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PRINTED: 04/11/2018 FORM APPROVED Indiana State Department of Health STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION(X1) PROVIDER/SUPPLIER/CIA IDENTIFICATION NUMBER:INDIANA UNIVERSITY HEALTH BEDFORD
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Montenegro and Form United is a joint reporting form used by the Internal Revenue Service (IRS) for reporting foreign financial accounts.
U.S. persons who have a financial interest in or signature authority over foreign financial accounts with an aggregate value exceeding $10,000 at any time during the calendar year are required to file Montenegro and Form United.
Montenegro and Form United can be filled out electronically through the Bank Secrecy Act (BSA) E-Filing System on the Financial Crimes Enforcement Network (FinCEN) website.
The purpose of Montenegro and Form United is to report foreign financial accounts to the IRS in order to combat tax evasion and money laundering.
The form requires information such as the account owner's name, address, account number, financial institution details, and the maximum value of the account during the reporting period.
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