Information Return of a 25% Foreign-Owned U.S. Corporation

or a Foreign Corporation Engaged in a U.S. Trade or Business

(Under Sections 6038A and 6038C of the Internal Revenue Code)

Form 5472

OMB No. 1545-0805

Expires 10-31-94 (Rev. July 1993)

Department of the Treasury

Internal Revenue Service

For tax year of the reporting corporation beginning , 19 , and ending , 19 

Reporting Corporation (See instructions.)

1a Name of reporting corporation 1b Employer identification number

Number, street, and room or suite no. (if a P.O. box, see instructions) 1c Total assets

$

City, state or province, ZIP or postal code, and country

Total number of Forms 5472

filed for the tax year

1d Principal business activity

Total value of gross payments made or received 1f

(see instructions)

1e

25% Foreign Shareholder (See instructions.)

1a Name and address of direct 25% foreign shareholder

1c Principal country(ies) where

business is conducted

1b

1d Country of citizenship,

organization, or incorporation

1e Country(ies) under whose laws the direct 25% foreign

shareholder files an income tax return as a resident

Related Party

1a Name and address of related party

1d Relationship—Check boxes that apply: Related to reporting corporation Related to 25% foreign shareholder 25% foreign shareholder

1e Principal country(ies) where business is conducted Country(ies) under whose laws the related party files an income tax return as

a resident

1f

Part I

Part II

Part III

$

U.S. identifying number, if any

1b

1c Principal business activity

Cat. No. 49987Y Form 5472 (Rev. 7-93)

2a Name and address of direct 25% foreign shareholder

2c Principal country(ies) where

business is conducted

2b

2d Country of citizenship,

organization, or incorporation

2e Country(ies) under whose laws the direct 25% foreign

shareholder files an income tax return as a resident

U.S. identifying number, if any

U.S. identifying number, if any

For Paperwork Reduction Act Notice, see page 2.

1h Country of incorporation 1j Principal country(ies) where

business is conducted

1i Country(ies) under whose laws the reporting corporation files

an income tax return as a resident

3a Name and address of ultimate indirect 25% foreign shareholder

3c Principal country(ies) where

business is conducted

3b

3d Country of citizenship,

organization, or incorporation

3e Country(ies) under whose laws the ultimate indirect 25%

foreign shareholder files an income tax return as a resident

U.S. identifying number, if any

4a Name and address of ultimate indirect 25% foreign shareholder

4c Principal country(ies) where

business is conducted

4b

4d Country of citizenship,

organization, or incorporation

4e Country(ies) under whose laws the ultimate indirect 25%

foreign shareholder files an income tax return as a resident

U.S. identifying number, if any

1g Check here

if this is a

consolidated filing

of Form 5472 ©

Note: Enter all information in the English language. Show money items in U.S. dollars.

Check applicable box: Is the related party a © foreign person or © U.S. person?

All reporting corporations must complete this question and the rest of Part III.
Form 5472 (Rev. 7-93) Page 2

Describe All Nonmonetary and Less-Than-Full Consideration Transactions Between the Reporting

Corporation and the Foreign Related Party

Additional Information

1 Does the reporting corporation import goods from a foreign related party? Yes No

If “Yes,” is the basis or inventory costs of the goods valued at greater than the customs value of the imported goods? Yes No

If “No,” do not complete the rest of Part VI.

2a

b If “Yes,” attach a statement explaining the reason or reasons for such difference.

c If the answers to questions 1 and 2a are “Yes,” were the documents used to support this treatment of the imported

goods in existence and available in the United States at the time of filing Form 5472? Yes No

Part VI

Part V

General Instructions

(References are to the Internal Revenue

Code unless otherwise noted.)

Paperwork Reduction Act Notice.—We

ask for the information on this form to

carry out the Internal Revenue laws of the

United States. You are required to give us

the information. We need it to ensure that

you are complying with these laws and to

allow us to figure and collect the right

amount of tax.

The time needed to complete and file

this form will vary depending on individual

circumstances. The estimated average time

is:

Recordkeeping 17 hr., 13 min.

