-
TIN:
Form
990-T
Department of the Treasury
Internal Revenue Service
Exempt Organization Business Income Tax Return
(and proxy tax under section 6033(e))
For calendar year 2022 or other tax year beginning
07-01-2022
and ending
06-30-2023
►Go to
www.irs.gov/Form990T
for instructions and the latest information.
►Do not enter SSN numbers on this form as it may be made public if your organization is a 501(c)(3).
OMB No. 1545-0047
20
22
Open to Public Inspection for 501(c)(3) Organizations Only
A
Check box if address changed.
B
Exempt under section
501(
c3
)
408(e)
220(e)
408A
530(a)
529(a)
529A
Print or Type
Name of organization (
Check box if name changed and see instructions.)
The Children's Mercy Hospital Foundation
Number, street, and room or suite no. If a P.O. box, see instructions.
2401 Gillham Road
City or town, state or province, and ZIP or foreign postal code
Kansas City
,
MO
64108
C
Book value of all assets at end of year
.....►
272,874,067
D
Employer identification number
43-1564302
E
Group exemption number
(see instructions)
F
Check box if an amended return.
G
Check organization type ►
501(c) corporation
501(c) trust
401(a) trust
Other trust State college/university
H
Check if filing only to ►
Claim credit from Form 8941
Claim a refund shown on Form 2439
I
Check if a 501(c)(3) organization filing a consolidated return with a 501(c)(2) titleholding corporation
.........►
J
Enter the number of attached Schedules A (Form 990-T)
...............►
1
K
During the tax year, was the corporation a subsidiary in an affiliated group or a parent-subsidiary controlled group?
...►
Yes
No
If "Yes," enter the name and identifying number of the parent corporation ►
L
The books are in care of ►
Denise Willadsen
2401 Gillham Road
Kansas City
,
MO
64108
Telephone number ►
(816) 234-3000
Part I
Total Unrelated Business Taxable Income
1
Total of unrelated business taxable income computed from all unrelated trades or businesses (see instructions)
..............................
1
0
2
Reserved
..............................
2
3
Add lines 1 and 2
............................
3
0
4
Charitable contributions (see instructions for limitation rules)
..............
4
0
5
Total unrelated business taxable income before net operating losses. Subtract line 4 from line 3
....
5
6
Deduction for net operating loss. See instructions
.................
6
7
Total of unrelated business taxable income before specific deduction and section 199A deduction.
Subtract line 6 from line 5
.........................
7
8
Specific deduction (generally $1,000, but see instructions for exceptions)
..........
8
1,000
9
Trusts.
Section 199A deduction. See instructions
.................
9
10
Total deductions.
Add lines 8 and 9
......................
10
1,000
11
Unrelated business taxable income.
Subtract line 10 from line 7. If line 10 is greater than line 7, enter zero
................................
11
0
Part II
Tax Computation
1
Organizations taxable as corporations.
Multiply Part I, line 11 by 21% (0.21)
.......►
1
0
2
Trusts taxable at trust rates.
See instructions for tax computation. Income tax on the amount on
Part I, line 11 from:
Tax rate schedule or
Schedule D (Form 1041)
........►
2
3
Proxy tax.
See instructions
.......................►
3
4
Other tax amounts. See instructions
....................
4
5
Alternative minimum tax (trusts only)
.....................
5
6
Tax on noncompliant facility income.
See instructions
................
6
7
Total.
Add lines 3 through 6 to line 1 or 2, whichever applies
...............
7
0
For Paperwork Reduction Act Notice, see instructions.
Cat. No. 11291J
Form
990-T
(2022)
Form 990-T (2022)
Page
2
Part III
Tax and Payments
1a
Foreign tax credit (corporations attach Form 1118; trusts attach Form 1116)
1a
b
Other credits (see instructions)
..............
1b
c
General business credit. Attach Form 3800 (see instructions)
.....
1c
d
Credit for prior year minimum tax (attach Form 8801 or 8827)
....
