Form 1120-F (Schedule V 1120-F (Schedule V List of Vessels or Aircraft, Operators, and Owners

SCHEDULE V
(Form 1120-F)

OMB No. 1545-0126

List of Vessels or Aircraft, Operators, and Owners

2009

䊳

Department of the Treasury
Internal Revenue Service
Name of corporation

䊳

Attach to Form 1120-F.
See separate instructions.

Employer identification number

Provide the information requested on lines 1 through 9 for each vessel or aircraft with respect to which the corporation is
subject to a 4% rate of tax under section 887.
A

B

C

D

1

Name of vessel or aircraft

2

Vessel or aircraft ID number

3

Was the vessel or aircraft chartered in?

Yes

No

Yes

No

Yes

No

Yes

No

4

Was the vessel or aircraft chartered out?

Yes

No

Yes

No

Yes

No

Yes

No

5

Name of registered owner

6

EIN or SSN of registered owner

7

Name of operator

8

EIN or SSN of operator

9

U.S. source gross transportation income

10

Total U.S. source gross transportation income. Add the amounts on line 9, columns
A through D (and the amounts on line 9 of any attachments)

10

11

Amount of line 10 that is exempt by treaty (attach Form 8833)

11

12

Subtract line 11 from line 10. Enter the result here and on Form 1120-F, Section I,
line 9, column (b)

For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 1120-F.

12

Cat. No. 50821R

Schedule V (Form 1120-F) 2009