enter their last name, first name and middle initial, if any, in that order. All others should enter their complete organization name.

(2) In the identifying number block, enter the social security number or employer identi. fication number.

Part III, line 6.-This part should be completed only where check is cashed or a bank check is purchased with currency. Part IV.-See Instruction "Identification Required," above.

.

(3) a savings and loan association or a building and loan association organized under the laws of any state or of the United States;

(4) an insured institution as defined in section 401 of the National Housing Act;

(5) a savings bank, industrial bank or other thrift institu tion;

(6) a credit union organized under the laws of any state or of the United States; and

(7) any other organization chartered under the banking laws of any state and subject to the supervision of the bank supervisory authorities of a state.

Currency. The coin and currency of the United States or of any other country, which circulate in and are customarily used and accepted as money in the country in which issued. It includes United States silver certificates, United States notes and Federal Reserve notes, but does not include bank checks or other negotiable instruments not customarily ac cepted as money.

Financial Institution.-Each agency, branch or office within the United States of any person doing business in one or more of the capacities listed below!

(1) a bank;

(2) a broker or dealer in securities, registered or required to be registered with the Securities and Exchange Commission under the Securities Exchange Act of 1934; (3) a person who engages as a business in dealing in or exchanging currency as, for example, a dealer in foreign exchange or a person engaged primarily in the cashing of checks;

(4) a person who engages as a business in the issuing, selling or redeeming of travelers' checks, money or. ders, or similar instruments, except one who does so as a selling agent exclusively, or as an incidental part of another business;

(5) an operator of a credit card system which issues, or authorizes the issuance of, credit cards that may be used for the acquisition of monetary instruments, goods, or services outside the United States.

(6) a licensed transmitter of funds, or other person engaged in the business of transmitting funds abroad for others.

Person. An individual, a corporation, a partnership, a trust or estate, a joint stock company, an association, a syn. dicate, joint venture, or other unincorporated organization or group, and all entities cognizable as legal personalities.

Transaction in Currency.-A transaction involving the phys. ical transfer of currency from one person to another. A transaction which is a transfer of funds by means of bank check, bank draft, wire transfer, or other written order, and which does not include the physical transfer of currency is not a transaction in currency within the meaning of this part.

Jeneral Instructions

This report is required by Treasury Department regulations (31 Code of Federal Reg. ulations 103).

Who Must File.--Each person who physically transports, mails, or ships, or causes to be physically transported, mailed, shipped or received currency or other monetary instruments in an aggre. gate amount exceeding $5,000 on any one occasion from the United States to any place outside the United States, or into the United States from any place outside the United States.

A TRANSFER OF FUNDS THROUGH NORMAL BANKING PROCEDURES WHICH DOES NOT INVOLVE THE PHYSI. CAL TRANSPORTATION OF CURRENCY OR MONETARY INSTRUMENTS IS NOT REQUIRED TO BE REPORTED.

Exceptions.-The following persons ar t required to file reports: (1) a Fed. erb..eserve bank, (2) a bank, a foreign bank, or a broker or dealer in securities In respect to currency or other monetary instruments mailed or shipped through the postal service or by common carrier, (3) a commercial bank or trust company organized under the laws of any State or of the United States with respect to over. land shipments of currency or monetary Instruments shipped to or received from an established customer maintaining a deposit relationship with the bank, in amounts which the bank may reasonably conclude do not exceed amounts com. mensurate with the customary conduct of the business, industry or profession of the customer concerned, (4) a person who is not a citizen or resident of the United States in respect to currency or other monetary instruments mailed or shined from abroad to a bank or broker 이 ler in securities through the postal service or by common carrier, (5) a common carrier of passengers in respect to currency or other monetary instruments in the possession of its passengers, (6) a common carrier of goods in respect to shipments of currency or monetary instruments not declared to be such by the shipper, (7) a travelers' check issuer or its agent in respect to the transportation of travelers' checks prior to their delivery to selling agents for eventual sale to the public, nor by (8) a person engaged as a business in the transportation of currency, monetary instruments and other commercial papers with respect to the transportation of currency or other monetary instruments overland between established offices of banks or brokers or dealers in securities and foreign persons.

