Form 926 Return by a U.S. Transferor of Property to a Foreign Cor

926

Form
(Rev. December 2013)
Department of the Treasury
Internal Revenue Service

Part I

▶

Return by a U.S. Transferor of Property
to a Foreign Corporation

Information about Form 926 and its separate instructions is at www.irs.gov/form926.
▶ Attach to your income tax return for the year of the transfer or distribution.

Attachment
Sequence No. 128

U.S. Transferor Information (see instructions)
Identifying number (see instructions)

Name of transferor

1

OMB No. 1545-0026

If the transferor was a corporation, complete questions 1a through 1d.
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):

a

No
No

Yes

No

Yes

No

Identifying number

Controlling shareholder

c

Yes
Yes

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

d Have basis adjustments under section 367(a)(5) been made? .
2
a

EIN of parent corporation

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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.
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)

4a Identifying number, if any

5

Address (including country)

4b Reference ID number
(see instructions)

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.

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Cat. No. 16982D

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Yes

No

Form 926 (Rev. 12-2013)

Page 2

Form 926 (Rev. 12-2013)

Part III

Information Regarding Transfer of Property (see instructions)

Type of
property

(a)
Date of
transfer

(b)
Description of
property

(c)
Fair market value on
date of transfer

(d)
Cost or other
basis

(e)
Gain recognized on
transfer

Cash
Stock and
securities

Installment
obligations,
account
receivables or
similar property
Foreign currency
or other property
denominated in
foreign currency

Inventory

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 final
and temp. Regs. sec.
1.367(a)-4(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. 12-2013)

Page 3

Form 926 (Rev. 12-2013)

Part IV
9

Additional Information Regarding Transfer of Property (see instructions)

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 . . . . . . . . . . . . . . . .

a
b
c
d

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Yes
Yes
Yes
Yes

No
No
No
No

Did this transfer result from a change in the classification of the transferee to that of a foreign corporation?
Indicate whether the transferor was required to recognize income under final and Temporary Regulations
sections 1.367(a)-4 through 1.367(a)-6 for any of the following:
a Tainted property . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
b Depreciation recapture . . . . . . . . . . . . . . . . . . . . . . . . . . . .
c Branch loss recapture . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
d Any other income recognition provision contained in the above-referenced regulations . . . . . . .

Yes

No

Yes
Yes
Yes
Yes

No
No
No
No

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12
13

14

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

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?

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Yes

No

17a

Was intangible property (within the meaning of section 936(h)(3)(B)) transferred as a result of the
transaction? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

No

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b If “Yes,” describe the nature of the rights to the intangible property that was transferred as a result of the
transaction:

Form 926 (Rev. 12-2013)