Learning about the law

or the form 1 hr., 41 min.

Preparing and sending

the form to the IRS 2 hr., 3 min.

If you have comments concerning the

accuracy of these time estimates or

suggestions for making this form more

simple, we would be happy to hear from

you. You can write to both the Internal

Revenue Service and the Office of

Management and Budget at the addresses

Monetary Transactions Between Reporting Corporations and Foreign Related Party

If reasonable estimates are used, check here © . (See instructions.)

1 Sales of stock in trade (inventory) 1

2 Sales of tangible property other than stock in trade 2

3 Rents and royalties received (for other than intangible property rights) 3

4 Sales, leases, licenses, etc., of intangible property rights (e.g., patents, trademarks, secret formulas) 4

5 Consideration received for technical, managerial, engineering, construction, scientific, or like services 5

6 Commissions received 6

7 Amounts borrowed (see instructions) a Beginning balance b Ending balance or monthly average © 7b

8 Interest received 8

9 Premiums received for insurance or reinsurance 9

10 Other amounts received (see instructions) 10

11 Total. Combine amounts on lines 1 through 10 11

12 Purchases of stock in trade (inventory) 12

13 Purchases of tangible property other than stock in trade 13

14 Rents and royalties paid (for other than intangible property rights) 14

15 Purchases, leases, licenses, etc., of intangible property rights (e.g., patents, trademarks, secret formulas) 15

16 Consideration paid for technical, managerial, engineering, construction, scientific, or like services 16

17 Commissions paid 17

18 Amounts loaned (see instructions) a Beginning balance b Ending balance or monthly average © 18b

19 Interest paid 19

20 Premiums paid for insurance or reinsurance 20

21 Other amounts paid (see instructions) 21

22 Total. Combine amounts on lines 12 through 21 22

Part IV

Purpose of form.—Use Form 5472 to

provide information required under

sections 6038A and 6038C whenever

transactions occur between a reporting

corporation and a foreign or domestic

related party.

Who must file.—Generally, a reporting

corporation must file Form 5472 if it had a

reportable transaction with a foreign or

domestic related party. For the meaning of

reporting corporation, reportable

transaction, and related party, see

“Definitions” on page 3.

Exceptions to filing.—A reporting

corporation is not required to file Form

5472 if:

1. It had no reportable transactions of

the types listed in Parts IV and V of the

form.

4. It is a foreign corporation that does

not have a permanent establishment in the

United States under an applicable income

tax treaty and timely files the notice

required under section 6114.

5. It is a foreign corporation all of whose

gross income is exempt from taxation

under section 883 and it timely and fully

complies with the reporting requirements

of sections 883 and 887.

6. Both the reporting corporation and the

related party are not U.S. persons as

defined in section 7701(a)(30) and the

transactions will not generate in any tax

year gross income from sources within the

United States or income effectively

connected, or treated as effectively

connected, with the conduct of a trade or

business within the United States, and will

(Attach separate sheet and check here © .) (See instructions.)

All reporting corporations must complete Part VI.

2. A U.S. person that controls the foreign

related corporation files Form 5471,

Information Return of U.S. Persons With

Respect To Certain Foreign Corporations,

for the tax year to report information under

section 6038. To qualify for this exception,

Form 5471 must contain information

3. The related corporation qualifies as a

foreign sales corporation for the tax year

and files Form 1120-FSC, U.S. Income

Tax Return of a Foreign Sales Corporation.

listed in the instructions for the tax return

with which this form is filed.

required by Regulations section

1.6038-2(f)(11) concerning the reportable

transactions between the reporting

corporation and the related party for the

tax year.
Form 5472 (Rev. 7-93) Page 3

Each member of a group of corporations

filing a consolidated information return is a

separate reporting corporation subject to a

separate $10,000 penalty and each

member is jointly and severally liable.

Criminal penalties under sections 7203,

7206, and 7207 may also apply for failure

to submit information or for filing false or

fraudulent information.