When and Where to File:

A. Recipients.-Each person who recelves currency or other monetary instruments shall file Form 4790, within 30 days after receipt, with the Customs officer in charge at any port of entry or departure or by mail with the Commis

sioner of Customs, Attention: Currency Transportation Reports, Washington, D.C. 20226.

B. Shippers or Mailers.-If the cur rency or other monetary instrument does not accompany the person entering or departing the United States, Form 4790 may be filed by mail on or before the date of entry, departure, mailing, or shipping with the Commissioner of Customs, Attention: Currency Transportation Reports, Washington, D.C. 20226.

C. Travelers.-Travelers carrying cur rency or other monetary instruments with them shall file Form 4790 at the time of entry into the United States or the time of departure from the United States with the Customs officer in charge at any Cus. toms port of entry or departure.

An additional report of a particular transportation, mailing, or shipping of currency or other monetary instruments, is not required if a complete and truthful report has already been filed. However, no person otherwise required to file a report shall be excused from liability for failure to do so if, in fact, a complete and truthful report has not been filed. Forms may be obtained from any Internal Revenue or Bureau of Customs office.

PENALTIES.-Civil and criminal pen. alties, including under certain circumstances a fine of not more than $500,000 and imprisonment of not more than five years, are provided for failure to file a report, supply information, and for filing a false or fraudulent report. In addition, the currency or monetary instrument may be subject to seizure and forfeiture. See sections 103.47, 103.48 and 103.49 of the regulations.

Definitions

Bank.--Each agent, agency, branch or office within the United States of a foreign bank and each agency, branch or office within the United States of any person doing business in one or more of the capacities listed:

(1) a commercial bank or trust com. pany organized under the laws of any state or of the United States;

(?) a private bank;

(3) a savings and loan association or a building and loan association organized under the laws of any state or of the United States;

(4) an insured institution as defined in section 401 of the National Housing Act;

(5) a savings bank, industrial bank or other thrift institution;

(6) a credit union organized under the laws of any state or of the United States; and

(7) any other organization chartered under the banking laws of any state and subject to the supervision of the bank supervisory authorities of a state.

Foreign Bank.-A bank organized under foreign law, or an agency, branch or office located outside the United States of a bank. The terrn does not include an agent, agency, branch or office within the United States of a bank organized undur foreign law.

Broker or Dealer in Securities.-A broker o ciealer in securities, registered or required to be registered with the Securities and Exchange Commission under the Securities Exchange Act of 1934.

IDENTIFYING NUMBER.-Individuals should enter their social security number, if any. However, allens who do not have a social security number should enter passport or alien registration number. All others should enter their em. ployer identification number.

Investment Security.-An instrument which: (1) is issued in bearer or registered form; (2) is of a type commonly dealt in upon securities exchanges or markets or commonly recognized in any area in which it is issued or dealt in as a medium for investment; (3) is either one of a class or series or by its terms is divis. ible into a class or series of instruments; and (4) evidences a share, participation or other interest in property or in an enterprise or evidences an obligation of the issuer.

Monetary Instruments.-Coin or currency of the United States or of any other country, travelers' checks, money orders, investment securities in bearer form or otherwise in such form that title thereto passes upon delivery, and negotiable instruments (except warehouse receipts or bills of lading) in bearer form or otherwise in such form that title thereto passes upon delivery The term does not include bank checks made pay. able to the order of a nan ed person which have not been endorsed or which bear restrictive endorsement: .

Person. An individual, a corporation, a partnership, a trust or estate, a joint stock company, an association, a syndi. cate, joint venture, or other unincorporated organization or group, and all en tities cognizable as legal personalities.

Special Instructions

You should complete each line which applies to you.

Part II.-Line 22, Enter the exact date you shipped or received currency or the monetary instrument(s).

Line 23, Check the applicable box and give the complete name and address of the shipper or recipient.

Part III.-Line 26, If currency or monetary instruments of more than one coun try is involved, attach a schedule showing each kind, country, and amount.