Form 5471 (Rev. 1-86)
Sauces Reconciliation of Book Profits to Earnings and Profits. Do not complete this schedule if total assets

Page 4

(Schedule F, line 13, column (b)) are less than $25,000.

Earnings and profits are determined under: [_] Section 902 LJ Section 964(a)

1

2

Auaw

N

8
9

Profit or (loss) for the year per books of account (before reduction for any income, war profits, and excess
profitstaxes). . . . . ray 1

Net adjustments to book profit in | determining earnings and Net additions
Profits for U.S. tax purposes (see instructions):

Capital gains or losses

Depreciation

Depletion

Investment or incentive allowance

Charges to statutory reserves .

Inventory valuation adjustments .

Other (attach schedule—exclude income, war profits, and
excess profits taxes) .

Total net additions .

Total net subtractions . re rn
Line 1 plus line 3lessline4 . . 5

Net subtractions

masxeanoce

Unrealized exchange gain or (loss) under section 964(a) (omit ite earnings and, profits are not computed under
section964(a)). . . . . 6

Earnings and profits for the year “(betore re reduction for any income, war ar profits, and excess profits taxes) (add
lines5and6) Lo 2. LZ

Income, war profits, and excess profits ‘taxes paid or accrued (from line 5, column (), Schedule 6) .. . LS

Earnings and profits (subtract line 8 fromline7)_. . . 9

Saicicas Analysis of Unappropriated Retained Earnings. Do not “complete this schedule if total assets (Schedule

F, line 13, column (b)) are less than $25,000.

opwne

AUaAWNH FOO nD

ilies Summary of Subpart F Income (see worksheets contained i in the instructions)

Balance at beginning of annual accounting period .

Net income per books .

Other increases (itemize) >

lw!)

Total (add lines 1 through 3) .

Distributions out of earnings and profits:
a Paid during first 60 days of annual accounting period eee LSA
b Paid during remainder of annual accounting period .

© AddlinesSaand5b. 2. le fee ee. [BE

Other distributions (itemize) >.

Other decreases (itemize) >.

Total (add lines 5c through 7)

Balance at end of annual accounting period (subtract line 8 from line 4)"

Subpart F income (Line 17, Worksheet A).

Increase in earnings invested in United States property (Line 14, Worksheet Oy

Previously excluded subpart F income withdrawn from qualified investments (Line 6, Worksheet D).

Factoring income (see instructions)

1

2

3

Previously excluded export trade income withdrawn from investment in export trade assets (Line 7, Worksheet F) . 4
oe 5

6

Total of lines 1 through 5 (Enter here and on your in income tax return. )

Secaae Accumulated Earnings and Profits Since 1962

Was the income of the foreign corporation blocked (see section 964(b))?

_ Yes[_] No[ ]

Earnings and Profits Taxed
Total Earnings Under Subpart F Other Earnings
and Profits Investment in Oth and Profits
USS. Property er
1 Balance at beginning of year
2 Current year earnings and profits
3 Actual distributions in current year
4 Balance at end of year
aitriigm@ Persons with Whom, or on Whose Behalf, this Return is Filed (d) Check applicable box(es)
(a) Name (b) Address (c) Identifying number [Shareholder] Officer | Director

# USGP.O: 1986 -491-473/20070


rom D471

(Rev, January 1986)

Information Return with Respect toa

Foreign Corporation

OMB No. 1545-0704
Expires 11-30-88

Department of the Treasury Information furnished for the foreign corporation's annual To Be Filed
Internal Revenue Service accounting period beginning 19 and ending jg. In Duplicate
Name and address of person filing this return Identifying number

Filer's tax year beginning and ending 19

Important: Fill in all applicable lines and ‘sections. All information must be in the English language AND all amounts must be
stated in U.S. dollars unless otherwise indicated.

la Name of foreign corporation and address where books and records are located

b Employer identification number, if any

¢ Country under whose laws incorporated

‘d Were any of the corporation's accounting/tax records maintained on a computerized system?

UO Yes

{_No

e Date of Incorporation

f Principal country in which business
1s conducted

g Business code number

h Principal business activity

2 Provide the following information for the above-stated accounting period of the foreign corporation

Name, address, and identifying number of

branch or agent in U.S. (if any)

If U.S. income tax returns were filed, please indicate:

If the foreign corporation joined in filing a
consolidated return, name of corporation filing
the consolidated return

Amount of U.S.
income tax paid
(after all credits)

Taxable income or
(loss)

Schedule A

Stock of the Foreign Corporation

(a) Description of each class of stock

(b) Beginning of annual accounting period

(c) End of annual accounting period

Number of shares

Number of shares

(1) Issued (2) Outstanding

(1) Issued (2) Outstanding

Sirians) U.S. Shareholders of Foreign Corporation

(c) Number of shares of outstanding stock held at

(a) Name, address, and
identifying number of
shareholder

(d) Pro rata share

Beginning of annual accounting period | _ End of annual iting period
() Glass ginning of annual accounting perio accounting p (2) Bro rata share
q@ (2) | @)Con- (4) () (6) Con- income
Directly Indirectly | structively | Directly Indirectly | structively

Total percentage of voting stock of the e foreign corporation 0 owned iby ‘you at the end of the annual accounting period of

the foreign corporation

%

For Paperwork Reduction Act Notice, see page 1 of the instructions.

