Form 8858
(Rev. December 2018)
Department of the Treasury
Internal Revenue Service
Information Return of U.S. Persons With Respect to Foreign
Disregarded Entities (FDEs) and Foreign Branches (FBs)
Go to www.irs.gov/Form8858 for instructions and the latest information.
Information furnished for the FDE’s or FB’s annual accounting period (see instructions)
beginning , 20 , and ending , 20
OMB No. 1545-1910
Attachment
Sequence No. 140
Name of person filing this return Filer’s identifying number
Number, street, and room or suite no. (or P.O. box number if mail is not delivered to street address)
City or town, state, and ZIP code
Filer’s tax year beginning , 20 , and ending , 20
Important: Fill in all applicable lines and schedules. All information must be in English. All amounts must be stated in
U.S. dollars unless otherwise indicated.
Check here FDE of a U.S. person FDE of a controlled foreign corporation (CFC) FDE of a controlled foreign partnership
FB of a U.S. person FB of a CFC FB of a controlled foreign partnership
Check here Initial 8858 Final 8858
1a Name and address of FDE or FB b(1) U.S. identifying number, if any
b(2) Reference ID number (see instructions)
c For FDE, country(ies) under whose laws organized and entity type under local tax law d Date(s) of organization e Effective date as FDE
f If benefits under a U.S. tax treaty were claimed with respect to
income of the FDE or FB, enter the treaty and article number
g Country in which principal business
activity is conducted
h Principal business
activity
i Functional currency
2 Provide the following information for the FDE’s or FB’s accounting period stated above.
a Name, address, and identifying number of branch office or agent (if any) in
the United States
b Name and address (including corporate department, if applicable) of person(s)
with custody of the books and records of the FDE or FB, and the location of
such books and records, if different
3 For the tax owner of the FDE or FB (if different from the filer), provide the following (see instructions):
a Name and address b Annual accounting period covered by the return (see instructions)
c(1) U.S. identifying number, if any
c(2) Reference ID number (see instructions)
d Country under whose laws organized e Functional currency
4 For the direct owner of the FDE or FB (if different from the tax owner), provide the following (see instructions):
a Name and address b Country under whose laws organized
c U.S. identifying number, if any d Functional currency
5 Attach an organizational chart that identifies the name, placement, percentage of ownership, tax classification, and country of organization of all entities in the chain of
ownership between the tax owner and the FDE or FB, and the chain of ownership between the FDE or FB and each entity in which the FDE or FB has a 10% or more
direct or indirect interest. See instructions.
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 21457L
Form
8858 (Rev. 12-2018)
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)
Form 8858 (Rev. 12-2018)
Page 3
Schedule G Other Information (continued)
Yes No
6
a
During the tax year, did the FDE or FB receive, or accrue the receipt of, any amounts defined as a
base erosion payment under section 59A(d) or have a base erosion tax benefit under section 59A(c)(2) from
a foreign person which is a related party of the taxpayer? See instructions. If “Yes,” complete lines 6b
and 6c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
b Enter the total amount of the base erosion payments
$
c Enter the total amount of the base erosion tax benefit
$
7
a
During the tax year, did the FDE or FB pay, or accrue the payment of, any amounts defined as a base
erosion payment under section 59A(d) or have a base erosion tax benefit under section 59A(c)(2) to a
foreign person which is a related party of the taxpayer? See instructions. If “Yes,” complete lines 7b and 7c
b Enter the total amount of the base erosion payments
$
c Enter the total amount of the base erosion tax benefit
$
8 Is the FDE or FB a qualified business unit as defined in section 989(a)?. . . . . . . . . . . . .
9
Answer the following question only if the tax owner of the FDE or FB is a CFC: Were there any
intracompany transactions between the FDE or FB and the CFC or any other branch of the CFC during the
tax year, in which the FDE or FB acted as a manufacturing, selling, or purchasing branch? . . . . . .
10
a
Answer the remaining questions in Schedule G only if the tax owner of the FB or the interest in the FDE
is a U.S. corporation: If the FB or the interest in the FDE is a separate unit under Regulations section
1.1503(d)-1(b)(4), and is not part of a combined separate unit under Regulations section 1.1503(d)-1(b)(4)(ii),
does the separate unit have a dual consolidated loss as defined in Regulations section 1.1503(d)-1(b)(5)(ii)?
b If “Yes,” enter the amount of the dual consolidated loss . . . . . . . . . .
