FORM BE-12A (REV 9/2017)
218 Number of Parts III filed by the U.S. affiliate – If there is only one, enter “1. ............................................
Part III – Investment and Transactions Between U.S. Affiliate and Affiliated Foreign Group
Name of U.S. business enterprise shown on
page 1 of this BE-12A
Instructions for Part III – Prepare a separate Part III to report each ownership interest held by a foreign parent, at anytime during the fiscal year that
ended in calendar year 2017, in the U.S. affiliate named on page 1 of this BE-12. If a foreign parent held both direct and indirect ownership interests in
this U.S. affiliate, prepare one Part III to report the direct interest and a separate Part III to report the indirect interest. A Part III must also be prepared
for foreign parent ownership interests disposed of during the year.
Use this Part III to report the foreign parent with the largest voting interest at year-end. Use copies of this Part III to report all additional direct and
indirect voting interests, if any, held by foreign parents in this U.S. affiliate. Additional Part III pages may be downloaded from www.bea.gov/fdi.
If more than one Part III is filed, do not duplicate positions in, or transactions with, the U.S. affiliate.
Section A – IDENTIFICATION OF FOREIGN PARENT AND ULTIMATE BENEFICIAL OWNER (UBO)
BEA USE ONLY
Control number
3010
1
219 Enter name of foreign parent being reported in this Part III. If the foreign parent is an individual enter “individual.
0
3011
220 For the foreign parent named in item 219 , this Part III is being used to report – Mark (X) one. A direct foreign parent ownership interest in the
U.S. affiliate should match the percentage reported on page 4. An indirect foreign parent ownership interest in the U.S. affiliate must be calculated
based on the percentages reported on page 5.
1
3012
A direct ownership interest in the U.S. affiliate. See example 1 on page 21 for an illustration of a direct ownership interest.
An indirect ownership interest in the U.S. affiliate. See example 2 on page 21 for an illustration of an indirect ownership interest, and
diagram on page 33 for an illustration of how to calculate percentage of indirect foreign parent ownership.
3013
1
Close FY 2017 Close FY 2016
221 If item 220 is marked direct–
Give percent of –
“Voting interest” and “equity interest” are defined in instruction
14–17 on page 39. If the U.S. affiliate is a partnership or Limited
Liability Company also see instructions 8.b. and 8.c. on page
38.
NOTE – Ownership percentages reported in item 221 must
match those reported in item 14 for the foreign parent listed in
item 219 .
(1) (2)
1 2
a. Voting interest owned ...............................
% % . .
3014
1 2
b. Equity interest owned ...............................
% % . .
3015
222 Country in which foreign parent named in item 219
BEA USE ONLY
a. is incorporated or organized, if a
business enterprise, or is a resident,
if an individual. See instruction V.G.
on page 42 ................................................
b. is located, if a business enterprise
and the country is different from that
in item 222a ..............................................
1
3016
1
3017
223 Enter the industry code of the foreign parent named in item 219 , from the list of codes on page 21 that best describes
the PRIMARY activity of the SINGLE entity named as the foreign parent. DO NOT base the code on the worldwide sales
of all consolidated subsidiaries of the foreign parent. ..........................................................................................................................
1
3018
Page 20
— — — — — — — —
— — — — — — — —
--Select Country--
--Select Country--
--Select Industry--
FORM BE-12A (REV 9/2017)
FOREIGN PARENT AND UBO INDUSTRY CODES
Note: “ISI codes” are International Surveys Industry codes, as given in the Guide to Industry
Classifications for International Surveys, 2017.
