IRS
Form
8300
(Rev. December 2023)
Report of Cash Payments Over $10,000
Received in a Trade or Business
Department of the Treasury
Internal Revenue Service
See instructions for definition of cash.
Use this form for transactions occurring after December 31, 2023. Do not use prior versions after this date.
For Privacy Act and Paperwork Reduction Act Notice, see the instructions.
OMB No. 1506-0018
FinCEN
Form
8300
(Rev. August 2014)
Department of the Treasury
Financial Crimes
Enforcement Network
1 Check appropriate box(es) if: a Amends prior report; b Suspicious transaction.
Part I 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
7
Address (number, street, and apt. or suite no.) 8 Date of birth
(see instructions)
M M D D Y Y Y Y
9
City 10 State 11 ZIP code 12 Country (if not U.S.) 13
Occupation, profession, or business
14
Identifying
document (ID)
a Describe ID
b Issued by
c Number
Part II 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 Taxpayer identification number
20
Doing business as (DBA) name (see instructions) 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.)
27
Alien
identification (ID)
a Describe ID
b Issued by
c Number
Part III Description of Transaction and Method of Payment
28
Date cash received
M M D D Y Y Y Y
29 Total cash received
$ .00
30 If cash was received in
more than one payment,
check here . . . . .
31 Total price if different from
item 29
$ .00
32 Amount of cash received (in U.S. dollar equivalent) (must equal item 29) (see instructions):
a U.S. currency
$
.00
(Amount in $100 bills or higher $ .00 )
b Foreign currency
$
.00
(Country )
c Cashier’s check(s)
$
.00
d Money order(s)
$
.00
e Bank draft(s)
$
.00
f Traveler’s check(s)
$
.00
}
Issuer’s name(s) and serial number(s) of the monetary instrument(s)
33 Type of transaction
a
Personal property purchased
b
Real property purchased
c
Personal services provided
d
Business services provided
e
Intangible property purchased
f
Debt obligations paid
g
Exchange of cash
h
Escrow or trust funds
i
Bail received by court clerks
j
Other (specify in item 34)
34
Specific description of property or service shown in 33.
Give serial or registration number, address, docket
number, etc.
Part IV 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
42 Under penalties of perjury, I declare that to the best of my knowledge the information I have furnished above is true, correct, and complete.
Signature
Authorized official
Title
43 Date of
signature
M M D D Y Y Y Y
44 Type or print name of contact person 45 Contact telephone number
IRS Form 8300 (Rev. 12-2023)
Cat. No. 62133S
FinCEN Form 8300 (Rev. 8-2014)
IRS Form 8300 (Rev. 12-2023)
Page 2
FinCEN Form 8300 (Rev. 8-2014)
Multiple Parties
(Complete applicable parts below if box 2 or 15 on page 1 is checked.)
Part I
Continued—Complete if box 2 on page 1 is checked
3
Last name 4 First name 5 M.I. 6 Taxpayer identification number
7
Address (number, street, and apt. or suite no.) 8 Date of birth
(see instructions)
M M D D Y Y Y Y
9
City 10 State 11 ZIP code 12 Country (if not U.S.) 13 Occupation, profession, or business
14
Identifying
document (ID)
a Describe ID
b Issued by
c Number
3
Last name 4 First name 5 M.I. 6 Taxpayer identification number
7
Address (number, street, and apt. or suite no.) 8 Date of birth
(see instructions)
M M D D Y Y Y Y
9
City 10 State 11 ZIP code 12 Country (if not U.S.) 13 Occupation, profession, or business
14
Identifying
document (ID)
a Describe ID
b Issued by
c Number
Part II
Continued—Complete if box 15 on page 1 is checked
16
Individual’s last name or organization’s name 17 First name 18 M.I. 19 Taxpayer identification number
20
Doing business as (DBA) name (see instructions) 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.)
27
Alien
identification (ID)
a Describe ID
b Issued by
c Number
16
Individual’s last name or organization’s name 17 First name 18 M.I. 19 Taxpayer identification number
20
Doing business as (DBA) name (see instructions) 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.)
27
Alien
identification (ID)
a Describe ID
b Issued by
c 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. 12-2023) FinCEN Form 8300 (Rev. 8-2014)
