Form 5471 (Rev. 11-87)

Page 4

STE) Reconciliation of Book Profits to Earnings and Profits. You are not required to complete this schedule if

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

”

Profit or (loss) for the year per books of account (before reduction for any income, war profits, and excess
profitstaxes). . . 2 2. . ee

2 Net adjustments to book profit in determining earnings and Net additions Net subtractions

profits for U.S. tax purposes (see instructions): _
Capitalgainsorlosses - . 2.) ee ee ee _

Depreciation
Depletion . . . .

Investment or incentive allowance

Charges to statutory reserves .

Inventory valuation adjustments .

mroance

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

Total net additions .

Total net subtractions .

MMMM

Line 1 plus line 3 less line 4

Unrealized exchange gain or (loss) . so FT
Earnings and profits for the year (before reduction for any income, war profits, and excess profits taxes) (add
linesSand6) 6 1 we

8 Income, war profits, and excess profits taxes paid or accrued (from line 5, column (d), Schedule E)

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

Noaoaw

M

| Schedule |} Analysis of Unappropriated Retained Earnings. You are not required to complete
assets (Schedule F, line 13, column (b)) are less than $25,000.

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Balance at beginning of annual accounting period .
Net income per books .
Other increases (itemize) >
Total (add lines 1 through 3) .
Distributions out of earnings and profits
Other distributions (itemize) >
Other decreases (itemize) >

Total(addlines5through7) . . . 2... ee .
Balance at end of annual accounting period (subtract line 8 from line 4)

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

Subpart F income (line 17, Worksheet A) . Co
Increase in earnings invested in United States property (line 14,WorksheetC) . . . . . .
Previously excluded subpart F income withdrawn from qualified investments (line 6, Worksheet D)
Previously excluded export trade income withdrawn from investment in export trade assets (line 7, Worksheet F)
Factoring income (see instructions) Ce
Total of lines 1 through 5 (Enter here and on your income tax return.)

OUAWNH Pony anawne

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

_ Yes[_] Nol]

arita@ Accumulated Earnings and Profits Since 1962

Earnings and Profits Taxed
Total Earnings Under Subpart F Other Earnings
and Profits Investment in Othe and Profits

U.S. 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

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



Information Return with Respect to
Foreign Corporation

Information furnished for the foreign corporation's annual

rom 5471

(Rev. November 1987)

Department of the Treasury

a

OMB No. 1545-0704
Expires 11-30-90

To Be Filed

Internal Revenue Service accounting period beginning 19 and ending 19 In Duplicate
Name and address of person filing this return Identification number
Filer’s tax year beginning 119 _,andending 19

Important:
stated in U.S. dollars unless otherwise indicated.

Fill in all applicable lines and sections. All information must be in the English language AND all amounts must be

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

b Employer identification number, if any

¢ Country under whose laws incorporated

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

LO Yes

No

| Principal country in which business
is conducted

e Date of incorporation g Business code number

h_ Principal business activity

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

| If U.S. income tax returns were

filed, please indicate:

Name, address, and identifying number of

If the foreign corporation joined in filing a
branch or agent in U.S. (if any) havi : e

consolidated return, name of corporation filing
the consolidated return

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

Taxable income or
(loss)

Cie «© Stock of the Foreign Corporation

(b) Beginning of annual accounting period

(c) End of annual accounting period

(a) Description of each class of stock Number of shares

Number of shares

(2) Issued (2) Outstanding

(1) Issued (2) Outstanding

U. S. Shareholders of Foreign Corporation

(b) % of ownership

(¢) Number of shares of outstanding stock held at

(a) Name, address, and of corporation |” Beginning of annual accounting period

End of annual accounting period

(d) Pro rata share

identifying number of

shareholder qd) (2) (3) Con- (4)
Value of Stock | Directly | indirectly | structively | Directly

of subparts F and
(6) Con- Gincome

(5)
Indirectly | structively

Total percentage of voting stock of the e foreign corporation o 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. 11-87)


