SCHEDULE C 

(Form 1116)

(December 2021)

Foreign Tax Redeterminations

Department of the Treasury 

Internal Revenue Service

▶ See separate instructions.

▶ Go to www.irs.gov/Form1116 for instructions and the latest information.

OMB No. 1545-0121 For calendar year 20 , or other tax year beginning , 20 , and ending , 20 .

Name Identifying number as shown 

on page 1 of your tax return

Use a separate Schedule C (Form 1116) for each applicable category of income listed below. See instructions. Check only one box on each schedule. 

a Section 951A category income

b Foreign branch category income

c Passive category income

d General category income

e Section 901(j) income

f Certain income re-sourced by treaty

g Lump-sum distributions

h If box e is checked, enter the country code for the sanctioned country. See instructions . . . . . . . . . . . . . . . . . . ▶

i If box f is checked, enter the country code for the treaty country. See instructions . . . . . . . . . . . . . . . . . . . . ▶

Part I Increase in Amount of Foreign Taxes Accrued (see instructions)

Enter redetermined amounts by payor for each separate relation back year (starting with the most recent) followed by a subtotal for each relation back year. 

1. U.S. Tax Year of Taxpayer 

to Which Tax Relates 

(relation back year) 

(MM/DD/YYYY)

A

2a. Name of Payor 

(see instructions)

2b. EIN or 

Reference ID 

Number of Payor

3. Country or U.S. Possession 

to Which Tax Is Paid 

(enter code—see instructions)

4. Date Additional 

Foreign Tax Was Paid 

(MM/DD/YYYY)

5. Foreign Tax Year 

to Which Tax Relates 

(MM/DD/YYYY)

(1)

(2)

(3)

B

 

(1)

(2)

(3)

6. Payor’s Income 

Subject to Tax in the 

Foreign Jurisdiction 

(see instructions)

7. Additional Tax 

Accrued in 

Local Currency in 

Which the Tax Is Payable

8. Additional Tax 

Accrued in 

Functional Currency 

of Payor

9. Conversion Rate 

of Local Currency 

to U.S. Dollars

10. Additional Tax 

Accrued in U.S. Dollars 

(divide column 7 

by column 9)

11. U.S. Dollar Tax 

of Payor Reported on 

Original/Amended Return

12. Revised Tax Accrued 

(add column 10 

and column 11)

13. Check Box if 

Contested Tax 

(see instructions)

(1)

A (2)

(3)

Subtotal by Relation Back Year of Taxpayer (add amounts in columns 10, 11, and 12) . . ▶ 

(1)

B (2)

(3)

Subtotal by Relation Back Year of Taxpayer (add amounts in columns 10, 11, and 12) . . ▶

For Privacy Act and Paperwork Reduction Act Notice, see the separate instructions. Cat. No. 75187Q Schedule C (Form 1116) (12-2021)
Schedule C (Form 1116) (12-2021) Page 2

Part II Decrease in Amount of Foreign Taxes Paid or Accrued (see instructions)

Enter redetermined amounts by payor for each separate relation back year (starting with the most recent) followed by a subtotal for each relation back year. 

1. U.S. Tax Year of Taxpayer 

to Which Tax Relates 

(relation back year) 

(MM/DD/YYYY)

A

2a. Name of Payor 

(see instructions)

2b. EIN or 

Reference ID 

Number of Payor

3. Country or U.S. Possession 

From Which Tax Was 

Refunded or Deemed Refunded 

(enter code—see instructions)

4. Date Foreign Tax 

Was Refunded or 

Deemed Refunded 

(MM/DD/YYYY) 

(see instructions)

5. Foreign Tax Year 

to Which Tax Relates 

(MM/DD/YYYY)

(1)

(2)

(3)

B

 

(1)

(2)

(3)

6. Payor’s Income 

Subject to Tax in the 

Foreign Jurisdiction 

(see instructions)

7. Tax Refunded 

or Deemed Refunded 

in Local Currency in 

Which the Tax Is Payable

8. Refunded Amount 

in Functional Currency 

of Payor

9. Conversion Rate 

of Local Currency 

to U.S. Dollars

10. Refunded Amount 

in U.S. Dollars 

(divide column 7 

by column 9)

11. U.S. Dollar Tax 

of Payor Reported on 

Original/Amended Return

12. Revised Tax 

Paid or Accrued 

(subtract column 10 

from column 11)

13. Check Box if 

Section 905(c)(2) 

Two Year Rule 

Applies 

(see instructions)

(1)

A (2)

(3)

Subtotal by Relation Back Year of Taxpayer (add amounts in columns 10, 11, and 12) . . ▶ 

(1)

B (2)

(3)

Subtotal by Relation Back Year of Taxpayer (add amounts in columns 10, 11, and 12) . . ▶

Part III Change in Foreign Taxes Paid or Accrued

Enter the information below for the change to the total amount of foreign taxes paid or accrued and the foreign tax credits (FTCs) claimed for each relation back year.

1. Relation Back Year 

(MM/DD/YYYY)

2. Redetermined Foreign Taxes 

Paid or Accrued

3. Foreign Taxes Paid or Accrued 

per Original/Amended Return

4. Amount of FTC Claimed 

per Original/Amended Return

5. Amount of FTC Claimed 

After Redetermination

A

B

Part IV Change in U.S. Tax Liability

Enter the information below for the change in U.S. tax liability for each relation back year and other affected year (see instructions). 

1. Relation Back Year or Affected Tax Year 

(MM/DD/YYYY)

2. Total Redetermined 

U.S. Tax Liability

3. Total U.S. Tax Liability 

per Original/Amended Return

4. Difference 

(subtract column 3 from column 2)

A

B

Schedule C (Form 1116) (12-2021)