Form 5471 (Rev. 1-86)


Form 5471 (Rev. 1-86)

Page 2

Siicgey Earnings and Profits

1 Net sales (gross receipts less returns and allowances):

a Unrelated customers la

b Related customers Jb

c Addlines laand 1b .
2 Cost of goods sold and/or operations (line 7, Schedule b)
3 Gross profit (subtract line 2 from line 1c)
4 Dividends
5 Interest . .
6 Gross rents, royalties, ‘and license fees
7 Net gain or (loss) on sale of capital assets
| 8 Other income (attach schedule)

Income

9 Total income (add lines 3 through 8) .

10 Compensation not deducted elsewhere

11 Rents, royalties, and license fees .

12 Interest. .

13 Depreciation not deducted elsewhere

14 Depletion

15 Taxes (exclude income, 2, war profits, ande excess profits taxes) .

16 Other deductions (attach schedule—exclude income, war profits, ande excess profits taxes)

Deductions

17 Total deductions (add lines 10 through 16).

18 Earnings and profits (before reduction for any income, war profits, or excess profits taxes):
a Subtractline17fromlineQ . . . .. . , [18a

b Unrealized exchange gain or (loss) under section 964(a). (Omit if
earnings and profits are not computed under section 964(a).)

18b

¢ Combine lines 18a and 18b
19 Income, war profits, and excess profits taxes paid ¢ oraccrued (from line 5, column (d), Schedule £)

Earnings
and Profits

20 Earnings and profits (subtract line 19 from line 18c) .

18¢ |

19

-

20

Succes ~4Cost of Goods Sold and/or Operations

1 Beginning inventory .
2 Merchandise bought for manufacture or sale:
2a

a From unrelated suppliers . Co . aE
b  Fromrelated suppliers . 2b

¢ Add lines 2a and 2b
3 Wages and salaries
4 Other costs (attach schedule)

5 Total (add lines 1 through 4)
6 Ending inventory

7 Cost of goods sold and/or operations (subtract line 6 from line 5). Enter here and on line 2, Schedule C
a_ ifyou are engaged in manufacturing, did you value your inventory using the full

absorption method (Regulations section 1471-11? . . . . Ul Yes 0 No

[ Schedule E | Income, War Profits, and Excess Profits Taxes Paid or Accrued

Amount of tax

(a)

(b) (©)

Nami r) .S. i
lame of country or U.S. possession In foreign currency Conversion rate

(d)

In U.S. dollars

US

=

Blwin je

5 Total. Enter here and on line 19, Schedule C



Form 5471 (Rev. 1-86)

Page 3

Balance Sheets

(a)

(b)

Assets

1 Cash
Trade notes and accounts receivable
a Less allowance for bad debts
Inventories .
Other current assets (attach schedule). soe .
Loans to stockholders and other related persons (complete Schedule 6, line 1)
Investment in subsidiaries (attach schedule) .
Buildings and structures .
a Less accumulated depreciation
8 Other fixed depreciable assets
a Less accumulated depreciation
9 Depletable assets
a Less accumulated depletion
10 Land (net of any amortization)
11 Intangible assets: a Goodwill
b Organization costs .
c Patents, trademarks, and other intangible assets,
d_ Less accumulated amortization for lines lla, b,andc .
12 Other assets (attach schedule)

N

Nauaw

13 Total assets

Beginning of

annual accounting

period |

End of annual
accounting
period

Liabilities and Stockholder's Equity

14 Accounts payable
15 Other current liabilities (attach schedule) .
16 Loans from stockholders and other related persons (complete Schedule 6, line 2)
17 Other liabilities (attach schedule)
18 Capital stock: a Preferred stock

b Common stock
19 Paid-in or capital surplus (attach reconciliation)
20 Retained earnings: a Appropriated

b  Unappropriated
21 Less cost of treasury stock

22 Total liabilities and stockholders’ equity.

SUR ~Loans to and from Shareholders and Other Related Persons

Complete the following summary showing the total amount of outstanding balances at the beginning and end of the foreign corporation's
annual accounting period represented by indebtedness and loans of the foreign corporation (column (a)) to persons described in columns
(b) through (f). Exclude open accounts which arise and are collected in full during the ordinary course of business.

(a) (b) (c)
- Any domestic
Outstanding balances of foreign us fi ‘corporation
corporation person fling | controfed by US
person filing this,
return

(da)

Any foreign
corporation
controlled by U.S.
person filing this
return

(e)

10% or more U.S.
shareholder of
controlled foreign
corporation (other
than controlling
shareholder)

(f)

10% or more U.S.
shareholder of
domestic
corporation filing
this return

1 Loans to persons described in columns (b)
through (f):
a At beginning of foreign corporation's an-
nual accounting period

b At end of foreign corporation's annual ac-
counting period

2 Loans from persons described in columns 0)
through (f):
a At beginning of foreign corporation's an-
nual accounting period

b At end of foreign corporation's annual
accounting period . .