17 Information (ISI codes 5111–5191)
18 Professional, scientific, and technical services
(ISI codes 5411–5419)
19 Other services (ISI codes 1150, 2132, 2133, 5321,
5329, and 5611–8130)
Manufacturing, including fabricating,
assembling, and processing of goods:
20 Food (ISI codes 3111–3119)
21 Beverages and tobacco products (ISI codes 3121 and 3122)
22 Pharmaceuticals and medicine (ISI code 3254)
23 Other chemicals (ISI codes 3251–3259, except 3254)
24 Nonmetallic mineral products (ISI codes 3271–3279)
25 Primary and fabricated metal products
(ISI codes 3311–3329)
26 Computer and electronic products (ISI codes 3341–3346)
27 Machinery (ISI codes 3331–3339)
28 Electrical equipment, appliances and
components (ISI codes 3351–3359)
29 Motor vehicles and parts (ISI codes 3361–3363)
30 Other transportation equipment (ISI codes 3364–3369)
31 Other manufacturing (ISI codes 3130–3231, 3261, 3262,
3370–3399)
32 Petroleum manufacturing, including integrated petroleum
and petroleum refining without extraction (ISI codes
3242–3244)
01 Government and government-owned or
-sponsored enterprise, or quasi-government
organization or agency
02 Pension fund — Government run
03 Pension fund — Privately run
04 Estate, trust, or nonprofit organization
05 Individual
Private business enterprise, investment
organization, or group engaged in:
06 Insurance (ISI codes 5242, 5243, 5249)
07 Agriculture, forestry, fishing and hunting
(ISI codes 1110–1140)
08 Mining (ISI codes 2111–2127)
09 Construction (ISI codes 2360–2380)
10 Transportation and warehousing (ISI codes 4810–
4939)
11 Utilities (ISI codes 2211–2213)
12 Wholesale and retail trade (ISI codes 4231–4540)
13 Banking, including bank holding companies
(ISI codes 5221 and 5229)
14 Holding companies, excluding bank holding
companies (ISI codes 5512 and 5513)
15 Other finance (ISI codes 5223, 5224, 5231, 5238, that
part of ISI code 5252 that is not estates and trusts,
and ISI code 5331)
16 Real estate (ISI code 5310)
Part III – Investment and Transactions Between U.S. Affiliate and Affiliated Foreign Group – Continued
Page 21
Example 1. Ownership held directly by a foreign parent
Foreign company Y is the
foreign parent because it is
the first owner located outside
the U.S. in a chain of ownership
that owns 10 percent or more
of the U.S. affiliate.
Foreign
United States
Foreign company X
Foreign company Y
(foreign parent)
10 to 100 percent
U.S. affiliate
Example 2. Ownership held directly by all U.S. affiliates of
the foreign parent(s)
Foreign
United States
U.S. affiliate B is indirectly
owned by the foreign parent
through U.S. affiliate A. U.S.
affiliate A has a direct ownership
interest in U.S. affiliate B.
Foreign parent
10 to 100 percent
U.S. affiliate A
U.S. affiliate B
EXAMPLES OF DIRECT AND INDIRECT FOREIGN OWNERSHIP
FORM BE-12A (REV 9/2017)
Part III – Investment and Transactions Between U.S. Affiliate and Affiliated Foreign Group – Continued
Section A – IDENTIFICATION OF FOREIGN PARENT AND ULTIMATE BENEFICIAL OWNER (UBO) – Continued
Furnish the name, country, and industry code of the UBO. The UBO is that person or entity, proceeding up the ownership chain
beginning with and including the foreign parent, that is not more than 50 percent owned or controlled by another person or entity. See
instruction II.P. on page 36 for the complete definition of UBO.
NOTE: See the diagrams at the bottom of this page for examples of the UBO.
224 Is the foreign parent named in item 219 also the UBO? If the foreign parent is owned or controlled MORE THAN 50 percent by another
person or entity, then the foreign parent is NOT the UBO.
1 Yes – (example 1 below) – Skip to 227
3019
2 No – (examples 2A and 2B below) – Continue with item 225
225 Enter the name of the UBO of the foreign parent. If the UBO is an individual, or an associated group of individuals, enter “individual. See
instruction II.D. on page 35 for the definition of associated group. Identifying the UBO as “bearer shares” is not an acceptable response.
0
3021
226 Enter country in which the UBO is incorporated or organized, if a business enterprise, or is resident, if an
individual or government. For individuals, see instruction V.G. on page 42.
BEA USE ONLY
227 Enter the industry code of the UBO from the list of codes on page 21. Select the industry code that best reflects the consolidated worldwide
sales of the UBO, including all of its majority-owned subsidiaries.
3023 1
DO NOT use code "14" for UBO.
Page 22
1
1
EXAMPLES OF THE ULTIMATE BENEFICIAL OWNER (UBO)
Example 1 – The UBO and foreign parent are the same
Foreign company X
The UBO and foreign parent are the
same if the foreign parent is NOT
more than 50 percent owned or
controlled by another person or entity.
