Schedule K-3
(Form 1065)
2021
Partner’s Share of Income, Deductions,
Credits, etc.—International
Department of the Treasury
Internal Revenue Service
OMB No. 1545-0123
For calendar year 2021, or tax year beginning
/
/ 2021 , ending
/ /
See separate instructions.
Final K-3 Amended K-3
Information About the Partnership
A Partnership’s employer identification number (EIN)
B Partnership’s name, address, city, state, and ZIP code
Information About the Partner
C Partner’s SSN or Taxpayer Identification Number (TIN) (Do not use TIN of a
disregarded entity. See instructions.)
D Name, address, city, state, and ZIP code for partner entered in C. See instructions.
E Check to indicate the parts of Schedule K-3 that apply.
Yes No
1 Does Part I apply? If “Yes,” complete and attach Part I . . . . . . . . . . . . . . . . . . .
1
2 Does Part II apply? If “Yes,” complete and attach Part II . . . . . . . . . . . . . . . . . . 2
3 Does Part III apply? If “Yes,” complete and attach Part III . . . . . . . . . . . . . . . . . . 3
4 Does Part IV apply? If “Yes,” complete and attach Part IV . . . . . . . . . . . . . . . . . . 4
5 Does Part V apply? If “Yes,” complete and attach Part V . . . . . . . . . . . . . . . . . . 5
6 Does Part VI apply? If “Yes,” complete and attach Part VI . . . . . . . . . . . . . . . . . .
6
7 Does Part VII apply? If “Yes,” complete and attach Part VII . . . . . . . . . . . . . . . . . 7
8 Does Part VIII apply? If “Yes,” complete and attach Part VIII . . . . . . . . . . . . . . . . . 8
9 Does Part IX apply? If “Yes,” complete and attach Part IX . . . . . . . . . . . . . . . . . . 9
10 Does Part X apply? If “Yes,” complete and attach Part X . . . . . . . . . . . . . . . . . . 10
11 Does Part XI apply? If “Yes,” complete and attach Part XI . . . . . . . . . . . . . . . . . . 11
12 Reserved for future use . . . . . . . . . . . . . . . . . . . . . . . . . . . .
12
13 Does Part XIII apply? If “Yes,” complete and attach Part XIII . . . . . . . . . . . . . . . . .
13
For IRS Use Only
For Paperwork Reduction Act Notice, see the Instructions for Form 1065. www.irs.gov/Form1065 Cat. No. 74715S Schedule K-3 (Form 1065) 2021
Schedule K-3 (Form 1065) 2021
Page 2
Name of partnership
EIN
Name of partner
SSN or TIN
Part I Partner’s Share of Partnership’s Other Current Year International Information
Check box(es) for additional specified attachments. See instructions.
1. Gain on personal property sale
2. Foreign oil and gas taxes
3. Splitter arrangements
4. Foreign tax translation
5. High-taxed income
6. Section 267A disallowed deduction
7. Form 8858 information
8. Form 5471 information
9. Other forms
10. Partner loan transactions
11. Dual consolidated loss
✣❈❅❃❋ ✢❏❘
12. Other international items
(attach description and statement)
Part II Foreign Tax Credit Limitation
Section 1—Gross Income
Description (a) U.S. source
Foreign Source
(f) Sourced by
partner
(g) Total
(b) Foreign branch
category income
(c) Passive
category income
(d) General
category income
(e) Other
(category code )
1 Sales
A
B
C
2
Gross income from performance of services
A
B
C
3 Gross rental real estate income
A
B
C
4 Other gross rental income
A
B
C
5 Guaranteed payments . . . . .
6 Interest income
A
B
C
7 Ordinary dividends (exclude amount
on line 8)
A
B
C
Schedule K-3 (Form 1065) 2021
Schedule K-3 (Form 1065) 2021
Page 3
Name of partnership
EIN
Name of partner
SSN or TIN
Part II Foreign Tax Credit Limitation (continued)
Section 1—Gross Income (continued)
Description (a) U.S. source
Foreign Source
(f) Sourced by
partner
(g) Total
(b) Foreign branch
category income
(c) Passive
category income
(d) General
category income
(e) Other
(category code )