Specific Instructions

Part I

Penalties

Penalties for failure to file Form 5472.—

A penalty of $10,000 will be assessed on

any reporting corporation that fails to file

Form 5472 when due and in the manner

prescribed. The penalty also applies for

failure to maintain records as required by

Regulations section 1.6038A-3.

If the failure continues for more than 90

days after notification by the IRS, an

additional penalty of $10,000 will apply

with respect to each related party for

which a failure occurs for each 30-day

period (or part of a 30-day period) during

which the failure continues after the

90-day period ends.

Foreign person.—The term “foreign

person” means an individual who is not a

citizen or resident of the United States; an

individual who is a citizen of a United

States possession who is not otherwise a

United States citizen or resident; any

partnership, association, company, or

corporation that is not created or

organized in the United States; any foreign

estate or foreign trust described in section

7701(a)(31); or any foreign government (or

agency or instrumentality thereof) to the

extent that a foreign government is

engaged in the conduct of a commercial

activity as defined under section 892. The

term does not, however, include any

foreign person who consents to file a joint

income tax return.

Definitions

Reporting corporation.—A reporting

corporation is a 25% foreign-owned

domestic corporation or a foreign

corporation engaged in a trade or business

within the United States.

25% foreign-owned.—A corporation is

25% foreign-owned if it has at least one

direct or indirect 25% foreign shareholder

at any time during the tax year.

25% foreign shareholder.—Generally, a

foreign person is a 25% foreign

shareholder if the person owns directly or

indirectly at least 25% of: (a) the total

voting power of all classes of stock of the

corporation entitled to vote, or (b) the total

value of all classes of stock of the

corporation.

When determining if a corporation is

25% foreign-owned, the constructive

ownership rules of section 318 apply with

certain modifications. Substitute “10%” for

“50%” in section 318(a)(2)(C). Do not apply

sections 318(a)(3)(A), (B), and (C) so as to

consider a U.S. person as owning stock

that is owned by a foreign person.

Related party.—The term “related party”

means (1) any direct or indirect 25%

foreign shareholder of the reporting

corporation, (2) any person who is related

(within the meaning of sections 267(b) or

707(b)(1)) to the reporting corporation,

(3) any person who is related (within the

meaning of sections 267(b) or 707(b)) to a

25% foreign shareholder of the reporting

corporation, or (4) any other person who is

related to the reporting corporation within

the meaning of section 482 and the related

regulations.

The term related party does not include

any corporation filing a consolidated

Federal income tax return with the

reporting corporation.

Reportable transaction.—A reportable

transaction is any type of transaction listed

in Part IV of the form (for example, sales,

rents, etc.), for which monetary

consideration (including U.S. and foreign

currency) was the sole consideration paid

or received during the tax year of the

reporting corporation or any transaction or

group of transactions listed in Part IV of

the form, if any part of the consideration

paid or received was not monetary

consideration or if less than full

consideration was paid or received.

Transactions with a U.S. related party,

however, are not required to be specifically

identified and valued in Parts IV and V.

Direct 25% foreign shareholder.—A

foreign person is a direct 25% foreign

shareholder if it owns directly at least 25%

of the stock of the reporting corporation by

vote or by value.

Ultimate indirect 25% foreign

shareholder.—An ultimate indirect 25%

foreign shareholder is a 25% foreign

shareholder whose ownership of stock of

the reporting corporation is not attributed

(under the principles of section 958(a)(1)

and (2)) to any other 25% foreign

shareholder. See Rev. Proc. 91-55, 1991-2

C.B. 784.

Record maintenance requirements.—A

reporting corporation must keep the

permanent books of accounts or records

as required by section 6001 that are

sufficient to establish the correctness of

the Federal income tax return of the

reporting corporation including information

or records that might be relevant to

determine the correct treatment of

transactions with related parties. See

Regulations section 1.6038A-3 for more

detailed information. Also see Regulations

section 1.6038A-1(h) and (i) for special

rules that apply to small corporations and

reporting corporations with related party

transactions of de minimis value.

Line 1a—Address.—Include the suite,

room, or other unit number after the street

address. If the Post Office does not deliver

mail to the street address and the

corporation has a P.O. box, show the P.O.

box number instead of the street address.