1 to 50 percent
Foreign parent = UBO
Foreign
United States
U.S. affiliate
Examples 2A and 2B – The foreign parent is NOT the UBO
A. The UBO is a foreign person or entity
B. The UBO is a U.S. person or entity
Foreign company X
(UBO)
Foreign company Z is the foreign
parent of the U.S. affiliate. U.S.
company C is the UBO.
Foreign company Y is the foreign
parent of the U.S. affiliate; foreign
company X is the UBO. The foreign
parent is not the UBO if the foreign
parent is more than 50 percent
owned or controlled by another
person or entity.
>50 Percent
Foreign company Z
(Foreign Parent)
Foreign company Y
(foreign parent)
>50 Percent
Foreign
Foreign
United States
United States
U.S. affiliate
U.S. company C
(UBO)
U.S. affiliate
1 3022
--Select Country--
--Select Industry--
FORM BE-12A (REV 9/2017)
NOTE: Amounts reported in Sections B, C, D, and E must be for the fully consolidated U.S. affiliate. The consolidation rules begin
on page 36.
228 Copy your answer from item 220 to the appropriate box below and follow the applicable instructions.
1
A direct interest – Continue with item 229 . Do not duplicate data reported on other Parts III.
1
1
b.
An indirect interest – Skip to item 230 . Do not duplicate data reported on other Parts III.
2
a.
Item 229e – Report dividends as of the date they were declared or paid, GROSS of any U.S. tax withheld. Any subsequent settlement of
dividends declared but not paid SHOULD NOT be reported a second time, but should be reflected only as a reduction in item 235 .
Exclude stock and liquidating dividends. Report liquidating dividends in item 241 .
Item 229f – Report gross amounts of earnings distributed by unincorporated U.S. affiliates, whether out of current or past earnings.
Section B – FOREIGN PARENT’S DIRECT EQUITY SHARE IN THE U.S. AFFILIATE, AS CONSOLIDATED
229 What is the foreign parent’s share of:
a. The U.S. affiliate’s net income (loss), after provision for income taxes?
Enter the foreign parent’s share of item 49 .................................................................................................................
b. Certain gains (losses) included in net income in item 229a ? Enter the foreign parent’s share of item 42 .................
c. U.S. Federal, state, and local income taxes on certain gains (losses) reported in 229b ?
Enter the portion of item 46 that is the income tax effect on the amount reported in item 229b ...............................
d. Certain gains (losses) not included in net income in item 229a but taken to other comprehensive income?
Enter the foreign parent’s share of the CHANGE in item 77b of the balance sheet ....................................................
e. Dividends on common and preferred stock (gross of U.S. withholding taxes) excluding stock dividends? ...................
f. Earnings distributed by unincorporated U.S. affiliates? .................................................................................................
g. U.S. tax withheld on dividends (item 229e ) or on distributed earnings of unincorporated U.S. affiliate
(item 229f )? .................................................................................................................................................................
FY 2017
1
1
1
3085
3086
3087
3088
3074
3075
1
1
1
1
3076
Part III – Investment and Transactions Between U.S. Affiliate and Affiliated Foreign Group – Continued
Page 23
BEA USE ONLY
1
3077
$ Bil. Mil. Thous. Dols.
000
000
000
000
000
000
000
INSTRUCTIONS FOR SECTION B
Section C – REVERSE OWNERSHIP
1
1
1
2
3092
CLOSE FY 2017
Voting
Interest
(1)
Equity
Interest
(2)
Value of
equity owned
(3)
Percent Percent
000
31 2
3093
___ ___ ___ . ___% ___ ___ ___ . ___%
$ Bil. Mil. Thous. Dols.
230 Did the U.S. affiliate have a voting and/or equity interest in the foreign parent?
A U.S. affiliate has reverse ownership in its foreign parent if it has a voting or
equity interest in the foreign parent.
Yes – Enter percent of ownership, to the tenth of one percent, and
the dollar value of the equity owned in the foreign parent by the U.S.
affiliate at the end of FY 2017 ......................................................................
