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I.R.S. SPECIFICATIONS
TO BE REMOVED BEFORE PRINTING
INSTRUCTIONS TO PRINTERS
FORM 926, PAGE 1 of 4
MARGINS: TOP 13 mm (1⁄ 2 "), CENTER SIDES.
PAPER: WHITE WRITING, SUB. 20. INK: BLACK
FLAT SIZE: 216 mm (8 1⁄ 2 ") 3 279 mm (11")
PERFORATE: ON FOLD
Date
Action
Department of the Treasury
Internal Revenue Service
Part I
Revised proofs
requested
Return by a U.S. Transferor of Property
to a Foreign Corporation
Form
(Rev. December 2008)
©
Signature
O.K. to print
PRINTS: HEAD TO HEAD
DO NOT PRINT — DO NOT PRINT — DO NOT PRINT — DO NOT PRINT
926
Date
OMB No. 1545-0026
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Attachment
Sequence No.
Attach to your income tax return for the year of the transfer or distribution.
128
U.S. Transferor Information (see instructions)
Name of transferor
Identifying number (see instructions)
1
If the transferor was a corporation, complete questions 1a through 1d.
a If the transfer was a section 361(a) or (b) transfer, was the transferor controlled (under section 368(c)) by
5 or fewer domestic corporations?
b Did the transferor remain in existence after the transfer?
If not, list the controlling shareholder(s) and their identifying number(s):
Controlling shareholder
Yes
Yes
No
No
Yes
No
Yes
No
Identifying number
c If the transferor was a member of an affiliated group filing a consolidated return, was it the parent
corporation?
If not, list the name and employer identification number (EIN) of the parent corporation:
Name of parent corporation
EIN of parent corporation
d Have basis adjustments under section 367(a)(5) been made?
2
If the transferor was a partner in a partnership that was the actual transferor (but is not treated as such under section 367),
complete questions 2a through 2d.
a List the name and EIN of the transferor’s partnership:
Name of partnership
EIN of partnership
b Did the partner pick up its pro rata share of gain on the transfer of partnership assets?
c Is the partner disposing of its entire interest in the partnership?
d Is the partner disposing of an interest in a limited partnership that is regularly traded on an established
securities market?
Part II
Yes
Yes
No
No
Yes
No
Transferee Foreign Corporation Information (see instructions)
3
Name of transferee (foreign corporation)
5
Address (including country)
6
Country code of country of incorporation or organization (see instructions)
7
Foreign law characterization (see instructions)
8
Is the transferee foreign corporation a controlled foreign corporation?
For Paperwork Reduction Act Notice, see separate instructions.
4 Identifying number, if any
Yes
Cat. No. 16982D
Form
926
No
(Rev. 12-2008)
8
I.R.S. SPECIFICATIONS
TO BE REMOVED BEFORE PRINTING
INSTRUCTIONS TO PRINTERS
FORM 926, PAGE 2 of 4
MARGINS: TOP 13 mm (1⁄ 2 "), CENTER SIDES.
PAPER: WHITE WRITING, SUB. 20. INK: BLACK
FLAT SIZE: 216 mm (81⁄ 2 ") 3 279 mm (11")
PERFORATE: ON FOLD
PRINTS: HEAD TO HEAD
DO NOT PRINT — DO NOT PRINT — DO NOT PRINT — DO NOT PRINT
Form 926 (Rev. 12-2008)
Part III
Page
2
Information Regarding Transfer of Property (see instructions)
Type of
property
Cash
Stock and
securities
Installment
obligations,
account
receivables or
similar property
Foreign currency
or other property
denominated in
foreign currency
Inventory
(a)
Date of
transfer
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(b)
Description of
property
(c)
Fair market value on
date of transfer
(d)
Cost or other
basis
(e)
Gain recognized on
transfer
Assets subject to
depreciation
recapture (see
Temp. Regs. sec.
1.367(a)-4T(b))
Tangible property
used in trade or
business not listed
under another
category
Intangible
property
Property to be
leased (as
described in
Temp. Regs. sec.
1.367(a)-4T(c))
Property to be
sold (as
described in
Temp. Regs. sec.
1.367(a)-4T(d))
Transfers of oil and
gas working interests
(as described in
Temp. Regs. sec.
1.367(a)-4T(e))
Other property
Supplemental Information Required To Be Reported (see instructions):
Form
926
(Rev. 12-2008)
8
I.R.S. SPECIFICATIONS
TO BE REMOVED BEFORE PRINTING
INSTRUCTIONS TO PRINTERS
FORM 926, PAGE 3 of 4 (page 4 is blank)
MARGINS: TOP 13 mm (1⁄ 2 "), CENTER SIDES.
PAPER: WHITE WRITING, SUB. 20. INK: BLACK
FLAT SIZE: 216 mm (81⁄ 2 ") 3 279 mm (11")
PERFORATE: ON FOLD
PRINTS: HEAD TO HEAD
DO NOT PRINT — DO NOT PRINT — DO NOT PRINT — DO NOT PRINT
Form 926 (Rev. 12-2008)
Part IV
Page
3
Additional Information Regarding Transfer of Property (see instructions)
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9 Enter the transferor’s interest in the foreign transferee corporation before and after the transfer:
(a) Before
% (b) After
%
©
10
Type of nonrecognition transaction (see instructions)
11
Indicate whether any transfer reported in Part III is subject to any of the following:
Gain recognition under section 904(f)(3)
Gain recognition under section 904(f)(5)(F)
Recapture under section 1503(d)
Exchange gain under section 987
Yes
Yes
Yes
Yes
No
No
No
No
12
Did this transfer result from a change in the classification of the transferee to that of a foreign corporation?
Yes
No
13
Indicate whether the transferor was required to recognize income under Temporary Regulations sections
1.367(a)-4T through 1.367(a)-6T for any of the following:
Tainted property
Depreciation recapture
Branch loss recapture
Any other income recognition provision contained in the above-referenced regulations
Yes
Yes
Yes
Yes
No
No
No
No
Did the transferor transfer assets which qualify for the trade or business exception under section 367(a)(3)?
Yes
No
15a Did the transferor transfer foreign goodwill or going concern value as defined in Temporary Regulations
section 1.367(a)-1T(d)(5)(iii)?
Yes
No
Yes
No
Yes
No
a
b
c
d
a
b
c
d
14
b If the answer to line 15a is “Yes,” enter the amount of foreign goodwill or going concern value
transferred © $
16
Was cash the only property transferred?
17a Was intangible property (within the meaning of section 936(h)(3)(B)) transferred as a result of the
transaction?
b If “Yes,” describe the nature of the rights to the intangible property that was transferred as a result of the
transaction:
Form
Printed on recycled paper
926
(Rev. 12-2008)
File Type | application/pdf |
File Title | Form 926 (Rev. December 2008) |
Subject | Return by a U.S. Transferor of Property to a Foreign Corporation |
Author | SE:W:CAR:MP |
File Modified | 2008-11-05 |
File Created | 2008-10-29 |