Line 1d—Principal business activity.—

See the instructions for Form 1120 or Form

1120-F for a list of principal business

activities.

The rules contained in section 318 apply

to the definition of “related party” with the

modifications listed under the definition of

“25% foreign shareholder,” above.

Note: A member is not required to join in

filing a consolidated Form 5472 just

because the other members of the group

choose to file one or more Forms 5472 on

a consolidated basis.

When and where to file.—File Form 5472

by the due date of the reporting

corporation’s income tax return (including

extensions). A separate Form 5472 must

be filed for each foreign or domestic

related party with which the reporting

corporation had a reportable transaction

during the tax year. Attach Form 5472 to

the income tax return and file a copy of

Form 5472 with the Internal Revenue

Service Center, Philadelphia, PA 19255. If

the reporting corporation’s income tax

return is not filed when due, file a timely

Form 5472 (with a copy to Philadelphia)

separately with the service center where

the tax return is due. When the tax return

is filed, attach a copy of the previously

filed Form 5472.

Line 1c—Total assets.—Domestic

reporting corporations enter the total

assets from item D, page 1, Form 1120.

Foreign reporting corporations enter the

amount from line 15, column (d),

Schedule L, Form 1120-F.

Note: Only reporting corporations that

engage in reportable transactions during

the tax year must file Form 5472.

Note: Filing a substantially incomplete

Form 5472 constitutes a failure to file Form

5472.

All filers must complete Part I.

Consolidated returns.—If a reporting

corporation is a member of an affiliated

group filing a consolidated income tax

return, Regulations section 1.6038A-2 may

be satisfied by filing a U.S. consolidated

Form 5472. The common parent must

attach to Form 5472, a schedule stating

which members of the U.S. affiliated group

are reporting corporations under section

6038A and which of those members are

joining in the consolidated filing of Form

5472. The schedule must show the name,

address, and employer identification

number of each member who is including

transactions on the consolidated Form

5472.

not generate in any tax year any expense,

loss, or other deduction that is allocable or

apportionable to such income.
Form 5472 (Rev. 7-93) Page 4

Reasonable estimates.—When actual

amounts are not determinable, enter

reasonable estimates (see below) of the

total dollar amount of each of the

categories of transactions conducted

between the reporting corporation and the

related person in which monetary

consideration (U.S. currency or foreign

currency) was the sole consideration paid

or received during the tax year of the

reporting corporation.

A reasonable estimate is any amount

reported on Form 5472 that is at least

75% but not more than 125% of the actual

amount required to be reported.

Small amounts.—If any actual amount in a

transaction or a series of transactions

between a foreign related party and the

reporting corporation does not exceed a

total of $50,000, the amount may be

reported as “$50,000 or less.”

Part V

Part II

Part IV

Generally, all reportable transactions

between the reporting corporation and a

related foreign party must be entered on

Part IV.

When completing Part IV or Part V, the

terms “paid” and “received” include

accrued payments and accrued receipts.

State all amounts in U.S. dollars and

attach a schedule showing the exchange

rates used.

If the related party is a foreign person,

the reporting corporation must attach a

schedule describing each reportable

transaction, or group of reportable

transactions, listed in Part IV of the form.

The description must include sufficient

information so that the nature and

approximate monetary value of the

transaction or group of transactions can be

determined. The schedule should include:

1. A description of all property (including

monetary consideration), rights, or

obligations transferred from the reporting

corporation to the foreign related party and

from the foreign related party to the

reporting corporation;

2. A description of all services performed

by the reporting corporation for the foreign

related party and by the foreign related

party for the reporting corporation; and

3. A reasonable estimate of the fair

market value of all properties and services

exchanged, if possible, or some other

reasonable indicator of value.

If the entire consideration received for

any transaction includes both tangible and

intangible property and the consideration

paid is solely monetary consideration,

report the transaction in Part IV instead of

Part V if the intangible property was related

and incidental to the transfer of the

tangible property (for example, a right to

warranty services).