No – Continue with item 231
FORM BE-12A (REV 9/2017)
Part III – Investment and Transactions Between U.S. Affiliate and Affiliated Foreign Group – Continued
Section D – PAYABLE AND RECEIVABLE BALANCES, AND INTEREST, BETWEEN AFFILIATED FOREIGN GROUP AND
U.S. AFFILIATE, AS CONSOLIDATED
Finance Industry Classifications
5221 Depository credit intermediation (Banking)
5223 Activities related to credit intermediation
5224 Non-depository credit intermediation, except branches and agencies
5229 Non-depository branches and agencies
5231 Securities and commodity contracts intermediation and brokerage
5238 Other financial investment activities and exchanges
5252 Funds, trusts, and other finance vehicles
Insurance Industry Classifications
5242 Agencies, brokerages, and other insurance related activities
5243 Insurance carriers, except direct life insurance carriers
5249 Direct life insurance carriers
Real Estate and Rental and Leasing Industry Classifications
5310 Real estate
5321 Automotive equipment rental and leasing
5329 Other rental and leasing activities
5331 Lessors of nonfinancial intangible assets, except copyrighted works
Questions 231 through 234
are intended to assist banks and other types of finance companies in determining how to complete the rest of Part III .
U.S. affiliates that also file Treasury International Capital (TIC) B Forms may not be required to complete 235 through 238 .
231 Is the foreign parent listed in 219 a depository or non-depository bank (ISI codes 5221 or 5229), a securities broker or dealer
(ISI codes 5231) or in the finance industry (ISI codes 5223, 5224, 5238, 5252)?
232 Is the U.S. affiliate a “bank” (ISI codes 5221 or 5229) or primarily acting as a securities broker or dealer (ISI codes 5231)?
Note: A “bank” is a business engaged in deposit banking or closely related functions, including commercial
banks, Edge Act corporations, U.S. branches and agencies of foreign banks, savings and loans, savings banks,
bank holding companies and financial holding companies under the Gramm–Leach–Bliley Act.
233 Do any of the U.S. business enterprises consolidated in this report have insurance (ISI codes 5242, 5243, or 5249), real estate
(ISI code 5310), or leasing activities (ISI codes 5321, 5329, or 5331)?
234 Do any of the U.S. business enterprises consolidated in this report have depository or non-depository banking activities
(ISI codes 5221 or 5229) or securities broker or dealer activities (ISI codes 5231)?
3052
1
2
Yes
No – SKIP to 235 .
3053
1
2
Yes
No – SKIP to 234 .
3054
1
2
Yes – Complete 235 thru 238 but ONLY report balances and interest between this U.S. affiliate and the affiliated
foreign group that relate to insurance, real estate, and leasing activities.
No – SKIP to 239 .
3055
1
2
Yes – Complete 235 thru 238 but ONLY report balances and interest between this U.S. affliliate and the
affiliated foreign group NOT related to depository or non-depository banking activities or securities broker
or dealer activities.
No – Continue to 235 .
Page 24
FORM BE-12A (REV 9/2017)
Part III – Investment and Transactions Between U.S. Affiliate and Affiliated Foreign Group – Continued
Report all current and long-term intercompany accounts and interest between the U.S. affiliate and the affiliated foreign group.
• Derivatives Contracts – EXCLUDE the value of outstanding financial derivatives contracts
and any payments or receipts resulting from the settlement of those contracts. For example, the
settlements of interest rate derivatives should NOT be reported as interest or as another type of
transaction on this form. Derivatives contracts are covered by the Treasury International Capital (TIC)
Form D, Report of Holdings of, and Transactions in, Financial Derivatives Contracts.
• Leases – If leases between the U.S. affiliate and the affiliated foreign group are capitalized, then the
outstanding capitalized value should be reported as an intercompany balance. Lease payments should
be disaggregated into the amounts that are (i) a reduction in an intercompany balance, and (ii) interest.
• Insurance Technical Reserves – INCLUDE these provisions (prepaid premiums, claims payable, etc.)
when with related parties.
DO NOT net payables and receivables.
DO NOT net interest expense against interest income.
Interest expense and interest income should be reported on the accrual basis.
Please see the diagram above and on page 13 to identify the Foreign Parent and the Foreign Affiliates of the Foreign Parent (FAFP). Report payable
and receivable balances as well as the annual interest expense and interest income, separately for each. Note: Country detail will be required for
FAFP transactions in 237 and 238 .
235 What were the total short- and long-term payable balances owed by the U.S. affiliate to the affiliated foreign group, and the related
interest expense?
Payable/expensed to:
TOTAL short- and long-term payables Interest expense
Close FY 2017 Close FY 2016 FY 2017
$ Bil. Mil. Thou. Dols. $ Bil. Mil. Thou. Dols. $ Bil. Mil. Thou. Dols.