8 Qualified dividends
A
B
C
9 Reserved for future use . . . . .
10 Royalties and license fees
A
B
C
11 Net short-term capital gain
A
B
C
12 Net long-term capital gain
A
B
C
13 Collectibles (28%) gain
A
B
C
14 Unrecaptured section 1250 gain
A
B
C
15 Net section 1231 gain
A
B
C
Schedule K-3 (Form 1065) 2021
Schedule K-3 (Form 1065) 2021
Page 4
Name of partnership
EIN
Name of partner
SSN or TIN
Part II Foreign Tax Credit Limitation (continued)
Section 1—Gross Income (continued)
Description (a) U.S. source
Foreign Source
(f) Sourced by
partner
(g) Total
(b) Foreign branch
category income
(c) Passive
category income
(d) General
category income
(e) Other
(category code )
16 Section 986(c) gain . . . . . .
17 Section 987 gain . . . . . . .
18 Section 988 gain . . . . . . .
19 Section 951(a) inclusions
A
B
C
20 Other income (see instructions)
A
B
C
21 Reserved for future use
A
B
C
22 Reserved for future use
A
B
C
23 Reserved for future use
A
B
C
24
Total gross income (combine lines 1
through 23) . . . . . . .
A
B
C
Schedule K-3 (Form 1065) 2021
Schedule K-3 (Form 1065) 2021
Page 5
Name of partnership
EIN
Name of partner
SSN or TIN
Part II Foreign Tax Credit Limitation (continued)
Section 2—Deductions
Description (a) U.S. source
Foreign Source
(f) Sourced by
partner
(g) Total
(b) Foreign branch
category income
(c) Passive
category income
(d) General
category income
(e) Other
(category code )
25 Expenses allocable to sales income .
26 Expenses allocable to gross income
from performances of services . .
27 Net short-term capital loss . . . .
28 Net long-term capital loss . . . .
29 Collectibles loss . . . . . . .
30 Net section 1231 loss . . . . .
31 Other losses . . . . . . . .
32
Research & experimental (R&E) expenses
A
SIC code
. . . .
B SIC code
. . . .
C SIC code
. . . .
33
Allocable rental expenses—
depreciation, depletion, and amortization
34
Allocable rental expenses—other than
depreciation, depletion, and amortization
35
Allocable royalty and licensing
expenses—depreciation, depletion,
and amortization . . . . . . .
36
Allocable royalty and licensing
expenses—other than depreciation,
depletion, and amortization . . .
37 Depreciation not included on line 33
or 35 . . . . . . . . . .
38 Charitable contributions . . . .
39 Interest expense specifically allocable
under Regulations section 1.861-10(e)
40
Other interest expense specifically
allocable under Regulations section
1.861-10T . . . . . . . .
41 Other interest expense—business .
42 Other interest expense—investment .
43
Other interest expense—passive activity
44 Section 59(e)(2) expenditures,
excluding R&E expenses on line 32 .
45 Foreign taxes not creditable but
deductible . . . . . . . .
Schedule K-3 (Form 1065) 2021
Schedule K-3 (Form 1065) 2021
Page 6
Name of partnership
EIN
Name of partner
SSN or TIN
Part II Foreign Tax Credit Limitation (continued)
Section 2—Deductions (continued)
Description (a) U.S. source
Foreign Source
(f) Sourced by
partner
(g) Total
(b) Foreign branch
category income
(c) Passive
category income
(d) General
category income
(e) Other
(category code )
46 Section 986(c) loss . . . . . .
47 Section 987 loss . . . . . . .
48 Section 988 loss . . . . . . .
49 Other allocable deductions (see
instructions) . . . . . . . .
50 Other apportioned share of
deductions (see instructions) . . .
51 Reserved for future use . . . . .
52 Reserved for future use . . . . .
53 Reserved for future use . . . . .
54 Total deductions (combine lines 25
through 53) . . . . . . .
55 Net income (loss) (subtract line 54
from line 24) . . . . . . .
