Schedule BAdditional Interest Statement                                                   2013

Part IG Attach to return (after all IRS forms)Statement

Name(s) shown on returnYour social security number

List name of payer.Amount

Total. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

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