1d
e
Total credits.
Add lines 1a through 1d
.....................
1e
2
Subtract line 1e from Part II, line 7
.....................
2
0
3
Other amounts due. Check if from:
Form 4255
Form 8611
Form 8697
Form 8866
Other (attach statement)
..........
3
4
Total tax.
Add lines 2 and 3 (see instructions).
Check if includes tax previously deferred under
section 1294. Enter the tax amount here
4
0
5
Current net 965 tax liability paid from Form 965-A, Part II, column (k)
...........
5
0
6a
Payments: A 2021 overpayment credited to 2022
........
6a
8,000
b
2022 estimated tax payments. Check if section 643(g) election applies ►
6b
c
Tax deposited with Form 8868
..............
6c
d
Foreign organizations: Tax paid or withheld at source (see instructions)
.
6d
e
Backup withholding (see instructions)
............
6e
f
Credit for small employer health insurance premiums (attach Form 8941)
.
6f
g
Other credits, adjustments, and payments:
Form 2439
Form 4136
Other
Total ►
6g
7
Total payments.
Add lines 6a through 6g
.....................
7
8,000
8
Estimated tax penalty (see instructions). Check if Form 2220 is attached
........
►
8
9
Tax due.
If line 7 is smaller than the total of lines 4, 5, and 8, enter amount owed
.......►
9
10
Overpayment.
If line 7 is larger than the total of lines 4, 5, and 8, enter amount overpaid
....►
10
8,000
11
Enter the amount of line 10 you want:
Credited to 2023 estimated tax
►
8,000
Refunded
►
11
0
Part IV
Statements Regarding Certain Activities and Other Information
(see instructions)
1
At any time during the 2022 calendar year, did the organization have an interest in or a signature or other authority over a financial account (bank, securities, or other) in a foreign country? If "Yes," the organization may have to file FinCEN Form 114, Report of Foreign Bank and Financial Accounts. If "Yes," enter the name of the foreign country here ►
Yes
No
No
2
During the tax year, did the organization receive a distribution from, or was it the grantor of, or transferor to, a foreign trust?
No
If "Yes," see instructions for other forms the organization may have to file.
3
Enter the amount of tax-exempt interest received or accrued during the tax year
.....
► $
4
Enter available pre-2018 NOL carryovers here. ► $
. Do not include any post-2017 NOL carryover shown on Schedule A (Form 990-T). Don't reduce the NOL carryover shown here by any deduction reported on Part I, line 4.
5
Post-2017 NOL carryovers. Enter the Business Activity Code and available post-2017 NOL carryovers. Don't reduce the amounts shown below by any NOL claimed on any Schedule A, Part II, line 17 for the tax year. See instructions.
Business activity code
Available post-2017 NOL carryover
523000
$
262,793
$
$
$
6a
Did the organization change its method of accounting? (see instructions)
.................
No
b
If 6a is "Yes," has the organization described the change on Form 990, 990-EZ, 990-PF, or Form 1128? If "No," explain in Part V
Part V
Supplemental Information
Provide the explanation required by Part IV, line 6b. Also, provide any other addtional information. See instructions.
Sign Here
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge.
Signature of officer
Date
Title
May the IRS discuss this return with the preparer shown below (see instructions)?
Yes
No
Paid Preparer Use Only
Print/Type preparer's name
Preparer's signature
Date
Check
if
self-employed
PTIN
Firm's name
Firm's EIN
Firm's address
Phone no.
Form
990-T
(2022)
Additional Data
Software ID:
Software Version:
-
TIN:
SCHEDULE A
(Form 990-T)
Department of the Treasury
Internal Revenue Service
Unrelated Business Taxable Income
From an Unrelated Trade or Business
►Go to
www.irs.gov/Form990T
for instructions and the latest information.
►Do not enter SSN numbers on this form as it may be made public if your organization is a 501(c)(3).