A. Foreign parent .......................................................3056
1
000
2
000
3
000
B. Foreign affiliates of the foreign parent (FAFP) ...... 3072
1
000
2
000
3
000
C. TOTAL for affiliated foreign group .........................3059
1
000
2
000
3
000
236 What were the total short- and long-term receivable balances owed to the U.S. affiliate by the affiliated foreign group, and the related
interest income?
Receivable/income from:
TOTAL short- and long-term receivables Interest income
Close FY 2017 Close FY 2016 FY 2017
$ Bil. Mil. Thou. Dols. $ Bil. Mil. Thou. Dols. $ Bil. Mil. Thou. Dols.
A. Foreign parent .......................................................3057
1
000
2
000
3
000
B. Foreign affiliates of the foreign parent (FAFP) ...... 3094
1
000
2
000
3
000
C. TOTAL for affiliated foreign group .........................3081
1
000
2
000
3
000
Affiliated foreign group
>50%
Foreign Parent
This U.S. affiliate
>50%
FAFP
>50%
Foreign
United States
FAFP
FAFP
see page 13 for diagram description
Page 25
BEA USE ONLY
3064
3084
1
1
2
2
0
0
0
0
0
0
FORM BE-12A (REV 9/2017)
Part III – Investment and Transactions Between U.S. Affiliate and Affiliated Foreign Group – Continued
U.S. AFFILIATES' PAYABLES AND INTEREST EXPENSE TO FAFPs
237 How are the amounts reported in
235 B allocated by country?
Short- and long-term payables Interest expense
Close FY 2017 Close FY 2016 FY 2017
$ Bil. Mil. Thou. Dols. $ Bil. Mil. Thou. Dols. $ Bil. Mil. Thou. Dols.
A. Australia
4101
1
601
2
000
3
000
4
000
B. Brazil
4102
1
202
2
000
3
000
4
000
C. Canada
4103
1
100
2
000
3
000
4
000
D. China
4104
1
650
2
000
3
000
4
000
E. France
4105
1
307
2
000
3
000
4
000
F. Germany
4106
1
308
2
000
3
000
4
000
G. Japan
4107
1
614
2
000
3
000
4
000
H. Mexico
4108
1
213
2
000
3
000
4
000
I. Netherlands
4109
1
319
2
000
3
000
4
000
J. Singapore
4110
1
625
2
000
3
000
4
000
K. Switzerland
4111
1
325
2
000
3
000
4
000
L. United Kingdom
4112
1
327
2
000
3
000
4
000
M.
Other countries - Specify
4113
1 2
000
3
000
4
000
N.
4114
1 2
000
3
000
4
000
O.
4115
1 2
000
3
000
4
000
P.
4116
1 2
000
3
000
4
000
Q.
4117
1 2
000
3
000
4
000
R.
4118
1 2
000
3
000
4
000
S.
4119
1 2
000
3
000
4
000
T.
4120
1 2
000
3
000
4
000
U.
4121
1 2
000
3
000
4
000
V.
4122
1 2
000
3
000
4
000
W.
4123
1 2
000
3
000
4
000
X.
4124
1 2
000
3
000
4
000
Y.
4125
1 2
000
3
000
4
000
Z. Unallocated* 4148
1
709
2
000
3
000
4
000
Continue listing onto as many copied pages as needed.
*Unallocated – Combine values for countries which individually amount to less than $500 thousand.
Notes
Page 26
FORM BE-12A (REV 9/2017)
Part III – Investment and Transactions Between U.S. Affiliate and Affiliated Foreign Group – Continued
U.S. AFFILIATES' PAYABLES AND INTEREST EXPENSE TO FAFPs
237 How are the amounts reported in
235 B allocated by country?
Short- and long-term payables Interest expense
Close FY 2017 Close FY 2016 FY 2017
$ Bil. Mil. Thou. Dols. $ Bil. Mil. Thou. Dols. $ Bil. Mil. Thou. Dols.
