Schedule M (Form 5 Transactions Between Controllwd Foreign Corporation and

Transactions Between Controlled Foreign Corporation
and Shareholders or Other Related Persons

SCHEDULE M
(Form 5471)
(Rev. December 2007)
Department of the Treasury
Internal Revenue Service

©

OMB No. 1545-0704

Attach to Form 5471. See Instructions for Form 5471.
Identifying number

Name of person filing Form 5471

Name of foreign corporation

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 ©
(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
(e) 10% or more U.S. (f) 10% or more U.S.
corporation or
shareholder of controlled shareholder of any
partnership controlled
foreign corporation
corporation
by U.S. person filing
(other than the U.S.
controlling the
this return
person filing this return) foreign corporation

1 Sales of stock in trade (inventory)
2 Sales of tangible property other
than stock in trade
3 Sales
of
property
(patents, trademarks,

rights
etc.)

4 Buy-in payments received
5 Cost sharing payments received
6 Compensation received for technical, managerial, engineering,
construction, or like services
7 Commissions received
8 Rents, royalties,
fees received

and

license

9 Dividends received (exclude
deemed distributions under
subpart F and distributions of
previously taxed income)
10 Interest received
11 Premiums received for insurance or reinsurance
12 Add lines 1 through 11
13 Purchases of stock in trade
(inventory)
14 Purchases of tangible property
other than stock in trade
15 Purchases of property rights
(patents, trademarks, etc.)
16 Buy-in payments paid
17 Cost sharing payments paid
18 Compensation paid for technical, managerial, engineering,
construction, or like services
19 Commissions paid
20 Rents, royalties,
fees paid

and

license

21 Dividends paid
22 Interest paid
23 Premiums paid for insurance or
reinsurance
24 Add lines 13 through 23
25 Amounts borrowed (enter the
maximum loan balance during
the year) — see instructions
26 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. 12-2007)