Report of Cash Payments Over $10,000

Received in a Trade or Business

IRS

Form 8300

OMB No. 1545-0892

(Rev. March 2008) © See instructions for definition of cash.

Department of the Treasury

Internal Revenue Service For Privacy Act and Paperwork Reduction Act Notice, see page 5.

1 Check appropriate box(es) if: a Amends prior report; b Suspicious transaction.

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

13 Occupation, profession, or business

7 Address (number, street, and apt. or suite no.) 8 Date of birth ©

9 City 10 State 11 ZIP code 12 Country (if not U.S.)

Identifying a Describe ID ©

document (ID)

14

c

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

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.)

Description of Transaction and Method of Payment

d Business services provided

a Personal property purchased

e Intangible property purchased

b Real property purchased

c Personal services provided

32

28 Date cash received

$ .00

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

Under penalties of perjury, I declare that to the best of my knowledge the information I have furnished above is true, correct,

and complete.

42

Cat. No. 62133S FinCEN Form 8300 (Rev. 3-2008)

Part IV

Part I

Part II

Part III

U.S. currency

b Foreign currency

20 Doing business as (DBA) name (see instructions)

29 Total cash received

$ .00

If cash was received in

more than one payment,

check here ©

30 Total price if different from

item 29

31

$ .00

Amount of cash received (in U.S. dollar equivalent) (must equal item 29) (see instructions):

a

.00

.00

.00

.00

.00

c Cashier’s check(s)

d Money order(s)

e Bank draft(s)

f Traveler’s check(s)

(Amount in $100 bills or higher $ )

(Country © )

.00

33 Type of transaction

g Exchange of cash

h Escrow or trust funds

j Other (specify in item 34) ©

f Debt obligations paid

Specific description of property or service shown in

33. Give serial or registration number, address, docket

number, etc. ©

34

Issuer’s name(s) and serial number(s) of the monetary instrument(s) ©

%

(see instructions)

M M D D Y Y Y Y

M M D D Y Y Y Y

Taxpayer identification number

M M D D Y Y Y Y

i Bail received by court clerks

Signature Title

Date of

signature

Type or print name of contact person Contact telephone number

( )

43 44 45

$

$

$

$

$

© Use this form for transactions occurring after March 31, 2008. Do not use prior versions after this date.

FinCEN

Form 8300

OMB No. 1506-0018

(Rev. March 2008)

Department of the Treasury

Financial Crimes

Enforcement Network

© Authorized official ©

IRS Form 8300 (Rev. 3-2008)

b Issued by ©

Number ©

Alien a Describe ID ©

identification (ID)

27

c

b Issued by ©

Number ©
Continued—Complete if box 2 on page 1 is checked

Continued—Complete if box 15 on page 1 is checked

Part I

Part II

IRS Form 8300 (Rev. 3-2008) Page 2

Multiple Parties

(Complete applicable parts below if box 2 or 15 on page 1 is checked)

3 Last name 4 First name 5 M.I. 6 Taxpayer identification number

13 Occupation, profession, or business

7 Address (number, street, and apt. or suite no.) 8 Date of birth ©

9 City 10 State 11 ZIP code 12 Country (if not U.S.)

(see instructions)

M M D D Y Y Y Y

3 Last name 4 First name 5 M.I. 6 Taxpayer identification number

13 Occupation, profession, or business

7 Address (number, street, and apt. or suite no.) 8 Date of birth ©

9 City 10 State 11 ZIP code 12 Country (if not U.S.)

(see instructions)

M M D D Y Y Y Y

16 Individual’s last name or Organization’s name 17 First name 18 M.I. 19

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.)

20 Doing business as (DBA) name (see instructions)

Taxpayer identification number

16 Individual’s last name or Organization’s name 17 First name 18 M.I. 19

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.)