Part III Other Information for Preparation of Form 1116 or 1118
Section 1—R&E Expenses Apportionment Factors
Description (a) U.S. source
Foreign Source
(f) Sourced by
partner
(g) Total
(b) Foreign branch
category income
(c) Passive
category income
(d) General
category income
(e) Other
(category code
)
(country code )
1
Gross receipts by SIC code
A SIC code
B SIC code
C SIC code
D SIC code
E SIC code
F SIC code
2 Exclusive apportionment with respect to total R&E expenses entered on Part II, line 32. Enter the following.
A R&E expense with respect to activity performed in the United States
(i)
SIC code . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2A(i)
(ii) SIC code . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2A(ii)
(iii) SIC code . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2A(iii)
B R&E expense with respect to activity performed outside the United States
(i)
SIC code . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2B(i)
(ii) SIC code . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2B(ii)
(iii) SIC code . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2B(iii)
Schedule K-3 (Form 1065) 2021
Schedule K-3 (Form 1065) 2021
Page 7
Name of partnership
EIN
Name of partner
SSN or TIN
Part III Other Information for Preparation of Form 1116 or 1118 (continued)
Section 2—Interest Expense Apportionment Factors
Description (a) U.S. source
Foreign Source
(f) Sourced by
partner
(g) Total
(b) Foreign branch
category income
(c) Passive
category income
(d) General
category income
(e) Other
(category code
)
(country code )
1 Total average value of assets . . .
2
Sections 734(b) and 743(b)
adjustment to assets—average value .
3
Assets attracting directly allocable
interest expense under Regulations
section 1.861-10(e) . . . . . .
4
Other assets attracting directly
allocable interest expense under
Regulations section 1.861-10T . .
5 Assets excluded from apportionment
formula . . . . . . . . .
6a
Total assets used for apportionment
(subtract the sum of lines 3, 4, and 5
from the sum of lines 1 and 2) . . .
b Assets attracting business interest
expense . . . . . . . . .
c Assets attracting investment interest
expense . . . . . . . . .
d
Assets attracting passive activity
interest expense . . . . . . .
7
Basis in stock of 10%-owned
noncontrolled foreign corporations
(see attachment) . . . . . . .
8
Basis in stock of CFCs (see attachment)
Section 3—Foreign-Derived Intangible Income (FDII) Deduction Apportionment Factors
Description (a) U.S. source
Foreign Source
(e) Sourced by
partner
(f) Total
(b) Passive
category income
(c) General
category income
(d) Other
(category code
)
(country code )
1 Foreign-derived gross receipts . . . . .
2 Cost of goods sold . . . . . . . . .
3 Partnership deductions allocable to foreign-
derived gross receipts . . . . . . . .
4 Other partnership deductions apportioned to
foreign-derived gross receipts . . . . . .
Schedule K-3 (Form 1065) 2021
Schedule K-3 (Form 1065) 2021
Page 8
Name of partnership
EIN
Name of partner
SSN or TIN
Part III Other Information for Preparation of Form 1116 or 1118 (continued)
Section 4—Foreign Taxes
Description (a) Type of tax
(b) Section 951A category income (c) Foreign branch category income
U.S. Foreign U.S. Foreign Partner
1 Direct (section 901 or
903) foreign taxes:
Paid Accrued
A
B
C
D
E
F
2 Reduction of taxes (total)
A Taxes on foreign mineral income . . . . .
B Reserved for future use . . . . . . . .
C International boycott provisions . . . . .
D Failure-to-file penalties . . . . . . . .
E Taxes with respect to splitter arrangements . .
F Taxes on foreign corporate distributions . . .
G Other . . . . . . . . . . . . .
3 Foreign tax redeterminations
A
Related tax year
Date tax paid
B
Related tax year
Date tax paid
C
Related tax year
Date tax paid
4 Reserved for future use . . . . . . . .
5 Reserved for future use . . . . . . . .
6 Reserved for future use . . . . . . . .
Schedule K-3 (Form 1065) 2021
Schedule K-3 (Form 1065) 2021
Page 9
Name of partnership
EIN
Name of partner
SSN or TIN
Part III Other Information for Preparation of Form 1116 or 1118 (continued)
Section 4—Foreign Taxes (continued)
(d) Passive category income (e) General category income
(f) Other
(category code
)
(g) Total
U.S. Foreign Partner U.S. Foreign Partner
1
A
B
C
D
E
F
2
A
B
C
D
E
F
G
3
A
B
C
4
5
6
Section 5—Other Tax Information
Description
(a) U.S. source
Foreign Source
(g) Sourced by
partner
(h) Total
(b) Section 951A
category income
(c) Foreign branch
category income
(d) Passive
category income
(e) General
category income
(f) Other
(category code
)
(country code )
1
Section 743(b)
positive income
adjustment .
2
Section 743(b)
negative income
adjustment .
