OMB No. 1545-0126 U.S. Income Tax Return of a Foreign Corporation

Name Employer identification number

Number, street, and room or suite no. (see instructions) Check applicable boxes:

initial return amended return

City or town, state and ZIP code, or country final return change of address

Please type or print

A Country of incorporation

Foreign country under whose laws the income reported on this return

is subject to tax

B

Yes No

C Date incorporated

D The corporation’s books and records are maintained by:

Name

Did the corporation file a U.S. income tax return

for the preceding tax year?

H

Address

If the corporation had an agent in the United States at any time during

the tax year, enter:

E

Kind of agent

Was the corporation at any time during the tax year

engaged in a trade or business in the United States?

I

Name

Address

Did the corporation at any time during the tax year

have a permanent establishment in the United

States for purposes of applying section 894(b) and

any applicable tax treaty between the United

States and a foreign country?

J

If “Yes,” enter the name of the foreign country:

Note: Additional information is required at the bottom of pages 2 and 5.

Computation of Tax Due or Overpayment

1 Tax from Section I, line 11, page 2 1

2 Tax from Section II, Schedule J, line 9, page 4 2

3 Tax from Section III (add lines 6 and 10 on page 5) 3

4 Personal holding company tax (attach Schedule PH (Form 1120))—See General Instruction P 4

5 Total tax—Add lines 1 through 4 5

6 Payments:

a 1991 overpayment credited to 1992 6a

b 1992 estimated tax payments 6b

c Less 1992 refund applied for on Form 4466 6c ( ) Bal © 6d

e Tax deposited with Form 7004 6e

Credit from regulated investment companies (attach Form 2439) 6f f

Credit for Federal tax paid on fuels (attach Form 4136) 6g g

U.S. income tax paid or withheld at source (add line 12, page 2, and amounts

from Forms 8288-A and 8805 (attach Forms 8288-A and 8805))

h

6h

Total payments—Add 6i i lines 6d through 6h

7 Estimated tax penalty (see instructions). Check if Form 2220 is attached © 7

8 Tax due—If line 6i is smaller than the total of lines 5 and 7, enter amount owed 8

9 Overpayment—If line 6i is larger than the total of lines 5 and 7, enter amount overpaid 9

10 Enter amount of line 9 you want: Credited to 1993 estimated tax © Refunded © 10

Form 1120F

For calendar year 1992, or tax year beginning , 1992, and ending , 19 Department of the Treasury

Internal Revenue Service © See separate instructions.

Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge Please and belief, it is true, correct, and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge.

Sign

Here © Signature of officer Date Title

Date Preparer’s social security number Preparer’s

signature

Check if selfemployed ©

Paid

Preparer’s

Use Only

Firm’s name (or

yours if self-employed)

and address

E.I. No. ©

ZIP code ©

For Paperwork Reduction Act Notice, see page 1 of separate instructions. Cat. No. 11470I Form 1120F (1992)

©

©

©

Refer to the list on the last page of the instructions and state the

corporation’s principal:

F

(1) Business activity code number ©

(2) Business activity ©

(3) Product or service ©

Check method of accounting: (1) Cash (2) Accrual

(3) Other (specify) ©

G

Is the corporation a foreign personal holding

company? (See section 552 for definition.)

K

If “Yes,” have you filed Form 5471? (Sec. 6035)

Did the corporation have any transactions with

related parties? 

L

If “Yes,” it may have to file Form 5472 (see General

Instruction M1).

Enter number of Forms 5472 attached © 

ZIP code or country 
Form 1120F (1992) Page 2

SECTION I.—Certain Gains, Profits, and Income From U.S. Sources That Are NOT Effectively Connected With

the Conduct of a Trade or Business in the United States (see instructions)

If you are required to complete Section II or are using Form 1120F as a claim for refund of tax withheld at source, include below ALL income from

U.S. sources that is NOT effectively connected with the conduct of a trade or business in the United States. Otherwise, include only those items

of income on which the U.S. income tax was not fully paid at the source. The rate of tax on each item of gross income — no deductions are

allowed against these types of income — listed below is 30% (4% for the gross transportation tax) or such lower rate specified by tax treaty. Fill

in treaty rates where applicable. If the corporation claimed a lower treaty rate, also complete Item U, page 5.

