SCHEDULE M 

(Form 5471) 

(Rev. December 2012)

Department of the Treasury

Internal Revenue Service

Transactions Between Controlled Foreign Corporation 

and Shareholders or Other Related Persons

▶ Information about Schedule M (Form 5471) and its instructions is at www.irs.gov/form5471.

▶ Attach to Form 5471. 

OMB No. 1545-0704

Name of person filing Form 5471 Identifying number

Name of foreign corporation EIN (if any) Reference ID number (see instructions)

Important: Complete a separate Schedule M for each controlled foreign corporation. Enter the totals for each type of transaction that occurred during

the annual accounting period between the foreign corporation and the persons listed in columns (b) through (f). All amounts must be stated in U.S.

dollars translated from functional currency at the average exchange rate for the foreign corporation’s tax year. See instructions.

Enter the relevant functional currency and the exchange rate used throughout this schedule ▶

 (a) Transactions 

of 

 foreign corporation

(b) U.S. person

filing this return

(c) Any domestic

corporation or partnership controlled

by U.S. person filing this return

(d) Any other foreign corporation or partnership controlled

by U.S. person filing this return

(e) 10% or more U.S.

shareholder of

controlled foreign corporation (other than the U.S. person filing this return)

(f) 10% or more U.S.

shareholder of any corporation

controlling the foreign corporation

1 Sales of stock in trade (inventory) . . .

2 Sales of tangible property other than stock 

in trade . . . . . . . . . .

3 Sales of property rights (patents, 

trademarks, etc.) . . . . . . . .

4 Platform contribution transaction payments 

received . . . . . . . . . .

5 Cost sharing transaction payments 

received . . . . . . . . . .

6 Compensation received for technical, 

managerial, engineering, construction, or 

like services . . . . . . . . .

7 Commissions received . . . . . .

8 Rents, royalties, and license fees received 

9 Dividends received (exclude deemed 

distributions under subpart F and 

distributions of previously taxed income) 

10 Interest received . . . . . . . .

11 Premiums received for insurance or 

reinsurance . . . . . . . . .

12 Add lines 1 through 11 . . . . . .

13 Purchases of stock in trade (inventory) .

14 Purchases of tangible property other than 

stock in trade . . . . . . . . .

15 Purchases of property rights (patents, 

trademarks, etc.) . . . . . . . .

16 Platform contribution transaction payments 

paid . . . . . . . . . . .

17 Cost sharing transaction payments paid .

18 Compensation paid for technical, 

managerial, engineering, construction, or 

like services . . . . . . . . .

19 Commissions paid . . . . . . .

20 Rents, royalties, and license fees paid .

21 Dividends paid . . . . . . . .

22 Interest paid . . . . . . . . .

23 Premiums paid for insurance or reinsurance

24 Add lines 13 through 23. . . . . .

25 Amounts borrowed (enter the maximum 

loan balance during the year) — see 

instructions . . . . . . . . .

26 Amounts loaned (enter the maximum loan 

balance during the year) — see instructions

For Paperwork Reduction Act Notice, see the Instructions for Form 5471. Cat. No. 49963O Schedule M (Form 5471) (Rev. 12-2012)