( )
$
11
a
If the FB or the interest in the FDE is a separate unit and part of a combined separate unit under
Regulations section 1.1503(d)-1(b)(4)(ii), does the combined separate unit have a dual consolidated loss as
defined in Regulations section 1.1503(d)-1(b)(5)(ii)? If “Yes,” complete lines 11b and 11c . . . . . . .
b Enter the amount of the dual consolidated loss for the combined separate unit . .
( )
$
c
Enter the net income (loss) attributed to the individual FB or the individual interest in the FDE as determined
under Regulations section 1.1503(d)-5(c)(4)(ii)(A) . . . . . . . . . . . .
$
12
a
Was any portion of the dual consolidated loss in line 10b or 11b taken into account in computing U.S.
taxable income for the year? If “Yes,” go to line 12b. If “No,” go to line 13 . . . . . . . . . . .
b
Was this a permitted domestic use of the dual consolidated loss under Regulations section 1.1503(d)-6? If
“Yes,” see the instructions and go to line 12c. If “No,” go to line 12d . . . . . . . . . . . . .
c
If “Yes,” is the documentation that is required for the permitted domestic use under Regulations section
1.1503(d)-6 attached to the return? After answering this question, go to line 13a . . . . . . . . .
d
If this was not a permitted domestic use, was the dual consolidated loss used to compute consolidated
taxable income as provided under Regulations section 1.1503(d)-4? If “Yes,” go to line 12e . . . . . .
e
Enter the separate unit’s contribution to the cumulative consolidated taxable income
(“cumulative register”) as of the beginning of the tax year
. .
$
See instructions.
13
a
During the tax year, did any triggering event(s) occur under Regulations section 1.1503(d)-6(e) requiring
recapture of any dual consolidated loss(es) attributable to the FB or interest in the FDE, individually or as
part of a combined separate unit, in any prior tax years? . . . . . . . . . . . . . . . . .
b If “Yes,” enter the total amount of recapture . . . . . .
$
See instructions.
Form 8858 (Rev. 12-2018)
Form 8858 (Rev. 12-2018)
Page 4
Schedule H Current Earnings and Profits or Taxable Income (see instructions)
Important: Enter the amounts on lines 1 through 6 in functional currency.
1
Current year net income (loss) per foreign books of account . . . . . . . . . . . . . .
1
2
Total net additions . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2
3
Total net subtractions . . . . . . . . . . . . . . . . . . . . . . . . . . .
3
4
Current earnings and profits (or taxable income—see instructions) (line 1 plus line 2 minus line 3) . .
4
5
DASTM gain (loss) (if applicable) . . . . . . . . . . . . . . . . . . . . . . .
5
6
Combine lines 4 and 5 . . . . . . . . . . . . . . . . . . . . . . . . . . .
6
7
Current earnings and profits (or taxable income) in U.S. dollars (line 6 translated at the average
exchange rate determined under section 989(b) and the related regulations (see instructions)) . . .
7
8 Enter exchange rate used for line 7
Schedule I Transferred Loss Amount (see instructions)
Important: See instructions for who has to complete this section.
Yes No
1
Were any assets of an FB (including an FB that is an FDE) transferred to a foreign corporation? If “No,”
stop here. If “Yes,” go to line 2 . . . . . . . . . . . . . . . . . . . . . . . . . .
2
Was the transferor a domestic corporation that transferred substantially all of the assets of an FB (including
an FB that is an FDE) to a specified 10%-owned foreign corporation? If “No,” stop here. If “Yes,” go to
line 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3
Immediately after the transfer, was the domestic corporation a U.S. shareholder with respect to the
transferee foreign corporation? If “No,” stop here. If “Yes,” go to line 4 . . . . . . . . . . . .
4
Enter the transferred loss amount included in gross income as required under section 91. See
instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
Schedule J Income Taxes Paid or Accrued (see instructions)
Foreign Income Taxes
Foreign Tax Credit Separate Categories
(a)
Country or
Possession
(b)
Foreign Currency
(c)
Conversion Rate
(d)
U.S.
Dollar
(e)
Foreign Branch
(f)
Passive
(g)
General
(h)
Other
Totals
Form 8858 (Rev. 12-2018)