OMB No. 1545-0047
20
22
Open to Public Inspection for 501(c)(3) Organizations Only
A
Name of the organization
The Children's Mercy Hospital Foundation
B
Employer identification number
43-1564302
C
Unrelated business activity code (see instructions) ►
523000
D
Sequence:
1
of
1
E
Describe the unrelated trade or business ►
Flow-through Investments
Part I
Unrelated Trade or Business Income
(A) Income
(B) Expenses
(C) Net
1a
Gross receipts or sales
b
Less returns and allowances
c
Balance ►
1c
2
Cost of goods sold (Part III, line 8)
.........
2
3
Gross profit. Subtract line 2 from line 1c
.......
3
4a
Capital gain net income (attach Sch D (Form 1041 or Form
1120)) (see instructions)
............
4a
List of Attached Documents:
// Content
185,016
185,016
b
Net gain (loss) (Form 4797) (attach Form 4797)
(see instructions)
4b
c
Capital loss deduction for trusts
4c
5
Income (loss) from a partnership or an S corporation (attach statement)
................
5
List of Attached Documents:
// Content
-391,273
-391,273
6
Rent income (Part IV)
.............
6
0
0
7
Unrelated debt-financed income (Part V)
.......
7
0
0
8
Interest, annuities, royalties, and rents from a controlled
organization (Part VI)
.............
8
0
0
9
Investment income of section 501(c)(7), (9), or (17)
organizations (Part VII)
............
9
0
0
10
Exploited exempt activity income (Part VIII)
......
10
11
Advertising income (Part IX)
...........
11
0
0
12
Other income (see instructions; attach statement)
....
12
13
Total.
Combine lines 3 through 12
.........
13
-206,257
0
-206,257
Part II
Deductions Not Taken Elsewhere
(See instructions for limitations on deductions) Deductions must be directly connected with the unrelated business income
1
Compensation of officers, directors, and trustees (Part X)
.................
1
0
2
Salaries and wages
............................
2
3
Repairs and maintenance
..........................
3
4
Bad debts
...............................
4
5
Interest (attach statement) (see instructions)
...................
5
6
Taxes and licenses
.............................
6
7
Depreciation (attach Form 4562) (see instructions)
.........
7
8
Less depreciation claimed in Part III and elsewhere on return
.....
8a
8b
9
Depletion
...............................
9
10
Contributions to deferred compensation plans
.....................
10
11
Employee benefit programs
..........................
11
12
Excess exempt expenses (Part VIII)
.......................
12
13
Excess readership costs (Part IX)
........................
13
0
14
Other deductions (attach statement)
List of Attached Documents:
// Content
......................
14
7,152
15
Total deductions.
Add lines 1 through 14
.....................
15
7,152
16
Unrelated business income before net operating loss deduction. Subtract line 15 from Part I, line 13, column (C)
16
-213,409
17
Deduction for net operating loss (see instructions)
..................
17
0
18
Unrelated business taxable income.
Subtract line 17 from line 16
.............
18
-213,409
For Paperwork Reduction Act Notice, see instructions.
Cat. No. 74036O
Schedule A (Form 990-T) 2022
Schedule A (Form 990-T) 2022
Page
2
Part III
Cost of Goods Sold
Enter method of inventory valuation ►
1
Inventory at beginning of year
........................
1
2
Purchases
...............................
2
3
Cost of labor
..............................
3
4
Additional section 263A costs (attach statement)
..................
4
5
Other costs (attach statement)
........................
5
6
Total.
Add lines 1 through 5
..........................
6
7
Inventory at end of year
...........................
7
8
Cost of goods sold.
Subtract line 7 from line 6. Enter here and in Part I, line 2
..........
8
9
Do the rules of section 263A (with respect to property produced or acquired for resale) apply to the organization?
Yes
No
Part IV
Rent Income (From Real Property and Personal Property Leased with Real Property)
1
Description of property (property street address, city, state, ZIP code). Check if a dual-use (see instructions)
A
B
C
D
A
B
C
D
2
Rent received or accrued
a
From personal property (if the percentage of rent for personal property is more than 10% but not more than 50%)
......
b
From real and personal property (if the percentage of rent for personal property exceeds 50% or if the rent is based on profit or income)
..........
c
Total rents received or accrued by property. Add lines 2a and 2b, columns A through D
.
