SCHEDULE M
(Form 5471)
(Rev. December 2018)
Department of the Treasury
Internal Revenue Service
Transactions Between Controlled Foreign Corporation
and Shareholders or Other Related Persons
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Attach to Form 5471.
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Go to www.irs.gov/Form5471 for instructions and the latest information.
OMB No. 1545-0123
Name of person filing Form 5471 Identifying number
Name of foreign corporation EIN (if any) Reference ID number (see instructions)
Important: Complete a separate Schedule M for each controlled foreign corporation. Enter the totals for each type of transaction that occurred during
the annual accounting period between the foreign corporation and the persons listed in columns (b) through (f). All amounts must be stated in U.S.
dollars translated from functional currency at the average exchange rate for the foreign corporation’s tax year. See instructions.
Enter the relevant functional currency and the exchange rate used throughout this schedule
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(a) Transactions
of
foreign corporation
(b) U.S. person
filing this return
(c) Any domestic
corporation or
partnership controlled
by U.S. person filing
this return
(d) Any other foreign
corporation or
partnership 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)
(f) 10% or more U.S.
shareholder of any
corporation
controlling the
foreign corporation
1 Sales of stock in trade (inventory) . . .
2 Sales of tangible property other than stock
in trade . . . . . . . . . .
3 Sales of property rights (patents,
trademarks, etc.) . . . . . . .
4 Platform contribution transaction payments
received . . . . . . . . . .
5
Cost sharing transaction payments received
6
Compensation received for technical,
managerial, engineering, construction, or
like services . . . . . . . . .
7 Commissions received . . . . . .
8 Rents, royalties, and license fees received
9 Hybrid dividends received (see instructions)
10
Dividends received (exclude hybrid dividends,
deemed distributions under subpart F, and
distributions of previously taxed income) .
11 Interest received . . . . . . . .
12 Premiums received for insurance or
reinsurance . . . . . . . . .
13 Add lines 1 through 12 . . . . . .
14 Purchases of stock in trade (inventory) .
15 Purchases of tangible property other than
stock in trade . . . . . . . .
16 Purchases of property rights (patents,
trademarks, etc.) . . . . . . .
17 Platform contribution transaction payments
paid . . . . . . . . . . .
18 Cost sharing transaction payments paid .
19
Compensation paid for technical, managerial,
engineering, construction, or like services .
20 Commissions paid . . . . . . .
21 Rents, royalties, and license fees paid .
22 Hybrid dividends paid (see instructions) .
23
Dividends paid (exclude hybrid dividends paid)
24 Interest paid . . . . . . . . .
25
Premiums paid for insurance or reinsurance
26 Add lines 14 through 25 . . . . .
27 Accounts Payable . . . . . . .
28
Amounts borrowed (enter the maximum loan
balance during the year)—see instructions
29 Accounts Receivable . . . . . .
30 Amounts loaned (enter the maximum loan
balance during the year)—see instructions
For Paperwork Reduction Act Notice, see the Instructions for Form 5471.
Cat. No. 49963O Schedule M (Form 5471) (Rev. 12-2018)
