Schedule M (8858) Transactions Between Foreign Disregarded Entity of a For

9
TLS, have you
transmitted all R
text files for this
cycle update?

Date

I.R.S. SPECIFICATIONS

TO BE REMOVED BEFORE PRINTING

INSTRUCTIONS TO PRINTERS
SCHEDULE M (Form 8858), PAGE 1 of 2 (PAGE 2 IS BLANK)
MARGINS: TOP 13 mm (1⁄2 "), CENTER SIDES. PRINTS: FACE ONLY
PAPER: WHITE WRITING, SUB. 20. INK: BLACK
FLAT SIZE: 216 mm (8 1⁄2 ") x 279 mm (11")
PERFORATE: NONE

(December 2004)

Date

Revised proofs
requested

Transactions Between Foreign Disregarded Entity of a
Foreign Tax Owner and the Filer or Other Related Entities

Department of the Treasury
Internal Revenue Service

䊳

Attach to Form 8858.

䊳

Signature

O.K. to print

DO NOT PRINT — DO NOT PRINT — DO NOT PRINT — DO NOT PRINT

SCHEDULE M
(Form 8858)

Action

OMB No. 1545-1910

See separate instructions.

Name of person filing Form 8858

Identifying number

Name of foreign disregarded entity

Name of tax owner

Important: Complete a separate Schedule M for each foreign disregarded entity for which the tax owner is a controlled foreign
corporation or controlled foreign partnership. Enter the totals for each type of transaction that occurred during the annual accounting
period between the foreign disregarded entity and the persons listed in the applicable columns (b) through (f). All amounts must be
stated in U.S. dollars translated from functional currency at the appropriate exchange rate for the foreign disregarded entity’s tax
year (see instructions).
Enter the relevant functional currency and the exchange rate used throughout this schedule 䊳
Column Headings. This schedule contains two sets of column headings. Check the box that identifies the status of the tax
owner and complete lines 1 through 19 with respect to the applicable set of column headings:

(b) U.S. person filing
this return

(c) Any domestic
corporation or
partnership
controlling or
controlled by the filer

(d) Any foreign
corporation or
partnership
controlling or
controlled by the
filer (other than the
tax owner)

(e) Any U.S. person
with a 10% or more
direct interest in the
controlled foreign
partnership (other
than the filer)

(b) U.S. person filing
this return

(c) Any domestic
corporation or
partnership controlled
by the filer

(d) Any foreign
corporation or
partnership controlled
by the filer (other
than tax owner)

(e) 10% or more U.S.
shareholder of any
corporation
controlling the tax
owner

Controlled Foreign Partnership
(a) Transactions of
foreign disregarded
entity

Controlled Foreign Corporation
(a) Transactions of
foreign disregarded
entity

1

Sales of inventory

2

Sales of property rights

3

Compensation received
certain services

4

Commissions received

5

Rents, royalties, and license
fees received

6

Dividends/Distributions
received

7
8
9

Interest received
Other
Add lines 1 through 8

for

10

Purchases of inventory

11

Purchases of tangible property other than inventory

12

Purchases of property rights

13

Compensation paid for certain
services

14

Commissions paid

15

Rents, royalties, and license
fees paid
Interest paid
Add lines 10 through 16

16
17
18
19

Amounts
borrowed
instructions)
Amounts
loaned
instructions)

(f) 10% or more U.S.
shareholder, or other
owner, of any entity
controlling the tax
owner

(see
(see

For Paperwork Reduction Act Notice, see the Instructions for Form 8858.

Cat. No. 37387C

Schedule M (Form 8858) (12-2004)