Schedule V - List of Vessels or Aircraft, Operations, and Owners

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I.R.S. SPECIFICATIONS
TO BE REMOVED BEFORE PRINTING
INSTRUCTIONS TO PRINTERS
FORM 1120-F (Sch V), PAGE 1 of 2 (Page 2 is blank)
MARGINS; TOP 13mm (1/2"), CENTER SIDES.
PRINTS: ONE SIDED
PAPER: WHITE WRITING, SUB. 20.
INK: BLACK
FLAT SIZE: 216mm (8-1/2") x 279mm (11")
PERFORATE: None
DO NOT PRINT — DO NOT PRINT — DO NOT PRINT — DO NOT PRINT

SCHEDULE V
(Form 1120-F)

Action

Date

O.K. to print
Revised proofs
requested

OMB No. 1545-0126

List of Vessels or Aircraft, Operators, and Owners

f
o
s
a
0
t
1
f
0
a
2
r
/
D /05
0
1

2010

©

Department of the Treasury
Internal Revenue Service
Name of corporation

Signature

©

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

1

Name of vessel or type of aircraft

2

Vessel or aircraft ID number

3

Was the vessel or aircraft chartered in?

4

Was the vessel or aircraft chartered out?

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

B

C

D

Yes

No

Yes

No

Yes

No

Yes

No

Yes

No

Yes

No

Yes

No

Yes

No

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

Cat. No. 50821R

12
Schedule V (Form 1120-F) 2010