3 Reserved for
future use . .
4 Reserved for
future use . .
Schedule K-3 (Form 1065) 2021
Schedule K-3 (Form 1065) 2021
Page 10
Name of partnership
EIN
Name of partner
SSN or TIN
Part IV Information on Partner’s Section 250 Deduction With Respect to Foreign-Derived Intangible Income (FDII)
Section 1—Information To Determine Deduction Eligible Income (DEI) and Qualified Business Asset Investment (QBAI) on Form 8993
1 Net income (loss) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
2a DEI gross receipts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2a
b DEI cost of goods sold (COGS) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2b
c DEI properly allocated and apportioned deductions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2c
3 Section 951(a) inclusions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
4 CFC dividends . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
5 Financial services income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
6 Domestic oil and gas extraction income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
7 Foreign branch income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
8 Partnership QBAI . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
8
Section 2—Information To Determine Foreign-Derived Deduction Eligible Income on Form 8993 (see instructions)
(a) Foreign-derived
income from all sales of
general property
(b) Foreign-derived
income from all sales of
intangible property
(c) Foreign-derived
income from all services
(d) Total
(add columns (a)
through (c))
9 Gross receipts . . . . . . . . . . . . . . . . . . . . . .
10 COGS . . . . . . . . . . . . . . . . . . . . . . . . .
11 Allocable deductions . . . . . . . . . . . . . . . . . . . .
12 Other apportioned deductions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
12
Section 3—Other Information for Preparation of Form 8993
DEI FDDEI Total
13 Interest deductions
A Interest expense specifically allocable under Regulations section 1.861-10(e) . . . . . . . . . . . .
B Other interest expense specifically allocable under Regulations section 1.861-10T . . . . . . . . . .
C Other interest expense . . . . . . . . . . . . . . . . . . . . . . . . . . . .
14 Interest expense apportionment factors
A Total average value of assets . . . . . . . . . . . . . . . . . . . . . . . . . .
B Sections 734(b) and 743(b) adjustment to assets—average value . . . . . . . . . . . . . . .
C Assets attracting directly allocable interest expense under Regulations section 1.861-10(e) . . . . . . . .
D Other assets attracting directly allocable interest expense under Regulations section 1.861-10T . . . . . .
E Assets excluded from apportionment formula . . . . . . . . . . . . . . . . . . . . .
F
Total assets used for apportionment (the sum of lines 14C, 14D, and 14E subtracted from the sum of lines 14A and 14B)
R&E expenses apportionment factors
15 Gross receipts by SIC code
A
SIC code . . . . . . . . . . . . . . . . . . . . . . . . . . .
B SIC code . . . . . . . . . . . . . . . . . . . . . . . . . . .
C SIC code
. . . . . . . . . . . . . . . . . . . . . . . . . . .
16 R&E expenses by SIC code
A
SIC code . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16A
B SIC code . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16B
C SIC code . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16C
Schedule K-3 (Form 1065) 2021
Schedule K-3 (Form 1065) 2021
Page 11
Name of partnership
EIN
Name of partner
SSN or TIN
Part V Distributions From Foreign Corporations to Partnership
(a) Name of distributing foreign corporation
(b) EIN or
reference ID number
(c) Date of distribution
(d) Functional currency of
distributing foreign corporation
(e) Amount of distribution
in functional currency
A
B
C
D
E
F
G
H
I
J
K
L
M
N
O
(f) Amount of E&P distribution
in functional currency
(g) Spot rate (functional
currency to U.S. dollars)
(h) Amount of distribution
in U.S. dollars
(i) Amount of E&P distribution
in U.S. dollars
(j) Qualified foreign
corporation
(k) Reserved for
future use
A
B
C
D
E
F
G
H
I
J
K
L
M
N
O
Schedule K-3 (Form 1065) 2021
Schedule K-3 (Form 1065) 2021
Page 12
Name of partnership
EIN
Name of partner
SSN or TIN
Part VI Information on Partner’s Section 951(a)(1) and Section 951A Inclusions
a Separate category (enter code) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
b If box is checked, this is completed with respect to U.S. source income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(a) Name of CFC
(b) EIN or
reference ID number
(c) Ending of CFC
tax year
(d) Partner’s share of
CFC items through its
ownership in the
partnership
(e) Partner’s share of
subpart F income
(f) Partner’s section
951(a)(1)(B) inclusion
(g) Tested income
A
B
C
D
E
F
G
H
I
J
K
1
Partner’s total (sum for all CFCs) . . . . . . . . . . . . . . . . . . . . . .