3
Total rents received or accrued. Add line 2c columns A through D. Enter here and on Part I, line 6, column (A)
.►
0
4
Deductions directly connected with the income in lines 2(a) and 2(b) (attach statement)
.
5
Total deductions.
Add line 4 columns A through D. Enter here and on Part I, line 6, column (B)
.....►
0
Part V
Unrelated Debt-Financed Income
(see instructions)
1
Description of debt-financed property (street address, city, state, ZIP code). Check if a dual-use (see instructions)
A
B
C
D
A
B
C
D
2
Gross income from or allocable to debt-financed property
........
3
Deductions directly connected with or allocable to debt-financed property
a
Straight line depreciation (attach statement)
b
Other deductions (attach statement)
...
c
Total deductions (add lines 3a and 3b, columns A through D)
..........
4
Amount of average acquisition debt on or allocable to debt-financed property (attach statement)
...........
5
Average adjusted basis of or allocable to debt-financed property (attach statement)
...
6
Divide line 4 by line 5
.......
%
%
%
%
7
Gross income reportable. Multiply line 2 by line 6
8
Total gross income
(add line 7, columns A through D). Enter here and on Part I, line 7, column (A)
....►
0
9
Allocable deductions. Multiply line 3c by line 6
10
Total allocable deductions.
Add line 9, columns A through D. Enter here and on Part I, line 7, column (B)
..►
0
11
Total dividends-received deductions
included in line 10
.................►
0
Schedule A (Form 990-T) 2022
Schedule A (Form 990-T) 2022
Page
3
Part VI
Interest, Annuities, Royalties, and Rents from Controlled Organizations
(see instructions)
1.
Name of controlled organization
2.
Employer identification number
Exempt Controlled Organizations
3.
Net unrelated income (loss)
(see instructions)
4.
Total of specified payments made
5.
Part of column 4 that is included
in the controlling organization's
gross income
6.
Deductions directly connected with income in column 5
(1)
(2)
(3)
(4)
Nonexempt Controlled Organizations
7.
Taxable income
8.
Net unrelated
income (loss)
(see instructions)
9.
Total of specified payments made
10.
Part of column 9
that is included in the
controlling organization's
gross income
11.
Deductions directly connected with
income in column 10
(1)
(2)
(3)
(4)
Add columns 5 and 10.
Enter here and on Part I,
line 8, column (A)
Add columns 6 and 11.
Enter here and on Part I,
line 8, column (B)
Totals
.........................►
0
0
Part VII
Investment Income of a Section 501(c)(7), (9), or (17) Organization
(see instructions)
1.
Description of income
2.
Amount of income
3.
Deductions directly connected
(attach statement)
4.
Set-asides
(attach statement)
5. Total deductions and set-asides
(add columns 3 and 4)
(1)
(2)
(3)
(4)
Totals
.........►
Add amounts in column 2.
Enter here and on Part I,
line 9, column (A)
0
Add amounts in column 5.
Enter here and on Part I,
line 9, column (B)
0
Part VIII
Exploited Exempt Activity Income, Other Than Advertising Income
(see instructions)
1
Description of exploited activity:
2
Gross unrelated business income from trade or business. Enter here and on Part I, line 10, column (A)
...
2
3
Expenses directly connected with production of unrelated business income. Enter here and on Part I, line 10, column (B)
...............................
3
4
Net income (loss) from unrelated trade or business. Subtract line 3 from line 2. If a gain, complete
lines 5 through 7
.............................
4
5
Gross income from activity that is not unrelated business income
..............
5
6
Expenses attributable to income entered on line 5
...................
6
7
Excess exempt expenses. Subtract line 5 from line 6, but do not enter more than the amount on line 4. Enter here and on Part II, line 12
..........................