See the instructions for Part IV above for

information on reasonable estimates and

small amounts.

If the related party transactions occur

between a related party and a partnership

that is, in whole or in part, owned by a

reporting corporation, the reporting

corporation reports only the percentage of

the value of the transaction(s) equal to the

percentage of its partnership interest. This

rule does not apply if the reporting

corporation owns a less-than-25% interest

in the partnership. The rules of attribution

apply when determining the reporting

corporation’s percentage of partnership

interest.

Line 7—Amounts borrowed.—Report

amounts borrowed using either the

outstanding balance method or the

monthly average method. If the

outstanding balance method is used, enter

the beginning and ending outstanding

balance for the tax year on lines 7a and

7b. If the monthly average method is used,

skip line 7a and enter the monthly average

for the tax year on line 7b.

Line 10—Other amounts received.—Enter

on line 10 amounts received that are not

specifically reported in lines 1 though 9.

Include amounts in line 10 to the extent

that these amounts are taken into account

in determining the taxable income of the

reporting corporation.

Line 18—Amounts loaned.—Report

amounts loaned using either the

outstanding balance method or the

monthly average method. If the

outstanding balance method is used, enter

the beginning and ending outstanding

balance for the tax year on lines 18a and

18b. If the monthly average method is

used, skip line 18a and enter the monthly

average for the tax year on line 18b.

Line 21—Other amounts paid.—Enter on

line 21 amounts paid that are not

specifically reported on lines 12 through

20. Include amounts in line 21 to the

extent that these amounts are taken into

account in determining the taxable income

of the reporting corporation.

Do not complete Part IV if the reportable

transactions are with a domestic related

party.

Only 25% foreign-owned U.S. corporations

complete Part II.

The form provides sufficient space to

report information on two direct 25%

foreign shareholders and two ultimate

indirect 25% foreign shareholders. If there

are more than two direct foreign

shareholders or more than two ultimate

indirect 25% foreign shareholders, show

the information called for in Part II on an

attached sheet.

Report in lines 1a through 1e information

about the direct 25% foreign shareholder

who owns (by vote or value) the largest

percentage of the stock of the U.S.

reporting corporation.

Report in lines 2a through 2e information

about the direct 25% foreign shareholder

who owns (by vote or value) the

second-largest percentage of the stock of

the U.S. reporting corporation.

Report in lines 3a through 3e information

about the ultimate indirect 25% foreign

shareholder who owns (by vote or value)

the largest percentage of the stock of the

U.S. reporting corporation.

Report in lines 4a through 4e information

about the ultimate indirect 25% foreign

shareholder who owns (by vote or value)

the second-largest percentage of the stock

of the U.S. reporting corporation.

Lines 3a through 3e and lines 4a

through 4e.—Attach an explanation of the

attribution of ownership. See Rev. Proc.

91-55 and Regulations section

1.6038A-1(e).

Part III

All filers (foreign and domestic) must

complete Part III, even if the related party

has been identified in Part II as a 25%

foreign shareholder. Report in Part III

information about the related party with

which the reporting corporation had

reportable transactions during the tax year.

Line 1j.—Provide the principal country(ies)

where business is conducted. Do not

include a country(ies) in which business is

conducted solely through a subsidiary. Do

not enter “Worldwide” instead of listing the

country(ies). These rules also apply to lines

2c, 3c, 4c, Part II, and line 1e, Part III.

Line 1f.—File a separate Form 5472 for

each foreign or each U.S. person who is a

related party with which the reporting

corporation had a reportable transaction.

Enter the total number of Forms 5472

(including this one) being filed for the tax

year.

Do not attach the information required by

Part V if the reportable transactions are

with a domestic related party.

Line 1e—Total value of gross payments

made or received.—Enter on line 1e the

total value in U.S. dollars of all foreign

related party transactions reported in

Part IV and Part V of this Form 5472. This

is the total of the amounts entered on lines

11 and 22 of Part IV plus the fair market

value of the nonmonetary and less-than-full

consideration transactions reported in

Part V. Do not complete line 1e if the

reportable transaction is with a U.S. related

party.