(h) Tested loss
(i) Partner’s share of
tested income
(j) Partner’s share of
tested loss
(k) Partner’s share of
Qualified Business Asset
Investment (QBAI)
(l) Partner’s share of
the tested loss
QBAI amount
(m) Partner’s share of
tested interest income
(n) Partner’s share of
tested interest expense
A
B
C
D
E
F
G
H
I
J
K
1
Schedule K-3 (Form 1065) 2021
Schedule K-3 (Form 1065) 2021
Page 13
Name of partnership
EIN
Name of partner
SSN or TIN
Part VII Information To Complete Form 8621
Section 1—General Information on Passive Foreign Investment Company (PFIC), Qualified Electing Fund (QEF), or Qualifying Insurance Corporation (QIC)
General Information
(a) Name of PFIC
(b) EIN or
reference ID number
(c) Address of PFIC
(d) Beginning of
PFIC tax year
(e) Ending of
PFIC tax year
Summary of Annual Information Information Regarding Elections
(f) Description of each
class of PFIC shares
(g) Dates PFIC
shares acquired
during tax year
(if applicable)
(h) Partner’s share of
total number of
PFIC shares held by
partnership at end of
tax year
(i) Partner’s share of
total value of
PFIC shares held by
partnership at end of
tax year
(j) Election
made by
partnership
(see
instructions)
(k)
Box is
checked if
foreign
corporation has
documented its
eligibility to be
treated as a
qualifying
insurance
corporation
under section
1297(f)(2).
(l)
Box is
checked if PFIC
has indicated
its shares are
“marketable
stock” within
the meaning
of section
1296(e).
(m) Box is
checked if
PFIC is also
a controlled
foreign
corporation
(CFC) within
the meaning of
section 957.
(n) Box is
checked if
PFIC meets
the income
test or asset
test of section
1297(a) for the
tax year.
Schedule K-3 (Form 1065) 2021
Schedule K-3 (Form 1065) 2021
Page 14
Name of partnership
EIN
Name of partner
SSN or TIN
Part VII Information To Complete Form 8621 (continued)
Section 2—Additional Information on PFIC or QEF
General Information QEF Information
Mark-to-Market Information
Section 1291 and Other
Information
(a) Name of PFIC
(b) EIN or
reference ID number
(c) Partner’s share of
ordinary earnings
(d) Partner’s share of net
capital gain
(e) Partner’s share of
fair market value of
PFIC shares held by
partnership at beginning
of tax year
(f) Partner’s share of
fair market value of
PFIC shares held by
partnership at end of
tax year
(g) Dates PFIC shares
were acquired
Section 1291 and Other Information
(h) Partner’s share of
amount of cash and fair
market value of property
distributed by PFIC
during the current tax
year (if applicable)
(i) Dates of
distribution
(j) Partner’s share of
total creditable foreign
taxes attributable to
distribution by PFIC
(k) Partner’s share of
total distributions from
PFIC in preceding
3 tax years
(l) Dates PFIC
shares disposed of
during tax year
(if applicable)
(m) Partner’s share of
amount realized by
partnership on
disposition of PFIC
shares
(n)
Partner’s share of
partnership’s tax basis
in PFIC shares on dates
of disposition (including
partner-specific
adjustments)
(o) Partner’s share of
gain (loss) on
disposition by
partnership of PFIC
shares
Schedule K-3 (Form 1065) 2021
Schedule K-3 (Form 1065) 2021
Page 15
Name of partnership
EIN
Name of partner
SSN or TIN
Part VIII Partner’s Interest in Foreign Corporation Income (Section 960)
A
EIN or reference ID number of controlled foreign corporation
B Separate category. See instructions . . . .
C
If PAS was entered on line B, applicable grouping under Regulations section 1.904-4(c). See instructions . . . . . . . . . . . . . .
D
Box is checked if there is more than one source country for a line. See attachment and instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . .
E
Box is checked if U.S. source income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
F
Box is checked if FORI or FOGEI . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Amounts are in functional currency unless otherwise noted.
See instructions.