7
Schedule A (Form 990-T) 2022
Schedule A (Form 990-T) 2022
Page
4
Part IX
Advertising Income
1
Name(s) of periodical(s). Check box if reporting two or more periodicals on a consolidated basis.
A
B
C
D
Enter amounts for each periodical listed above in the corresponding column.
A
B
C
D
2
Gross advertising income
......
a
Add columns A through D. Enter here and on Part I, line 11, column (A)
.............►
0
3
Direct Advertising costs by periodical
..
a
Add columns A through D. Enter here and on Part I, line 11, column (B)
.............►
0
4
Advertising gain (loss). Subtract line 3 from line 2. For any column in line 4 showing a gain, complete lines 5 through 8. For any column in line 4 showing a loss or zero, do not complete lines 5 through 7, and enter zero on line 8
............
5
Readership costs
........
6
Circulation income
........
7
Excess readership costs. If line 6 is less than line 5, subtract line 6 from line 5. If line 5 is less than line 6, enter zero
.....
8
Excess readership costs allowed as a deduction. For each column showing a gain on line 4, enter the lesser of line 4 or line 7
.
a
Add line 8, columns A through D. Enter the greater of the columns total or zero here and on Part II, line 13
..►
0
Part X
Compensation of Officers, Directors, and Trustees
(see instructions)
1.
Name
2.
Title
3.
Percentage
of time devoted
to business
4.
Compensation
attributable to
unrelated business
(1)
(2)
(3)
(4)
Total.
Enter here and on Part II, line 1
.........................►
0
Part XI
Supplemental Information
(see instructions)
Schedule A (Form 990-T) 2022
Additional Data
Software ID:
Software Version:
-
TIN:
SCHEDULE D
(Form 1120)
List of Attached Documents:
// Content
Department of the Treasury
Internal Revenue Service
Capital Gains and Losses
Attach to Form 1120, 1120-C, 1120-F, 1120-FSC, 1120-H, 1120-IC-DISC, 1120-L,
1120-ND, 1120-PC, 1120-POL, 1120-REIT, 1120-RIC, 1120-SF, or certain Forms 990-T.
Go to
www.irs.gov/Form1120
for instructions and the latest information.
OMB No. 1545-0123
20
22
Name
The Children's Mercy Hospital Foundation
Employer identification number
43-1564302
Did the corporation dispose of any investment(s) in a qualified opportunity fund during the tax year?
.......
Yes
No
If “Yes,” attach Form 8949 and see its instructions for additional requirements for reporting your gain or loss.
Part I
Short–Term Capital Gains and Losses –– Generally Assets Held One Year or Less (see instructions)
See instructions for how to figure the amounts to enter on the lines below.
This form may be easier to complete if you round off cents to whole dollars.
(d)
Proceeds
(e)
Cost
(g)
Adjustments to gain or loss from Form(s) 8949, Part 1, line 2, column (g)
(h) Gain or (loss)
Subtract column (e) from column (d) and combine the result with column (g)
1a
Totals for all short-term transactions reported on Form 1099-B for which basis was reported to the IRS and for which you have no adjustments (see instructions). However, if you choose to report all these transactions on Form 8949, leave this line blank and go to line 1b
1b
Totals for all transactions reported on
Form(s) 8949 with
Box A
checked
2
Totals for all transactions reported on
Form(s) 8949 with
Box B
checked
3
Totals for all transactions reported on
Form(s) 8949 with
Box C
checked
4,094
4
Short-term capital gain from installment sales from Form 6252, line 26 or 37
...........
4
5
Short-term capital gain or (loss) from like-kind exchanges from Form 8824
...........
5
6
Unused capital loss carryover (attach computation)
..................
6
(
)
7
Net short-term capital gain or (loss). Combine lines 1a through 6 in column h
...........
7
4,094
Part II
Long–Term Capital Gains and Losses –– Generally Assets Held More Than One Year (see instructions)
See instructions for how to figure the amounts to enter on the lines below.