Name of treaty country, if any ©

(e)

Amount of U.S. income tax

paid or withheld at the source

(a)

Nature of income

(b)

Gross income

(c)

Rate of tax (%)

(d)

Amount of tax

1 Interest

2 Dividends

3 Rents

4 Royalties

5 Annuities

6 Gains from disposal of timber, coal, or

domestic iron ore with a retained

economic interest (attach supporting

schedule)

7 Gains from sale or exchange of

patents, copyrights, etc.

8 Fiduciary distributions (attach supporting schedule)

Gross transportation income (see

instructions)

9

4

Other fixed or determinable annual or

periodic gains, profits, and income 

10

11 Total—Enter here and on line 1, page 1 ©

12 Total—Enter here and include on line 6h, page 1 ©

If the corporation has an NOL for the tax year and is

electing under section 172(b)(3) to forego the

carryback period, check here ©

R

Did any individual, partnership, corporation, estate, or

trust at the end of the tax year own, directly or

indirectly, 50% or more of the corporation’s voting

stock? (For rules of attribution, see section 267(c).)

S

Did the corporation at the end of the tax year own,

directly or indirectly, 50% or more of the voting stock

of a U.S. corporation? (For rules of attribution, see

section 267(c).)

Q

If “Yes,” attach a schedule showing (1) name and

identifying number of such U.S. corporation;

(2) percentage owned; and (3) taxable income or (loss)

before NOL and special deductions of such U.S.

corporation for the tax year ending with or within your

tax year.

(1) Is the corporation a subsidiary in a

parent-subsidiary controlled group?

(2) Enter the name and identifying number of the

parent corporation or other entity with more than 50%

ownership ©

(3) Enter percentage owned ©

If “Yes,” complete the following:

Additional Information Required (continued from page 1)

Yes No Yes No

Enter tax-exempt interest received or accrued during

the tax year (see instructions) ©

P

Note: Additional information is required at the bottom of page 5.

Is the corporation a personal holding company? (See

section 542 for definition.)

M

Is the corporation a controlled foreign corporation?

(See section 957 for definition.)

N

O Is the corporation a personal service corporation? (See

instructions for definition.)
SECTION II.—Income Effectively Connected With the Conduct of a Trade or Business in the United States

(see instructions)

IMPORTANT—Fill in all applicable lines and schedules. If you need more space, see General Instruction M3.

1a Gross receipts or sales b Less returns and allowances c Bal © 1c

2 Cost of goods sold (Schedule A, line 8) 2

3 Gross profit (subtract line 2 from line 1c) 3

4 Dividends (Schedule C, line 14) 4

5 Interest 5

6 Gross rents 6

Income

7 Gross royalties 7

8 Capital gain net income (attach Schedule D (Form 1120)) 8

9 Net gain or (loss) from Form 4797, Part II, line 20 (attach Form 4797) 9

10 Other income (see instructions—attach schedule) 10

11 Total income—Add lines 3 through 10 © 11

12 Compensation of officers (Schedule E, line 4). Deduct only amounts connected with a U.S. business 12

13a b Salaries and wages Less jobs credit 13c

14 Repairs 14

15 Bad debts 15

16 Rents 16

17 Taxes 17

18 Interest deduction allowable under Regulations section 1.882-5 18

19 Charitable contributions (see instructions for 10% limitation) 19

20 Depreciation (attach Form 4562) 20

21 Less depreciation claimed on Schedule A and elsewhere on return 21

22 Balance (subtract line 21 from line 20) 22

23 Depletion 23

24 Advertising 24

25 Pension, profit-sharing, etc., plans 25

26 Employee benefit programs 26

27 Other deductions (attach schedule) 27

28 Total deductions—Add lines 12 through 27 © 28

29 29 Taxable income before NOL deduction and special deductions (subtract line 28 from line 11)