(i) Country code
(ii) Partner’s share
of net income
(iii) Partner’s share of
average asset value
(iv) Reserved for
future use
1 Subpart F income groups
a Dividends, interest, rents, royalties, and annuities (total) . . . . . . .
(1)
Unit
(2)
Unit
b Net gain from certain property transactions (total) . . . . . . . . .
(1)
Unit
(2)
Unit
c Net gain from commodities transactions (total) . . . . . . . . . .
(1)
Unit
(2)
Unit
d Net foreign currency gain (total) . . . . . . . . . . . . . .
(1)
Unit
(2)
Unit
e Income equivalent to interest (total) . . . . . . . . . . . . .
(1)
Unit
(2)
Unit
f Foreign base company sales income (total) . . . . . . . . . . .
(1)
Unit
(2)
Unit
g Foreign base company services income (total) . . . . . . . . . .
(1)
Unit
(2)
Unit
h Full inclusion foreign base company income (total) . . . . . . . .
(1)
Unit
(2)
Unit
i Insurance income (total) . . . . . . . . . . . . . . . .
(1)
Unit
(2)
Unit
j International boycott income (total) . . . . . . . . . . . . .
k Bribes, kickbacks, and other payments (total) . . . . . . . . . .
l Section 901(j) (total) . . . . . . . . . . . . . . . . . .
Schedule K-3 (Form 1065) 2021
Schedule K-3 (Form 1065) 2021
Page 16
Name of partnership
EIN
Name of partner
SSN or TIN
Part VIII Partner’s Interest in Foreign Corporation Income (Section 960) (continued)
Amounts are in functional currency unless otherwise noted.
See instructions.
(i) Country code
(ii) Partner’s share
of net income
(iii) Partner’s share of
average asset value
(iv) Reserved for
future use
2 Recaptured subpart F income . . . . . . . . . . . . . . .
3 Tested income group (total) . . . . . . . . . . . . . . .
(1)
Unit
(2)
Unit
4 Residual income group (total) . . . . . . . . . . . . . . .
(1)
Unit
(2)
Unit
5
Total . . . . . . . . . . . . . . . . . . . . .
Part IX Partner’s Information for Base Erosion and Anti-Abuse Tax (Section 59A)
Section 1—Applicable Taxpayer (see instructions)
Description (a) Total
(b) Total ECI gross
receipts
(c) Total non-ECI gross
receipts
1 Gross receipts for section 59A(e) . . . . . . . . . . . . . . . . . . . . . .
2 Gross receipts for the first preceding year . . . . . . . . . . . . . . . . . . . .
3 Gross receipts for the second preceding year . . . . . . . . . . . . . . . . . .
4 Gross receipts for the third preceding year . . . . . . . . . . . . . . . . . . .
5 Amounts included in the denominator of the base erosion percentage as described in Regulations section
1.59A-2(e)(3) . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Section 2—Base Erosion Payments and Base Erosion Tax Benefits (see instructions)
Description (a) Total
(b) Total base erosion
payments
(c) Total base erosion
tax benefits
6 Reserved for future use . . . . . . . . . . . . . . . . . . . . . . . . .
7 Reserved for future use . . . . . . . . . . . . . . . . . . . . . . . . .
8 Purchase or creations of property rights for intangibles (patents, trademarks, etc.) . . . . . . . .
9 Rents, royalties, and license fees . . . . . . . . . . . . . . . . . . . . . .
10a Compensation/consideration paid for services not excepted by section 59A(d)(5) . . . . . . . .
b Compensation/consideration paid for services excepted by section 59A(d)(5) . . . . . . . . .
11 Interest expense . . . . . . . . . . . . . . . . . . . . . . . . . . .
12 Payments for the purchase of tangible personal property . . . . . . . . . . . . . . .
13
Premiums and/or other considerations paid or accrued for insurance and reinsurance as covered by
sections 59A(d)(3) and 59A(c)(2)(A)(iii) . . . . . . . . . . . . . . . . . . . . .
14a Nonqualified derivative payments . . . . . . . . . . . . . . . . . . . . . .
b Qualified derivative payments excepted by section 59A(h) . . . . . . . . . . . . . . .
15 Payments reducing gross receipts made to surrogate foreign corporation . . . . . . . . . .
16 Other payments—specify
17
Base erosion tax benefits related to payments reported on lines 6 through 16, on which tax is imposed by
section 871 or 881, with respect to which tax has been withheld under section 1441 or 1442 at the 30%
(0.30) statutory withholding tax rate . . . . . . . . . . . . . . . . . . . . .