This form may be easier to complete if you round off cents to whole dollars.
(d)
Proceeds
(e)
Cost
(g)
Adjustments to gain or loss from Form(s) 8949, Part II, line 2, column (g)
(h) Gain or (loss)
Subtract column (e) from column (d) and combine the result with column (g)
8a
Totals for all long-term transactions reported on Form 1099-B for which basis was reported to the IRS and for which you have no adjustments (see instructions). However, if you choose to report all these transactions on Form 8949, leave this line blank and go to line 8b
8b
Totals for all transactions reported on
Form(s) 8949 with
Box D
checked
9
Totals for all transactions reported on
Form(s) 8949 with
Box E
checked
10
Totals for all transactions reported on
Form(s) 8949 with
Box F
checked
84,381
11
Enter gain from Form 4797, line 7 or 9
.......................
11
96,541
12
Long-term capital gain from installment sales from Form 6252, line 26 or 37
...........
12
13
Long-term capital gain or (loss) from like-kind exchanges from Form 8824
...........
13
14
Capital gain distributions (see instructions)
.....................
14
15
Net long-term capital gain or (loss). Combine lines 8a through 14 in column h
..........
15
180,922
Part III
Summary of Parts I and II
16
Enter excess of net short-term capital gain (line 7) over net long-term capital loss (line 15)
......
16
4,094
17
Net capital gain. Enter excess of net long-term capital gain (line 15) over net short-term capital loss (line 7)
.
17
180,922
18
Add lines 16 and 17. Enter here and on Form 1120, page 1, line 8, or the applicable line on other returns
..
18
185,016
Note:
If losses exceed gains, see
Capital losses
in the instructions.
For Paperwork Reduction Act Notice, see the Instructions for Form 1120.
Cat. No. 11460M
Schedule D (Form 1120) 2022
Additional Data
Software ID:
Software Version:
-
TIN:
Form
8949
Department of the Treasury
Internal Revenue Service
Sales and Other Dispositions of Capital Assets
Go to
www.irs.gov/Form8949
for instructions and the latest information.
File with your Schedule D to list your transactions for lines 1b, 2, 3, 8b, 9, and 10 of
Schedule D.
OMB No. 1545-0074
20
22
Attachment
Sequence No.
12A
Name(s) shown on return
The Children's Mercy Hospital Foundation
Social security number or taxpayer identification number
43-1564302
Before you check Box A, B, or C below, see whether you received any Form(s) 1099-B or substitute statement(s) from your broker. A substitute statement will have the same information as Form 1099-B. Either will show whether your basis (usually your cost) was reported to the IRS by your broker and may even tell you which box to check.
Part I
Short-Term.
Transactions involving capital assets you held 1 year or less are generally short term (see instructions). For long-term transactions, see page 2.
Note:
You may aggregate all short-term transactions reported on Form(s) 1099-B showing basis was reported to the IRS and for which no adjustments or codes are required. Enter the totals directly on Schedule D, line 1a; you aren't required to report these transactions on Form 8949 (see instructions).
You
must
check Box A, B,
or
C below. Check only one box.
If more than one box applies for your short-term transactions, complete a separate Form 8949, page 1, for each applicable box. If you have more short-term transactions than will fit on this page for one or more of the boxes, complete as many forms with the same box checked as you need.
(A)
Short-term transactions reported on Form(s) 1099-B showing basis was reported to the IRS (see
Note
above)
(B)
Short-term transactions reported on Form(s) 1099-B showing basis
wasn't
reported to the IRS
(C)
Short-term transactions not reported to you on Form 1099-B
1
(a)
Description of property
(Example: 100 sh. XYZ Co.)
(b)
Date acquired
(Mo., day, yr.)
(c)
Date sold or
disposed of
(Mo., day, yr.)
(d)
Proceeds
(sales price)
(see instructions)
(e)
Cost or other basis.
See the
Note
below
and see
Column (e)
in the separate
instructions
Adjustment, if any, to gain or loss.