Form 5471 (Rev. 11-87)

Page 2

Saicneg Earnings and Profits

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

a Unrelated customers la

1b

b Relatedcustomers . 2. 1 1 ee we ee

MM

c¢ Add lines la and 1b . : 1c
@ | 2 Cost of goods sold and/or operations (line 7, Schedule D) 2
E | 3 Gross profit (subtract line 2 from line 1¢) 3
=| 4 Dividends 4
5 Interest . . Se ee 5
6 Gross rents, royalties, ‘and license fees es 6
7 Net gain or (loss) on sale of capital assets 7
8 Other income (attach schedule) 8
9 Total income (add lines 3 through 8) - 9
10 Compensation not deducted elsewhere . 10
w {11 Rents, royalties, and license fees . 11
§ |12 Interest . . 12
3 13 Depreciation not deducted elsewhere. 13
3 14 Depletion . 14
& |15 Taxes (exclude income, war profits, and excess profits taxes) 15
16 Other deductions (attach schedule—exclude income, war profits, ande excess profits taxes) 16
17 Total deductions (add lines 10 through 16) . an . . Lo 17
4 2 18 Earnings and profits (before reduction for any income, war profits, or excess profits wanes): Y Y yy / yj
fo a Subtractline17fromlineQ9 2. 2 2. 2... LB 7/7 Y Yj
ta b Unrealizedexchange gainor(loss) . . . 2 1... ee LBD UV MMU
SZ} Combine lines 18a and 18b .
®© 119 Income, war profits, and excess profits taxes paid or accrued (from line 5, column @), Schedule E). 19
20 Earnings and profits (subtract line 19 from line 18c) . . 20

Cost of Goods Sold and/or Operations

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

Yy Uf
a From unrelated suppliers. 2a yy lL Y,
b From related suppliers . 2b Y/
¢ Add lines 2a and 2b 2c
3 Wages and salaries . 3
4 a Additional section 263A costs (see instructions) . 4a
b Other costs (attach schedule) 4b
5 Total (add lines 1 through 4b) . 5
6 Ending inventory . 6
7 Cost of goods sold and/or operations (subtract line 6 from line ‘5), ‘Enter here and on line 2, Schedule c 7 7
a Do the rules of section 263A (with respect to property produced or acquired for resale) apply to Yf
the corporation? . . ° propery na ...0 )2pPy fo No V7 Yj
b Was there any change (other than for section 263A purposes) in determining quantities, cost, or Yy -

valuations between opening and closing inventory? If “Yes,” attach explanation. [1] Yes (No

Suis Income, War Profits, and Excess Profits Taxes Paid or Accrued

(a) Amount of tax
. (b) (c) (a)
Name of country or U.S. possession In foreign Currency Conversion rate In U.S. dollars
US. YUL YY YY YY)

Blwlrole

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



Form 5471 (Rev. 11-87)

Page 3

Balance Sheets

(a)

(b)

Assets

Cash
Trade notes and accounts receivable
a__ Less allowance for bad debts
Inventories :
Other current assets (attach schedule). on .
Loans to stockholders and other related persons (complete Schedule G, line. » .
Investment in subsidiaries (attach schedule) .
Buildings and structures
a Less accumulated depreciation.
Other fixed depreciable assets
a__Less accumulated depreciation
9 Depletable assets oe
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 1la,b,andc .
12 Other assets (attach schedule) .

Naaeaw ne

C

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 G, 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

Less cost of treasury stock

2

rey

22 Total liabilities and stockholders’ equity

ESERETIEKA 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)
5 . Any domestic
Outstanding balances of foreign corporation
corporation US. person filing | controlled by U.S.
is return person filing this

return

(a)

Any foreign
corporation

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)

®

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 annual
accounting period

b At end of foreign corporation's annual
accounting period

2 Loans from persons described in ‘columns ‘®)
through (f):
a At beginning of foreign corporation’s annual
accounting period

b At end of foreign corporation's annual
accounting period woe ee