Schedule K-3 (Form 1065) 2021
Schedule K-3 (Form 1065) 2021
Page 17
Name of partnership
EIN
Name of partner
SSN or TIN
Part IX Partner’s Information for Base Erosion and Anti-Abuse Tax (Section 59A) (continued)
Section 2—Base Erosion Payments and Base Erosion Tax Benefits (see instructions) (continued)
(a) Total
(b) Total base erosion
payments
(c) Total base erosion
tax benefits
18
Portion of base erosion tax benefits reported on lines 6 through 16, on which tax is imposed by section
871 or 881, with respect to which tax has been withheld under section 1441 or 1442 at reduced
withholding rate pursuant to income tax treaty. Multiply ratio of percentage withheld divided by 30% (0.30)
times tax benefit. See instructions . . . . . . . . . . . . . . . . . . . . . .
19 Total base erosion tax benefits (subtract the sum of lines 17 and 18 from the sum of lines 8 through 16) .
20 Reserved for future use . . . . . . . . . . . . . . . . . . . . . . . . .
21 Reserved for future use . . . . . . . . . . . . . . . . . . . . . . . . .
22 Reserved for future use . . . . . . . . . . . . . . . . . . . . . . . . .
Part X Foreign Partner’s Character and Source of Income and Deductions
Section 1—Gross Income
Description (a) Total
(b) Partner
determination
Partnership Determination
ECI Non-ECI
(c) U.S. source (d) Foreign source
(e) U.S. source
(FDAP)
(f) U.S. source
(other)
(g) Foreign source
1 Ordinary business income (gross) . .
2 Gross rental real estate income . .
3 Other gross rental income . . . .
4 Guaranteed payments for services .
5
Guaranteed payments for use of capital
6 Interest income . . . . . . .
7 Dividends . . . . . . . . .
8 Dividend equivalents . . . . .
9 Royalties and license fees . . . .
10 Net short-term capital gain . . . .
11 Net long-term capital gain . . . .
12 Collectibles (28%) gain . . . . .
13 Unrecaptured section 1250 gain . .
14 Net section 1231 gain . . . . .
15 Reserved for future use . . . . .
16 Reserved for future use . . . . .
17 Reserved for future use . . . . .
18 Reserved for future use . . . . .
19 Reserved for future use . . . . .
20
Other income (loss) not included on
lines 1 through 19 . . . . . .
21 Gross income (sum of lines 1
through 20) . . . . . . .
Schedule K-3 (Form 1065) 2021
Schedule K-3 (Form 1065) 2021
Page 18
Name of partnership
EIN
Name of partner
SSN or TIN
Part X Foreign Partner’s Character and Source of Income and Deductions (continued)
Section 2—Deductions, Losses, and Net Income
Description (a) Total
(b) Partner
determination
Partnership Determination
ECI Non-ECI
(c) U.S. source (d) Foreign source
(e) U.S. source
(FDAP)
(f) U.S. source
(other)
(g) Foreign source
1
Expenses related to ordinary business
income (gross) . . . . . . .
2 Research and experimental expenses
3 Expenses from rental real estate . .
4 Expenses from other rental activities .
5 Royalty and licensing expenses . .
6 Section 179 deduction . . . . .
7 Interest expense on U.S.-booked
liabilities . . . . . . . . .
8
Interest expense directly allocable
under Regulations sections
1.882-5(a)(1)(ii)(B) and 1.861-10T . .
9 Other interest expense . . . . .
10 Section 59(e)(2) expenditures . . .
11 Net short-term capital loss . . . .
12 Net long-term capital loss . . . .
13 Collectibles loss . . . . . . .
14 Net section 1231 loss . . . . .
15 Other losses . . . . . . . .
16 Charitable contributions . . . .
17
Other
18
Other
19
Reserved for future use . . . . .
20 Reserved for future use . . . . .
21 Reserved for future use . . . . .
22 Reserved for future use . . . . .
23 Reserved for future use . . . . .
24 Total (sum of lines 1 through 23) . .
25
Net income (loss) (line 21 (Section 1)
minus line 24 (Section 2)) . . .
