Equity Index-Linked Note

Report an equity index-linked note and income from the note in Part 6.





Income Type

Income Amount


First District Bank Note Linked to S&P 500 Index


$1,001 - $15,000


None (or less than $201)

For You, Your Spouse, and Your Dependent Children

Part 6

Report an equity index-linked note if the value of the note was more than $1,000 at the end of the reporting period or if more than $200 in income was received during the reporting period.

Description:  Provide the name of the issuer and the name of the index to which the note is linked.

EIF:  Select “N/A.”

Value:  Report the value of the note by selecting the appropriate category.

Income Type:  Specify the type(s) of income if the total amount of income received during the reporting period exceeded $200.  Equity index-linked notes normally produce interest income but may also produce capital gains if sold.

Income Amount:  Select the category corresponding to the total amount of income received during the reporting period.