Form 8858 (Rev. 12-2018)
Page 2
Schedule C Income Statement (see instructions)
Important: Report all information in functional currency in accordance with U.S. GAAP. Also, report each amount in U.S.
dollars translated from functional currency (using GAAP translation rules or the average exchange rate determined under
section 989(b)). If the functional currency is the U.S. dollar, complete only the U.S. Dollars column. See instructions for
special rules for FDEs or FBs that use DASTM.
If you are using the average exchange rate (determined under section 989(b)), check the following box . . . . . .
Functional Currency U.S. Dollar
1 Gross receipts or sales (net of returns and allowances) . . . . . . . . . . 1
2 Cost of goods sold . . . . . . . . . . . . . . . . . . . . . . 2
3 Gross profit (subtract line 2 from line 1) . . . . . . . . . . . . . . . 3
4 Dividends . . . . . . . . . . . . . . . . . . . . . . . . . 4
5 Interest. . . . . . . . . . . . . . . . . . . . . . . . . . 5
6 Gross rents, royalties, and license fees . . . . . . . . . . . . . . . 6
7 Gross income from performance of services . . . . . . . . . . . . . 7
8 Foreign currency gain (loss) . . . . . . . . . . . . . . . . . . . 8
9 Other income. . . . . . . . . . . . . . . . . . . . . . . . 9
10 Total income (add lines 3 through 9) . . . . . . . . . . . . . . . . 10
11 Total deductions (exclude income tax expense) . . . . . . . . . . . . 11
12 Income tax expense . . . . . . . . . . . . . . . . . . . . . 12
13 Other adjustments . . . . . . . . . . . . . . . . . . . . . . 13
14 Net income (loss) per books . . . . . . . . . . . . . . . . . . .
14
Schedule C-1 Section 987 Gain or Loss Information
Note: See the instructions if there are multiple recipients of remittances from
the FDE or FB.
(a)
Amount stated in
functional currency of
FDE or FB
(b)
Amount stated in
functional currency of
recipient
1 Remittances from the FDE or FB . . . . . . . . . . . . . . . . . 1
2 Section 987 gain (loss) recognized by recipient . . . . . . . . . . . . 2
3
Section 987 gain (loss) deferred under Regulations section 1.987-12T (attach
statement). . . . . . . . . . . . . . . . . . . . . . . . .
3
Yes No
4 Were all remittances from the FDE or FB treated as made to the direct owner? . . . . . . . . . .
5
Did the tax owner change its method of accounting for section 987 gain or loss with respect to remittances
from the FDE or FB during the tax year? If “Yes,” attach a statement describing the method used prior to
the change and new method of accounting . . . . . . . . . . . . . . . . . . . . . .
Schedule F Balance Sheet
Important: Report all amounts in U.S. dollars computed in functional currency and translated into U.S. dollars in
accordance with U.S. GAAP. See instructions for an exception for FDEs or FBs that use DASTM.
Assets
(a)
Beginning of annual
accounting period
(b)
End of annual
accounting period
1 Cash and other current assets . . . . . . . . . . . . . . . . . . 1
2 Other assets . . . . . . . . . . . . . . . . . . . . . . . . 2
3 Total assets . . . . . . . . . . . . . . . . . . . . . . . . 3
Liabilities and Owner’s Equity
4 Liabilities . . . . . . . . . . . . . . . . . . . . . . . . . 4
5 Owner’s equity . . . . . . . . . . . . . . . . . . . . . . . 5
6 Total liabilities and owner’s equity . . . . . . . . . . . . . . . . . 6
Schedule G Other Information
Yes No
1 During the tax year, did the FDE or FB own an interest in any trust? . . . . . . . . . . . . . .
2
During the tax year, did the FDE or FB own at least a 10% interest, directly or indirectly, in any foreign
partnership? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3
Answer the following question only if the FDE made its election to be treated as disregarded from its owner
during the tax year: Did the tax owner claim a loss with respect to stock or debt of the FDE as a result of
the election? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
4
During the tax year, did the FDE or FB pay or accrue any foreign tax that was disqualified for credit under
section 901(m)? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
5
During the tax year, did the FDE or FB pay or accrue foreign taxes to which section 909 applies, or treat
foreign taxes that were previously suspended under section 909 as no longer suspended? . . . . . .
Form 8858 (Rev. 12-2018)