Schedule K-3 (Form 1065) 2021
Schedule K-3 (Form 1065) 2021
Page 19
Name of partnership
EIN
Name of partner
SSN or TIN
Part X Foreign Partner’s Character and Source of Income and Deductions (continued)
Section 3—Allocation and Apportionment Methods for Deductions
1 Gross income
a
Gross ECI . . . . . . . . . . . . . .
b
Worldwide gross income . . . . . . . . . .
2 Assets
a Average U.S. assets (inside basis) . . . . . . .
b
Worldwide assets . . . . . . . . . . . .
3 Liabilities
a U.S.-booked liabilities of partnership . . . . . .
b
Directly allocated partnership indebtedness . . . .
4 Personnel
a Personnel of U.S. trade or business . . . . . .
b
Worldwide personnel . . . . . . . . . . .
5 Gross receipts from sales or services by SIC code
(i) SIC code (ii) ECI (iii) Worldwide
a
b
6 Reserved for future use
(i) (ii) (iii)
a
b
7 Other allocation and apportionment key
(i) Key/Factor (ii) Allocation
a
b
8 Other allocation and apportionment key
(i) Key/Factor (ii) Allocation
a
b
Section 4—Reserved for Future Use
Reserved (a) (b) (c)
1 Reserved for future use . . . . . . . . . . . . . . . . . . . . . . . . .
2 Reserved for future use . . . . . . . . . . . . . . . . . . . . . . . . .
3 Reserved for future use . . . . . . . . . . . . . . . . . . . . . . . . .
4 Reserved for future use . . . . . . . . . . . . . . . . . . . . . . . . .
5 Reserved for future use . . . . . . . . . . . . . . . . . . . . . . . . .
6 Reserved for future use . . . . . . . . . . . . . . . . . . . . . . . . .
7 Reserved for future use . . . . . . . . . . . . . . . . . . . . . . . . .
8 Reserved for future use . . . . . . . . . . . . . . . . . . . . . . . . .
9 Reserved for future use . . . . . . . . . . . . . . . . . . . . . . . . .
10 Reserved for future use . . . . . . . . . . . . . . . . . . . . . . . . .
Schedule K-3 (Form 1065) 2021
Schedule K-3 (Form 1065) 2021
Page 20
Name of partnership
EIN
Name of partner
SSN or TIN
Part XI Section 871(m) Covered Partnerships
1
Box is checked if the partnership is a publicly traded partnership as defined in section 7704(b) and the partnership is a covered partnership as defined in Regulations section 1.871-15(m)(1) or
directly or indirectly holds an interest in a lower-tier partnership that is a covered partnership . . . . . . . . . . . . . . . . . . . . . . . . . . .
2
Number of units held by the partner
3 For each allocation period, see the following information for the number of units specified on line 2.
(i) Beginning of allocation period (ii) End of allocation period
(iii) Dividends
(enter four decimal places)
(iv) Dividend equivalents
(enter four decimal places)
(v) Total
(enter four decimal places)
. . .
. . .
. . .
. . .
Part XII Reserved for future use
Part XIII Foreign Partner’s Distributive Share of Deemed Sale Items on Transfer of Partnership Interest
A
Date of transfer of the partnership interest
.
B1 Percentage interest in the partnership transferred . . . . . .
B2 Number of units in the partnership transferred
B3 Reserved for future use
. . . . . . . . . . . . .
C Check if: 1 Capital 2 Preferred 3 Profits 4 Other
Partner’s Distributive Share
1 Total ordinary gain (loss) that would be recognized on the deemed sale of section 751 property . . . . . . . . . . . . . . . . .
1
2 Aggregate effectively connected ordinary gain (loss) that would be recognized on the deemed sale of section 751 property . . . . . . . . . 2
3 Aggregate effectively connected capital gain (loss) that would be recognized on the deemed sale of non-section 751 property . . . . . . . . 3
4 Gain (loss) that would be recognized under section 897(g) on the deemed sale of U.S. real property interests . . . . . . . . . . . . . 4
5 Check this box if the amount provided on line 2 or 3 is determined (in whole or in part) under Regulations section 1.864(c)(8)-1(c)(2)(ii)(E) (material
change in circumstances rule for a deemed sale of the partnership’s inventory property or intangibles) . . . . . . . . . . . .
6 Reserved for future use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
7 Reserved for future use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
8 Reserved for future use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
Schedule K-3 (Form 1065) 2021