4126
1
2
000
3
000
4
000
4127
1
2
000
3
000
4
000
4128
1
2
000
3
000
4
000
4129
1
2
000
3
000
4
000
4130
1
2
000
3
000
4
000
4131
1
2
000
3
000
4
000
4132
1
2
000
3
000
4
000
4133
1
2
000
3
000
4
000
4134
1
2
000
3
000
4
000
4135
1
2
000
3
000
4
000
4136
1
2
000
3
000
4
000
4137
1
2
000
3
000
4
000
4138
1 2
000
3
000
4
000
4139
1 2
000
3
000
4
000
4140
1 2
000
3
000
4
000
4141
1 2
000
3
000
4
000
4142
1 2
000
3
000
4
000
4143
1 2
000
3
000
4
000
4144
1 2
000
3
000
4
000
4145
1 2
000
3
000
4
000
4146
1 2
000
3
000
4
000
4147
1 2
000
3
000
4
000
--Select Country--
--Select Country--
--Select Country--
--Select Country--
--Select Country--
--Select Country--
--Select Country--
--Select Country--
--Select Country--
--Select Country--
--Select Country--
--Select Country--
--Select Country--
--Select Country--
--Select Country--
--Select Country--
--Select Country--
--Select Country--
--Select Country--
--Select Country--
--Select Country--
--Select Country--
FORM BE-12A (REV 9/2017)
Part III – Investment and Transactions Between U.S. Affiliate and Affiliated Foreign Group – Continued
Page 27
U.S. AFFILIATES' RECEIVABLES AND INTEREST INCOME TO FAFPs
238 How are the amounts reported in
236 B allocated by country?
Short- and long-term receivables Interest income
Close FY 2017 Close FY 2016 FY 2017
$ Bil. Mil. Thou. Dols. $ Bil. Mil. Thou. Dols. $ Bil. Mil. Thou. Dols.
A. Australia
4150
1
601
2
000
3
000
4
000
B. Brazil
4151
1
202
2
000
3
000
4
000
C. Canada
4152
1
100
2
000
3
000
4
000
D. China
4153
1
650
2
000
3
000
4
000
E. France
4154
1
307
2
000
3
000
4
000
F. Germany
4155
1
308
2
000
3
000
4
000
G. Japan
4156
1
614
2
000
3
000
4
000
H. Mexico
4157
1
213
2
000
3
000
4
000
I. Netherlands
4158
1
319
2
000
3
000
4
000
J. Singapore
4159
1
625
2
000
3
000
4
000
K. Switzerland
4160
1
325
2
000
3
000
4
000
L. United Kingdom
4161
1
327
2
000
3
000
4
000
M.
Other countries - Specify
4162
1 2
000
3
000
4
000
N.
4163
1 2
000
3
000
4
000
O.
4164
1 2
000
3
000
4
000
P.
4165
1 2
000
3
000
4
000
Q.
4166
1 2
000
3
000
4
000
R.
4167
1 2
000
3
000
4
000
S.
4168
1 2
000
3
000
4
000
T.
4169
1 2
000
3
000
4
000
U.
4170
1 2
000
3
000
4
000
V.
4171
1 2
000
3
000
4
000
W.
4172
1 2
000
3
000
4
000
X.
4173
1 2
000
3
000
4
000
Y.
4174
1 2
000
3
000
4
000
Z. Unallocated*
4198
1
709
2
000
3
000
4
000
Continue listing onto as many copied pages as needed.
*Unallocated – Combine values for countries which individually amount to less than $500 thousand.
Notes
--Select Country--
--Select Country--
--Select Country--
--Select Country--
--Select Country--
--Select Country--
--Select Country--
--Select Country--
--Select Country--
--Select Country--
--Select Country--
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FORM BE-12A (REV 9/2017)
Part III – Investment and Transactions Between U.S. Affiliate and Affiliated Foreign Group – Continued
U.S. AFFILIATES' RECEIVABLES AND INTEREST INCOME TO FAFPs
238 How are the amounts reported in
236 B allocated by country?
Short- and long-term receivables Interest income
Close FY 2017 Close FY 2016 FY 2017
$ Bil. Mil. Thou. Dols. $ Bil. Mil. Thou. Dols. $ Bil. Mil. Thou. Dols.