20 Doing business as (DBA) name (see instructions)

Taxpayer identification number

IRS Form 8300 (Rev. 3-2008) FinCEN Form 8300 (Rev. 3-2008)

FinCEN Form 8300 (Rev. 3-2008)

Identifying a Describe ID ©

document (ID)

14

c

b Issued by ©

Number ©

Alien a Describe ID ©

identification (ID)

27

c

b Issued by ©

Number ©

Identifying a Describe ID ©

document (ID)

14

c

b Issued by ©

Number ©

Alien a Describe ID ©

identification (ID)

27

c

b Issued by ©

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. 3-2008) Page 3

Important Reminders

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 the instructions

for Item 33 on page 5.

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.

Exceptions. Cash is not required to be

reported if it is received:

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.

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

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.

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

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.

● 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.

● In a transaction that is not in the

course of a person’s trade or business.

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.

Voluntary use of Form 8300. Form

8300 may be filed voluntarily for any

suspicious transaction (see Definitions

on page 4) for use by FinCEN and the

IRS, even if the total amount does not

exceed $10,000.

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: Keep a copy of each Form 8300 for 5

years from the date you file it.

Where to file. File the form with the

Internal Revenue Service, Detroit

Computing Center, P.O. Box 32621,

Detroit, Ml 48232.

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).

Casinos must file Form 8300 for

nongaming activities (restaurants, shops,

etc.).

FinCEN Form 8300 (Rev. 3-2008)

Section references are to the Internal

Revenue Code unless otherwise noted.

● 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 the

instructions on page 5.

● The meaning of the word “currency” 

for purposes of 31 U.S.C. 5331 is the

same as for the word “cash” (See Cash

on page 4).

Penalties may also be imposed for

causing, or attempting to cause, a trade

or business to fail to file a required

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.

● 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.
IRS Form 8300 (Rev. 3-2008) Page 4

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)

on page 3 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.

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.

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 below.

Item 1. If you are amending a prior

report, check box 1a. Complete the

appropriate items with the correct or

amended information only. Complete all

of Part IV. Staple a copy of the original

report to the amended 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

1-866-556-3974.

FinCEN Form 8300 (Rev. 3-2008)

Note. You must complete all three items

(a, b, and c) in this line to make sure

that Form 8300 will be processed

correctly.

Definitions

Cash. The term “cash” means the

following:

● U.S. and foreign coin and currency

received in any transaction.

● 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.

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.

Note. Cash does not include a check

drawn on the payer’s own account, such

as a personal check, regardless of the

amount.

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 a negotiable

instrument for cash, 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.

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.

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) on

page 3. 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. 3-2008) Page 5 FinCEN Form 8300 (Rev. 3-2008)

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.”

Privacy Act and Paperwork Reduction

Act Notice. Except as otherwise noted,

the information solicited on this form is

required by the Internal Revenue Service

(IRS) and the Financial Crimes

Enforcement Network (FinCEN) in order

to carry out the laws and regulations of

the United States Department of the

Treasury. Trades or businesses, except

for clerks of criminal courts, are required

to provide the information to the IRS and

FinCEN under both section 6050I and 31

U.S.C. 5331. Clerks of criminal courts

are required to provide the information

to the IRS under section 6050I. Section

6109 and 31 U.S.C. 5331 require that

you provide your social security number

in order to adequately identify you and

process your return and other papers.

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

counterintelligence activities, by directing

the federal Government’s attention to

unusual or questionable transactions.

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 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, 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

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

Title 26 and Title 31 of the United States

Code.

Item 42. This form must be signed by an

individual who has been authorized to

do so for the business that received the

cash.

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 Title 26

or Title 31.

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, you can write

to the Internal Revenue Service, Tax

Products Coordinating Committee,

SE:W:CAR:MP:T:T:SP, 1111 Constitution

Ave. NW, IR-6526, Washington, DC

20224. Do not send Form 8300 to this

address. Instead, see Where to File on

page 3.

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.

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 on page 3 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).

Note. You must complete all three items

(a, b, and c) in this line to make sure

that Form 8300 will be processed

correctly.