30 Less: a Net operating loss deduction 30a

Deductions (See instructions for limitations on deductions)

b Special deductions (Schedule C, line 15) 30b 30c

31 Taxable income or (loss) — Subtract line 30c from line 29 31

Cost of Goods Sold (see instructions)

1 Inventory at beginning of year 1

2 Purchases 2

3 Cost of labor 3

4 Additional section 263A costs (see instructions—attach schedule) 4

Other costs (attach schedule) 5

Add lines 1 through 5 

5

6 6

Inventory at end of year 7

Cost of goods sold. Subtract line 7 from line 6. Enter here and on Section II, line 2 

7

9a Check all methods used for valuing closing inventory:

(i) Cost

(ii) Lower of cost or market as described in Regulations section 1.471-4 (see instructions)

(iii) Writedown of ‘‘subnormal’’ goods as described in Regulations section 1.471-2(c) (see instructions)

(iv) Other (Specify method used and attach explanation.) ©

b Check if the LIFO inventory method was adopted this tax year for any goods ©

If checked, attach Form 970.

c If the LIFO inventory method was used for this tax year, enter percentage (or amounts) of closing

inventory computed under LIFO 9c

d Do the rules of section 263A (for property produced or acquired for resale) apply to the corporation? Yes No

e Was there any change in determining quantities, cost, or valuations between opening and closing inventory?

If ‘‘Yes,’’ attach explanation.

Form 1120F (1992) Page 3

c Bal ©

Yes No

Schedule A

8 8
SECTION II (continued)

Dividends and Special Deductions (see instructions)

(a) Dividends

received

(c) Special deductions:

(a) 3 (b) (b) %

Dividends from less-than-20%-owned domestic corporations that are

subject to the 70% deduction (other than debt-financed stock)

1

70

Dividends from 20%-or-more-owned domestic corporations that are

subject to the 80% deduction (other than debt-financed stock)

2

80

see

3 Dividends on debt-financed stock of domestic and foreign corporations (section 246A) instructions

4 Dividends on certain preferred stock of less-than-20%-owned public utilities 41.176

5 Dividends on certain preferred stock of 20%-or-more-owned public utilities 47.059

Dividends from less-than-20%-owned foreign corporations that are

subject to the 70% deduction

6

70

Dividends from 20%-or-more-owned foreign corporations that are subject

to the 80% deduction

7

80

8 Total—Add lines 1 through 7. See instructions for limitation

9 0ther dividends from foreign corporations not included on lines 3, 6, and 7

10 Foreign dividend gross-up (section 78)

11 IC-DISC and former DISC dividends not included on lines 1, 2, or 3 (section 246(d))

12 Other dividends

13 Deduction for dividends paid on certain preferred stock of a public utility

14 Total dividends—Add lines 1 through 12. Enter here and on line 4, page 3

15 Total deductions—Add lines 8 and 13. Enter here and on line 30b, page 3

Compensation of Officers (See instructions for line 12, page 3.)

Complete Schedule E only if your total receipts (line 1a plus lines 4 through 10 of Section II, page 3) are $500,000 or more.

Percent of corporation

stock owned (c) Percent of

time devoted

to business

(f) Amount of

compensation

(b) Social security

number (a) Name of officer

(d) Common (e) Preferred

1 % % %

% % %

% % %

% % %

% % %

% % %

% % %

2 Total compensation of officers

3 Compensation of officers claimed on Schedule A and elsewhere on this return

4 Subtract line 3 from line 2. Enter the result here and on line 12, page 3 

Tax Computation (see instructions)

1 Check if the corporation is a member of a controlled group (see sections 1561 and 1563) ©

2 If the box on line 1 is checked:

Enter the corporation’s share of the $50,000 and $25,000 taxable income bracket amounts

(in that order):

a

(i) $ (ii) $

$ Enter the corporation’s share of the additional 5% tax (not to exceed

$11,750)

b

3

3

4a Foreign tax credit (attach Form 1118) 4a

b Credit for fuel produced from a nonconventional source 4b

c Orphan drug credit (attach Form 6765) 4c

4d

d General business credit. Enter here and check which forms are

attached:

Form 3800 Form 3468 Form 5884 Form 6478

Form 6765 Form 8586 Form 8830 Form 8826

e Credit for prior year minimum tax (attach Form 8827) 4e

5 Total Credits.—Add lines 4a through 4e 5

6 Subtract line 5 from line 3 6

7 Recapture taxes. Check if from: Form 4255 Form 8611 7

8a Alternative minimum tax (attach Form 4626) 8a

b Environmental tax (attach Form 4626) 8b

9 Total tax under section 882(a). Add lines 6 through 8b. Enter here and on line 2, page 1 9

Form 1120F (1992) Page 4

Schedule J

Schedule E

Schedule C

Income tax. Check this box if the corporation is a qualified personal service corporation (see

page 13 of the instructions) ©
SECTION III.—Branch Profits Tax and Tax on Excess Interest (see instructions)

Part I—Branch Profits Tax

1 Enter the amount from line 29, Section II, page 3 1

2 Enter total amount of adjustments to arrive at effectively connected earnings and profits. See

instructions for types of adjustments as well as exceptions for certain types of income included

in effectively connected taxable income but not taken into account when computing effectively

connected earnings and profits, and the treatment of deductions apportioned to that income.

Attach a schedule showing the nature and amount of these adjustments. 2

Effectively connected earnings and profits. Combine line 1 and line 2 and enter the result here.

Attach a historical summary (see instructions for reporting requirements). If you are a foreign

insurance company, see the regulations under section 884 for a special rule for the computation

of effectively connected earnings and profits. If the special rule applies, attach a schedule showing

the computation.

3

3

4a Enter U.S. net equity at the end of the current tax year and attach schedule (see instructions) 4a

b Enter U.S. net equity at the end of the prior tax year and attach schedule (see instructions) 4b

Increase in U.S. net equity. If line 4a is greater than or equal to line 4b, subtract line 4b from

line 4a. Enter the result here and skip to line 4e

c

4c

d Decrease in U.S. net equity. If line 4b is greater than line 4a, subtract line 4a from line 4b and

enter the result here 4d

e Non-previously taxed accumulated effectively connected earnings and profits. Enter excess,

if any, of effectively connected earnings and profits for preceding tax years beginning after

1986 over any dividend equivalent amounts for those tax years 4e

5 Dividend equivalent amount. If an amount is entered on line 4c, subtract that amount from line

3 and enter the result here. Enter -0- if the result is equal to or less than zero. If no increase

is entered on line 4c, add the lesser of line 4d or line 4e to line 3 and enter the total here.

Attach a historical summary of dividend equivalent amounts for each tax year beginning after

1986

Branch profits tax. Multiply the amount on line 5 by 30% (or lower treaty rate if the corporation

is a qualified resident or otherwise qualifies for treaty benefits). Enter here and include on line

3, page 1. See instructions for: the requirements for qualification for treaty benefits; the definition

of qualified resident; and special rules for foreign corporations that have completely terminated

their U.S. trade or business during the tax year. If treaty benefits apply, attach a statement

explaining why the corporation is a qualified resident or otherwise qualifies for treaty benefits

and describe the benefits that apply. Also complete Item U below

6

6

Part II—Computation of Tax on Excess Interest

7 Enter the interest allowable as a deduction under Regulations section 1.882-5 (line 18, Section II, page 3) 7

Enter the interest paid by the foreign corporation’s U.S. trade or business (other than

nondeductible interest). (See instructions for definition.) If the interest paid by the foreign

corporation’s U.S. trade or business was increased because 80% or more of the foreign

corporation’s assets are U.S. assets, check this box ©

8

8

9a Excess interest. Subtract line 8 from line 7. Enter -0- if the result is equal to or less than zero 9a

b If the foreign corporation is a bank, enter the amount of excess interest treated as interest on

deposits. Otherwise, enter -0- 9b

c Subtract line 9b from line 9a 9c

10 Tax on excess interest. Multiply line 9c by 30% or lower treaty rate (if the corporation is a

qualified resident or otherwise qualifies for treaty benefits). Enter here and include on line 3,

page 1. (If treaty rate applies, attach a statement explaining why the corporation is a qualified

resident or otherwise qualifies for treaty benefits.) Also complete Item U below 10

Additional Information Required (continued from page 2)

If “Yes,” enter the treaty country and article(s)

Attach the statement required by Regulations section 301.6114-1(d) and write “Section 6114 Treaty Position Taken” across the

top margin of page 1 of the form.

Is the corporation claiming a reduction in, or exemption from, the branch profits tax due to a complete termination of all U.S.

trades or businesses, the tax-free liquidation or reorganization of a foreign corporation, or the tax-free incorporation of a U.S.

trade or business?

T

Yes No

Form 1120F (1992) Page 5

Is the corporation taking a position on this return that a U.S. tax treaty overrules or modifies an Internal Revenue law of the

United States thereby causing a reduction of tax? 

U

5

Note: Failure to disclose a treaty-based return position may result in a penalty of $10,000 (see section 6712).
Additional schedules to be completed with respect to Section II or Section III (see instructions)

Balance Sheets Beginning of tax year End of tax year

(a) (b) (c) (d) ASSETS

1 Cash

2a Trade notes and accounts receivable

( ) ) b Less allowance for bad debts

3 Inventories

4 U.S. government obligations

5 Tax-exempt securities (see instructions)

6 Other current assets (attach schedule)

7 Loans to stockholders

8 Mortgage and real estate loans

9 Other investments (attach schedule)

10a Buildings and other fixed depreciable assets

( ) ( ) b Less accumulated depreciation

11a Depletable assets

( ) ( ) b Less accumulated depletion

12 Land (net of any amortization)

13a Intangible assets (amortizable only)

( ) ( ) b Less accumulated amortization

14 Other assets (attach schedule)

15 Total assets

LIABILITIES AND STOCKHOLDERS’ EQUITY

16 Accounts payable

17 Mtges., notes, bonds payable in less than 1 year

18 Other current liabilities (attach schedule)

19 Loans from stockholders

20 Mtges., notes, bonds payable in 1 year or more

21 Other liabilities (attach schedule)

22 Capital stock: a Preferred stock

b Common stock

23 Paid-in or capital surplus

24 Retained earnings—Appropriated (attach schedule)

25 Retained earnings—Unappropriated ( ) ( ) 26 Less cost of treasury stock

27 Total liabilities and stockholders’ equity

Reconciliation of Income or (Loss) per Books With Income per Return (You are not required to

complete this schedule if the total assets (line 15, column (d), above) are less than $25,000.)

1 Net income (loss) per books Income recorded on books this year

not included on this return (itemize):

7

2 Federal income tax

3 Excess of capital losses over capital gains a Tax-exempt interest $

Income subject to tax not recorded on

books this year (itemize):

4

8 Deductions on this return not charged

against book income this year (itemize):

Expenses recorded on books this year

not deducted on this return (itemize):

5 a Depreciation

b

a

Contributions carryover

Depreciation

b Contributions carryover $

c Travel and entertainment $

9 Add lines 7 and 8

Income (line 29, page 3)—line 6 less 

line 9

10

6 Add lines 1 through 5

Analysis of Unappropriated Retained Earnings per Books (line 25 above) (You are not required

to complete this schedule if the total assets (line 15, column (d), above) are less than $25,000.)

1 Balance at beginning of year 5 Distributions: a Cash

2 Net income (loss) per books b Stock

3 Other increases (itemize): c Property

6 Other decreases (itemize):

7 Add lines 5a through 6

4 Add lines 1, 2, and 3 8 Balance at end of year (line 4 less line 7)

Form 1120F (1992) Page 6

Schedule M-2

Schedule M-1

Schedule L

$

$

$

(