If you enter an amount in column (g),
enter a code in column (f).
See the separate instructions.
(h)
Gain or (loss).
Subtract column (e)
from column (d) and
combine the result
with column (g)
(f)
Code(s) from
instructions
(g)
Amount of
adjustment
Dover Street
(
)
-684
Harbourvest Real Assets Fund IV
(
)
4,778
2 Totals
. Add the amounts in columns (d), (e), (g), and (h)
(subtract negative amounts). Enter each total here and include on your Schedule D,
line 1b
(if
Box A
above is checked),
line 2
(if
Box B
above is checked), or
line 3
(if
Box C
above is checked).
.......
(
)
4,094
Note:
If you checked Box A above but the basis reported to the IRS was incorrect, enter in column (e) the basis as reported to the IRS, and enter an adjustment in column (g) to correct the basis. See
Column
(g) in the separate instructions for how to figure the amount of the adjustment.
For Paperwork Reduction Act Notice, see your tax return instructions.
Cat. No. 37768Z
Form
8949
(2022)
Form 8949 (2022)
Attachment Sequence No.
12A
Page
2
Name(s) shown on return. Name and SSN or taxpayer identification no. not required if shown on other side
The Children's Mercy Hospital Foundation
Social security number or taxpayer identification number
43-1564302
Before you check Box D, E, or F below, see whether you received any Form(s) 1099-B or substitute statement(s) from your broker. A substitute statement will have the same information as Form 1099-B. Either will show whether your basis (usually your cost) was reported to the IRS by your broker and may even tell you which box to check.
Part II
Long-Term.
Transactions involving capital assets you held more than 1 year are generally long term (see instructions). For short-term transactions, see page 1.
Note:
You may aggregate all long-term transactions reported on Form(s) 1099-B showing basis was reported to the IRS and for which no adjustments or codes are required. Enter the totals directly on Schedule D, line 8a; you aren't required to report these transactions on Form 8949 (see instructions).
You
must
check Box D, E,
or
F below. Check only one box.
If more than one box applies for your long-term transactions, complete a separate Form 8949, page 2, for each applicable box. If you have more long-term transactions than will fit on this page for one or more of the boxes, complete as many forms with the same box checked as you need.
(D)
Long-term transactions reported on Form(s) 1099-B showing basis was reported to the IRS (see
Note
above)
(E)
Long-term transactions reported on Form(s) 1099-B showing basis
wasn't
reported to the IRS
(F)
Long-term transactions not reported to you on Form 1099-B
1
(a)
Description of property
(Example: 100 sh. XYZ Co.)
(b)
Date acquired
(Mo., day, yr.)
(c)
Date sold or
disposed of
(Mo., day, yr.)
(d)
Proceeds
(sales price)
(see instructions)
(e)
Cost or other basis.
See the
Note
below
and see
Column (e)
in the separate
instructions
Adjustment, if any, to gain or loss.
If you enter an amount in column (g),
enter a code in column (f).
See the separate instructions.
(h)
Gain or (loss).
Subtract column (e)
from column (d) and
combine the result
with column (g)
(f)
Code(s) from
instructions
(g)
Amount of
adjustment
Dover Street
(
)
81,048
Harbourvest Real Assets Fund IV
(
)
3,330
Blackstone Real Estate Partners X.F. LP
(
)
3
2 Totals
. Add the amounts in columns (d), (e), (g), and (h)
(subtract negative amounts). Enter each total here and include on your Schedule D,
line 8b
(if
Box D
above is checked),
line 9
(if
Box E
above is checked), or
line 10
(if
Box F
above is checked)
..........
(
)
84,381
Note:
If you checked Box D above but the basis reported to the IRS was incorrect, enter in column (e) the basis as reported to the IRS, and enter an adjustment in column (g) to correct the basis. See
Column
(g) in the separate instructions for how to figure the amount of the adjustment.
Form
8949
(2022)
Additional Data
Software ID:
Software Version: