Schedule K-3 

(Form 1120-S) 

2021

Shareholder’s Share of Income, Deductions, 

Credits, etc.—International

Department of the Treasury 

Internal Revenue Service 

OMB No. 1545-0123 

For calendar year 2021, or tax year beginning / / 2021 , ending / / 

▶ See separate instructions. 

Final K-3 Amended K-3 

Information About the Corporation 

A Corporation’s employer identification number (EIN)

B Corporation’s name, address, city, state, and ZIP code 

Information About the Shareholder

C Shareholder’s identifying number 

D Shareholder’s name, address, city, state, and ZIP code 

E Check to indicate the parts of Schedule K-3 that apply. Yes No

1 Does Part I apply? If “Yes,” complete and attach Part I . . . . . . . . . . . . . . . . . . . 1

2 Does Part II apply? If “Yes,” complete and attach Part II . . . . . . . . . . . . . . . . . . 2

3 Does Part III apply? If “Yes,” complete and attach Part III . . . . . . . . . . . . . . . . . . 3

4 Does Part IV apply? If “Yes,” complete and attach Part IV . . . . . . . . . . . . . . . . . . 4

5 Does Part V apply? If “Yes,” complete and attach Part V . . . . . . . . . . . . . . . . . . 5

6 Does Part VI apply? If “Yes,” complete and attach Part VI . . . . . . . . . . . . . . . . . . 6

7 Does Part VII apply? If “Yes,” complete and attach Part VII . . . . . . . . . . . . . . . . . 7

For IRS Use Only 

For Paperwork Reduction Act Notice, see the Instructions for Form 1120-S. www.irs.gov/Form1120S Cat. No. 74747C Schedule K-3 (Form 1120-S) 2021 
Schedule K-3 (Form 1120-S) 2021 Page 2 

Corporation’s name EIN Shareholder’s name Shareholder’s identifying number

Part I Shareholder’s Share of Corporation’s Other Current Year International Information

Check box(es) for additional specified attachments. See instructions.

1. Gain on personal property sale

2. Foreign oil and gas taxes

3. Splitter arrangements

4. Foreign tax translation

5. High-taxed income

6. Section 267A disallowed deduction

7. Form 8858 information

8. Form 5471 information

9. Other forms

10. Shareholder loan transactions

11. Entity treatment for certain S corporations

12. Other international items 

(attach description and statement)

Part II Foreign Tax Credit Limitation

Section 1—Gross Income

Description (a) U.S. source

Foreign Source (f) Sourced by 

shareholder (g) Total (b) Foreign branch 

category income

(c) Passive 

category income

(d) General 

category income

(e) Other 

(category code ) 

1 Sales

A

B

C

2 Gross income from performance of services

A

B

C

3 Gross rental real estate income

A

B

C

4 Other gross rental income

A

B

C

5 Reserved for future use . . . . .

6 Interest income

A

B

C

7 Ordinary dividends (exclude amount 

on line 8)

A

B

C

Schedule K-3 (Form 1120-S) 2021
Schedule K-3 (Form 1120-S) 2021 Page 3 

Corporation’s name EIN Shareholder’s name Shareholder’s identifying number

Part II Foreign Tax Credit Limitation (continued)

Section 1—Gross Income (continued)

Description (a) U.S. source

Foreign Source (f) Sourced by 

shareholder (g) Total (b) Foreign branch 

category income

(c) Passive 

category income

(d) General 

category income

(e) Other 

(category code ) 

8 Qualified dividends

A

B

C

9 Reserved for future use . . . . .

10 Royalties and license fees

A

B

C

11 Net short-term capital gain

A

B

C

12 Net long-term capital gain

A

B

C

13 Collectibles (28%) gain

A

B

C

14 Unrecaptured section 1250 gain

A

B

C

15 Net section 1231 gain

A

B

C

Schedule K-3 (Form 1120-S) 2021
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Corporation’s name EIN Shareholder’s name Shareholder’s identifying number

Part II Foreign Tax Credit Limitation (continued)

Section 1—Gross Income (continued)

Description (a) U.S. source

Foreign Source (f) Sourced by 

shareholder (g) Total (b) Foreign branch 

category income

(c) Passive 

category income

(d) General 

category income

(e) Other 

(category code ) 

16 Section 986(c) gain . . . . . .

17 Section 987 gain . . . . . . .

18 Section 988 gain . . . . . . .

19 Section 951(a) inclusions

A

B

C

20 Other income (see instructions)

A

B

C

21 Section 951A(a) inclusions (see 

instructions) . . . . . . . .

22 Reserved for future use

A

B

C

23 Reserved for future use

A

B

C

24 Total gross income (combine lines 1 

through 23) . . . . . . . ▶

A

B

C

Schedule K-3 (Form 1120-S) 2021
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Corporation’s name EIN Shareholder’s name Shareholder’s identifying number

Part II Foreign Tax Credit Limitation (continued)

Section 2—Deductions

Description (a) U.S. source

Foreign Source (f) Sourced by 

shareholder (g) Total (b) Foreign branch 

category income

(c) Passive 

category income

(d) General 

category income

(e) Other 

(category code ) 

25 Expenses allocable to sales income .

26 Expenses allocable to gross income 

from performances of services . .

27 Net short-term capital loss . . . .

28 Net long-term capital loss . . . .

29 Collectibles loss . . . . . . .

30 Net section 1231 loss . . . . .

31 Other losses . . . . . . . .

32 Research & experimental (R&E) expenses

A SIC code . . . .

B SIC code . . . .

C SIC code . . . .

33 Allocable rental expenses—

depreciation, depletion, and amortization 

34 Allocable rental expenses—other than 

depreciation, depletion, and amortization 

35 Allocable royalty and licensing 

expenses—depreciation, depletion, 

and amortization . . . . . . .

36 Allocable royalty and licensing 

expenses—other than depreciation, 

depletion, and amortization . . .

37 Depreciation not included on line 33 

or 35 . . . . . . . . . .

38 Charitable contributions . . . .

39 Interest expense specifically allocable 

under Regulations section 1.861-10(e) 

40 Other interest expense specifically 

allocable under Regulations section 

1.861-10T . . . . . . . .

41 Other interest expense—business .

42 Other interest expense—investment .

43 Other interest expense—passive activity

44 Section 59(e)(2) expenditures, 

excluding R&E expenses on line 32 .

45 Foreign taxes not creditable but 

deductible . . . . . . . .

Schedule K-3 (Form 1120-S) 2021
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Corporation’s name EIN Shareholder’s name Shareholder’s identifying number

Part II Foreign Tax Credit Limitation (continued)

Section 2—Deductions (continued)

Description (a) U.S. source

Foreign Source (f) Sourced by 

shareholder (g) Total (b) Foreign branch 

category income

(c) Passive 

category income

(d) General 

category income

(e) Other 

(category code ) 

46 Section 986(c) loss . . . . . .

47 Section 987 loss . . . . . . .

48 Section 988 loss . . . . . . .

49 Other allocable deductions (see 

instructions) . . . . . . . .

50 Other apportioned share of 

deductions (see instructions) . . .

51 Reserved for future use . . . . .

52 Reserved for future use . . . . .

53 Reserved for future use . . . . .

54 Total deductions (combine lines 25 

through 53) . . . . . . . ▶

55 Net income (loss) (subtract line 54 

from line 24) . . . . . . . ▶

Part III Other Information for Preparation of Form 1116 or 1118

Section 1—R&E Expenses Apportionment Factors

Description (a) U.S. source

Foreign Source

(f) Sourced by 

shareholder (g) Total (b) Foreign branch 

category income

(c) Passive category 

income

(d) General category 

income

(e) Other

(category code )

(country code )

 

1 Gross receipts by SIC code

A SIC code

B SIC code

C SIC code

D SIC code

E SIC code

F SIC code

2 Exclusive apportionment with respect to total R&E expenses entered on Part II, line 32. Enter the following.

A R&E expense with respect to activity performed in the United States

(i) SIC code . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ▶ 2A(i)

(ii) SIC code . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ▶ 2A(ii)

(iii) SIC code . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ▶ 2A(iii)

B R&E expense with respect to activity performed outside the United States

(i) SIC code . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ▶ 2B(i)

(ii) SIC code . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ▶ 2B(ii)

(iii) SIC code . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ▶ 2B(iii)

Schedule K-3 (Form 1120-S) 2021
Schedule K-3 (Form 1120-S) 2021 Page 7 

Corporation’s name EIN Shareholder’s name Shareholder’s identifying number

Part III Other Information for Preparation of Form 1116 or 1118 (continued)

Section 2—Interest Expense Apportionment Factors

Description (a) U.S. source

Foreign Source

(f) Sourced by 

shareholder (g) Total (b) Foreign branch 

category income

(c) Passive category 

income

(d) General category 

income

(e) Other

(category code )

(country code )

 

1 Total average value of assets . . .

2 Reserved for future use . . . . .

3 Assets attracting directly allocable 

interest expense under Regulations 

section 1.861-10(e) . . . . . .

4 Other assets attracting directly 

allocable interest expense under 

Regulations section 1.861-10T . .

5 Assets excluded from apportionment 

formula . . . . . . . . .

6a Total assets used for apportionment 

(subtract the sum of lines 3, 4, and 5 

from the sum of lines 1 and 2) . . .

b Assets attracting business interest 

expense . . . . . . . . .

c Assets attracting investment interest 

expense . . . . . . . . .

d Assets attracting passive activity 

interest expense . . . . . . .

7 Basis in stock of 10%-owned 

noncontrolled foreign corporations 

(see attachment) . . . . . . .

8 Basis in stock of CFCs (see attachment)

Schedule K-3 (Form 1120-S) 2021
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Corporation’s name EIN Shareholder’s name Shareholder’s identifying number

Part III Other Information for Preparation of Form 1116 or 1118 (continued)

Section 3—Foreign Taxes

Description (a) Type of tax (b) Section 951A category income (c) Foreign branch category income

 U.S. Foreign U.S. Foreign Shareholder

1 Direct (section 901 or 

903) foreign taxes: Paid Accrued

A

B

C

D

E

F

2 Reduction of taxes (total)

A Taxes on foreign mineral income . . . . .

B Reserved for future use . . . . . . . .

C International boycott provisions . . . . .

D Failure-to-file penalties . . . . . . . .

E Taxes with respect to splitter arrangements . .

F Taxes on foreign corporate distributions . . .

G Other . . . . . . . . . . . . .

3 Foreign tax redeterminations

A 

Related tax year ▶

Date tax paid ▶

B 

Related tax year ▶

Date tax paid ▶

C 

Related tax year ▶

Date tax paid ▶

4 Reserved for future use . . . . . . . .

5 Reserved for future use . . . . . . . .

6 Reserved for future use . . . . . . . .

Schedule K-3 (Form 1120-S) 2021
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Corporation’s name EIN Shareholder’s name Shareholder’s identifying number

Part III Other Information for Preparation of Form 1116 or 1118 (continued)

Section 3—Foreign Taxes (continued)

(d) Passive category income (e) General category income

(f) Other

(category code )

(g) Total

U.S. Foreign Shareholder U.S. Foreign Shareholder 

1

A

B

C

D

E

F

2

A

B

C

D

E

F

G

3

A

B

C

4

5

6

Schedule K-3 (Form 1120-S) 2021
Schedule K-3 (Form 1120-S) 2021 Page 10 

Corporation’s name EIN Shareholder’s name Shareholder’s identifying number

Part IV Distributions From Foreign Corporations to Corporation

(a) Name of distributing foreign corporation (b) EIN or 

reference ID number (c) Date of distribution (d) Functional currency of distributing foreign corporation

(e) Amount of distribution 

in functional currency

A

B

C

D

E

F

G

H

I

J

K

L

M

N

O

(f) Amount of E&P distribution 

in functional currency

(g) Spot rate (functional 

currency to U.S. dollars)

(h) Amount of distribution 

in U.S. dollars

(i) Amount of E&P distribution 

in U.S. dollars

(j) Qualified foreign 

corporation

(k) Reserved for 

future use

A

B

C

D

E

F

G

H

I

J

K

L

M

N

O

Schedule K-3 (Form 1120-S) 2021 
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Corporation’s name EIN Shareholder’s name Shareholder’s identifying number

Part V Information on Shareholder’s Section 951(a)(1) and Section 951A Inclusions

a Separate category (enter code) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

b If box is checked, this is completed with respect to U.S. source income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ▶

(a) Name of CFC (b) EIN or 

reference ID number

(c) Ending of CFC 

tax year

(d) Shareholder’s share 

of CFC items through 

their ownership in 

its corporation 

(“shareholder’s share”)

(e) Shareholder’s share 

of subpart F income

(f) Shareholder’s section 

951(a)(1)(B) inclusion (g) Tested income

A

B

C

D

E

F

G

H

I

J

K

1 Shareholder’s total (sum for all CFCs) . . . . . . . . . . . . . . . . . . . . . ▶

(h) Tested loss (i) Shareholder’s share 

of tested income

(j) Shareholder’s share 

of tested loss

(k) Shareholder’s share of 

Qualified Business Asset 

Investment (QBAI)

(l) Shareholder’s share of 

the tested loss 

QBAI amount

(m) Shareholder’s share of 

tested interest income

(n) Shareholder’s share of 

tested interest expense

A

B

C

D

E

F

G

H

I

J

K

1

Schedule K-3 (Form 1120-S) 2021
Schedule K-3 (Form 1120-S) 2021 Page 12 

Corporation’s name EIN Shareholder’s name Shareholder’s identifying number

Part VI Information To Complete Form 8621

Section 1—General Information on Passive Foreign Investment Company (PFIC), Qualified Electing Fund (QEF), or Qualifying Insurance Corporation (QIC)

General Information

(a) Name of PFIC (b) EIN or 

reference ID number (c) Address of PFIC (d) Beginning of PFIC tax year

(e) Ending of 

PFIC tax year

Summary of Annual Information Information Regarding Elections

(f) Description of each 

class of PFIC shares

(g) Dates PFIC 

shares acquired 

during tax year 

(if applicable)

(h) Shareholder’s share 

of total number of 

PFIC shares held by 

corporation at end of 

tax year

(i) Shareholder’s share 

of total value of 

PFIC shares held by 

corporation at end of 

tax year

(j) Election 

made by 

corporation 

(see 

instructions)

(k) Box is 

checked if 

foreign 

corporation has 

documented its 

eligibility to be 

treated as a 

qualifying 

insurance 

corporation 

under section 

1297(f)(2).

(l) Box is 

checked if PFIC 

has indicated 

its shares are 

“marketable 

stock” within 

the meaning 

of section 

1296(e).

(m) Box is 

checked if 

PFIC is also 

a controlled 

foreign 

corporation 

(CFC) within 

the meaning of 

section 957.

(n) Box is 

checked if 

PFIC meets 

the income 

test or asset 

test of section 

1297(a) for the 

tax year.

Schedule K-3 (Form 1120-S) 2021
Schedule K-3 (Form 1120-S) 2021 Page 13 

Corporation’s name EIN Shareholder’s name Shareholder’s identifying number

Part VI Information To Complete Form 8621 (continued)

Section 2—Additional Information on PFIC or QEF

General Information QEF Information Mark-to-Market Information Section 1291 and Other 

Information

(a) Name of PFIC (b) EIN or 

reference ID number

(c) Shareholder’s share 

of ordinary earnings

(d) Shareholder’s share 

of net capital gain

(e) Shareholder’s share 

of fair market value of 

PFIC shares held by 

corporation at beginning 

of tax year

(f) Shareholder’s share 

of fair market value of 

PFIC shares held by 

corporation at end of 

tax year

(g) Dates PFIC shares 

were acquired

Section 1291 and Other Information

(h) Shareholder’s share 

of amount of cash and 

fair market value of 

property distributed by 

PFIC during the current 

tax year (if applicable)

(i) Dates of 

distribution

(j) Shareholder’s share of 

total creditable foreign 

taxes attributable to 

distribution by PFIC

(k) Shareholder’s share 

of total distributions 

from PFIC in preceding 

3 tax years

(l) Dates PFIC 

shares disposed of 

during tax year 

(if applicable)

(m) Shareholder’s 

share of amount 

realized by corporation 

on disposition of 

PFIC shares

(n) Shareholder’s share 

of corporation’s tax 

basis in PFIC shares 

on dates of disposition

(o) Shareholder’s share 

of gain (loss) on 

disposition by 

corporation of PFIC 

shares

Schedule K-3 (Form 1120-S) 2021 
Schedule K-3 (Form 1120-S) 2021 Page 14 

Corporation’s name EIN Shareholder’s name Shareholder’s identifying number

Part VII Shareholder’s Share of Corporation’s Interest in Foreign Corporation Income (Section 960)

A EIN or reference ID number of controlled foreign corporation B Separate category. See instructions . . . .

C If PAS was entered on line B, applicable grouping under Regulations section 1.904-4(c). See instructions . . . . . . . . . . . . . .

D Box is checked if there is more than one source country for a line. See attachment and instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . ▶

E Box is checked if U.S. source income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ▶

F Box is checked if FORI or FOGEI . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ▶

Amounts are in functional currency unless otherwise noted. 

See instructions. (i) Country code (ii) Shareholder’s share 

of net income

(iii) Shareholder’s share of 

average asset value

(iv) Reserved for 

future use

1 Subpart F income groups

a Dividends, interest, rents, royalties, and annuities (total) . . . . . . .

(1) Unit

(2) Unit

b Net gain from certain property transactions (total) . . . . . . . . .

(1) Unit

(2) Unit

c Net gain from commodities transactions (total) . . . . . . . . . .

(1) Unit

(2) Unit

d Net foreign currency gain (total) . . . . . . . . . . . . . .

(1) Unit

(2) Unit

e Income equivalent to interest (total) . . . . . . . . . . . . .

(1) Unit

(2) Unit

f Foreign base company sales income (total) . . . . . . . . . . .

(1) Unit

(2) Unit

g Foreign base company services income (total) . . . . . . . . . .

(1) Unit

(2) Unit

h Full inclusion foreign base company income (total) . . . . . . . .

(1) Unit

(2) Unit

i Insurance income (total) . . . . . . . . . . . . . . . .

(1) Unit

(2) Unit

j International boycott income (total) . . . . . . . . . . . . .

k Bribes, kickbacks, and other payments (total) . . . . . . . . . .

l Section 901(j) (total) . . . . . . . . . . . . . . . . . .

Schedule K-3 (Form 1120-S) 2021
Schedule K-3 (Form 1120-S) 2021 Page 15 

Corporation’s name EIN Shareholder’s name Shareholder’s identifying number

Part VII Shareholder’s Share of Corporation’s Interest in Foreign Corporation Income (Section 960) (continued)

Amounts are in functional currency unless otherwise noted. 

See instructions. (i) Country code (ii) Shareholder’s share 

of net income

(iii) Shareholder’s share of 

average asset value

(iv) Reserved for 

future use

2 Recaptured subpart F income . . . . . . . . . . . . . . .

3 Tested income group (total) . . . . . . . . . . . . . . .

(1) Unit

(2) Unit

4 Residual income group (total) . . . . . . . . . . . . . . .

(1) Unit

(2) Unit

5 Total . . . . . . . . . . . . . . . . . . . . . ▶

Schedule K-3 (Form 1120-S) 2021