Summary of Changes

IRS - OMB REVIEW REQUEST FORM
Request for OMB review of currently approved document:
Date:

09/26/2011

Name: Bob

Kennedy

Office Symbols: SE:W:CAR:MP:T:B:C
Phone Number:

202-622-3403

Summary of Changes
Form
1) In Part I, line 5 was split into line 5a and line 5b. Line 5a asks the taxpayer to check the box if none of the bearer shares (other than bearer shares
maintained in a dematerialized or immobilized book-entry system) were relied on to satisfy any of the stock ownership tests described in
Regulations section 1.883-1(c)(2). Line 5b asks the taxpayer to check the box if any of the bearer shares were maintained in a dematerialized or
immobilized book-entry system and were relied on to satisfy any of the stock ownership tests in Regulations 1.883-1(c)(2). These changes were
made to reflect Regulations section 1.883-1(c)(3)(i)(G), which was added by T.D. 9502.
2) In Part III, new line 11b was added to request the percentage of the total value of the shares of the CFC that is owned by qualified U.S. persons as
bearer shares maintained in a dematerialized or immobilized book-entry system. This change was made to reflect Regulations section 1.883-3(d)(4),
which was added by T.D. 9502.
3) In Part IV, a "Total" line was added under the "Percentage" column for line 16b. This change was made at the request of Counsel.
4) In Part IV, new line 16c was added to request the percentage of the total value of the outstanding shares that is owned by qualified shareholders
as bearer shares maintained in a dematerialized or immobilized book-entry system. This change was made to reflect Regulations section 1.883-4(e)
(2), which was added by T.D. 9502.

Instructions
1) Part I, line 5 - This instruction will be deleted. The instruction was added for TY 2010 to reflect the rules before and after the effective date of T.D. 9502. The

instruction is no longer needed for TY 2011.
2) Part III, line 11 - The Instructions for old line 11 will become new line 11a. The new line 11a instructions will no longer mention the rules that
applied before the effective date of T.D. 9502. The Instructions for new line 11b will read as follows: Enter the percentage of the value of the
outstanding shares of the CFC that are bearer shares maintained in a dematerialized or immobilized book-entry system. In determining the
percentage to enter on line 11b, the numerator is the total value of bearer shares maintained in a dematerialized or immobilized book-entry
system.
The denominator is the total value of the CFC's outstanding stock, including the value of bearer shares.
3) Part IV, line 16c - We will add Instructions for new line 16c that will read as follows: Enter the percentage of the value of the outstanding
shares that is owned by the qualified shareholders as bearer shares maintained in a dematerialized or immobilized book-entry system. In
determining the percentage to enter on line 16c, the numerator is the total value of bearer shares maintained in a dematerialized or immobilized
book-entry system. The denominator is the total value of the outstanding shares of the corporation, including the value of bearer shares.

** The change does not affect all of the current filers of Schedule S (Form 1120-F). It also
does not result in an increase or decrease of filers.

Impact on Approved Collection
Public
Law No.

Regulation
No.

Other
Code
References

SAMPLE:
PL 109-567

REG-345675-08

T.D. 9502
Regulation
section 1.883
(see under
"Form" above)

RP 2009-134

+/- 5

Change In IRS Form
& Instructions
No. of Filers
Words
+/- 20,000

+/- 500

Attachments
+/- 1

**(see above)

*Please insert how this new (PL, REG, or other), document will affect the currently approved collection.