4175
1
2
000
3
000
4
000
4176
1
2
000
3
000
4
000
4177
1
2
000
3
000
4
000
4178
1
2
000
3
000
4
000
4179
1
2
000
3
000
4
000
4180
1
2
000
3
000
4
000
4181
1
2
000
3
000
4
000
4182
1
2
000
3
000
4
000
4183
1
2
000
3
000
4
000
4184
1
2
000
3
000
4
000
4185
1
2
000
3
000
4
000
4186
1
2
000
3
000
4
000
4187
1 2
000
3
000
4
000
4188
1 2
000
3
000
4
000
4189
1 2
000
3
000
4
000
4190
1 2
000
3
000
4
000
4191
1 2
000
3
000
4
000
4192
1 2
000
3
000
4
000
4193
1 2
000
3
000
4
000
4194
1 2
000
3
000
4
000
4195
1 2
000
3
000
4
000
4196
1 2
000
3
000
4
000
4197
1 2
000
3
000
4
000
--Select Country--
--Select Country--
--Select Country--
--Select Country--
--Select Country--
--Select Country--
--Select Country--
--Select Country--
--Select Country--
--Select Country--
--Select Country--
--Select Country--
--Select Country--
--Select Country--
--Select Country--
--Select Country--
--Select Country--
--Select Country--
--Select Country--
--Select Country--
--Select Country--
--Select Country--
--Select Country--
FORM BE-12A (REV 9/2017)
Section E – CHANGE IN THE FOREIGN PARENT’S SHARE OF THE U.S. AFFILIATE’S CAPITAL ACCOUNT (IF INCORPORATED)
OR EQUITY (IF UNINCORPORATED)
Part III – Investment and Transactions Between U.S. Affiliate and Affiliated Foreign Group – Continued
Page 28
000
239 During the year indicated in item 6, was there a change in the foreign parent’s share of the U.S. affiliate’s capital account
(if incorporated) or equity (if unincorporated)?
Report in 240 or 241 the transaction value (i.e., market value) of consideration given or received.
Unincorporated U.S. affiliates must report the foreign parent’s share of any increase (decrease) in the U.S. affiliate’s equity (or home office
account), arising from its transactions with the foreign parent, excluding amounts reported in Part III , Section B and Section D.
Include in 240 and 241 changes caused by:
Treasury stock transactions with the foreign parent and liquidating dividends;
Capitalization of intercompany debt (report the amount of debt converted to equity as the transaction value of the equity increase in
240C ), and adjust the debt balance as appropriate in 235A ;
Purchase or sale of capital stock by the foreign parent from or to the U.S. affiliate;
Change in capital of the U.S. affiliate owned by the foreign parent that did not result from a change of stock issued.
Exclude from 240 and 241 changes caused by:
Carrying net income (loss) to the equity account (i.e., retained earnings);
Dividends/earnings distributed and stock dividends. Report in 229E or 229F ;
Balance sheet translation adjustments;
The effect of treasury stock transactions with persons other than the foreign parent;
Reorganizations in capital structure that do not affect total equity;
Investments that are written off.
3097
1
2
Yes
No – DO NOT complete items 240 through 243 . You are done with this Part III.
240 What is the increase in the foreign parent’s equity interest in the U.S. affiliate due to:
3068
$ Bil. Mil. Thou. Dols.
A. Establishment of the U.S. affiliate or acquisition (partial or total) of an equity
interest in this U.S. affiliate by the foreign parent from other foreign persons? ..............................................
3067
B. Acquisition (partial or total) of an equity interest in this U.S. affiliate by the foreign
parent from other U.S. persons?.....................................................................................................................
241 What is the decrease in the foreign parent’s equity interest in the U.S. affiliate due to:
A. Liquidation or sale (partial or total) of an equity interest in this U.S. affiliate by the
foreign parent to other foreign persons?.........................................................................................................
3070
B. Sale (partial or total) of an equity interest in this U.S. affiliate by the foreign parent
to other U.S. persons? ....................................................................................................................................
3069
C. Return of capital and other transactions from the U.S. affiliate to the foreign parent? ......................................
242 What is the total change in the foreign parent’s equity interest in the U.S. affiliate
from the prior year? Sum of ( 240A + 240B + 240C ) minus ( 241A + 241B + 241C ) .....................................
3071
243 For items 240 and 241 , what are the amounts (e.g., goodwill) by
which the transaction value:
For acquisition 240
$ Bil. Mil. Thou. Dols.
A. Exceeds the value carried on the books of the U.S. affiliate? ............................
B. Is less than the value carried on the books of the U.S. affiliate? ............................
000
000
000
000
For liquidation or sale 241
1
1
1
1 2
$ Bil. Mil. Thou. Dols.
000
000
000
3095
C. Capital contributions and other transactions by the foreign parent to the U.S.
affiliate? ..........................................................................................................................................................
000
000
000
3096
1
1
1
1
1
1
1
2
3090
3091