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pdfSCHEDULE I-1
(Form 5471)
Information for Global Intangible Low-Taxed Income
OMB No. 1545-0704
(Rev. December 2019)
Department of the Treasury
Internal Revenue Service
Attach to Form 5471.
Go to www.irs.gov/Form5471 for instructions and the latest information.
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Identifying number
Name of person filing Form 5471
Name of foreign corporation
Reference ID number (see instructions)
EIN (if any)
Separate Category (Enter code–see instructions.)
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Functional
Currency
1
2
Gross income . . . . .
Exclusions
a Effectively connected income
b Subpart F income . . . .
c High-tax exception income
954(b)(4) . . . . . . .
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per section
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minus
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3
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5
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9b and line
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9d
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10a
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10b
line 10b). If zero or less,
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10c
For Paperwork Reduction Act Notice, see instructions.
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Conversion
Rate
U.S. Dollars
2a
2b
2c
d Related party dividends . . . . . .
2d
e Foreign oil and gas extraction income .
2e
3
Total exclusions (total of lines 2a–2e) . . . . . .
4
Gross income less total exclusions (line 1 minus line 3)
5
Deductions properly allocable to amount on line 4 .
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Tested income (loss) (line 4 minus line 5) . . . .
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Tested foreign income taxes . . . . . . . .
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Qualified business asset investment (QBAI) . . . .
9a Interest expense included on line 5 . .
9a
b Qualified interest expense . . . . .
9b
c Tested loss QBAI amount . . . . .
9c
d Tested interest expense (line 9a minus the sum of line
9c). If zero or less, enter -0- . . . . . . . . .
10a Interest income included in line 4
b Qualified interest income . . .
c Tested interest income (line 10a
enter -0- . . . . . . . .
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Cat. No. 71400M
Schedule I-1 (Form 5471) (Rev. 12-2019)
File Type | application/pdf |
File Title | Schedule I-1 (Form 5471) (Rev. December 2019) |
Subject | Information for Global Intangible Low-Taxed Income |
Author | SE:W:CAR:MP |
File Modified | 2019-12-11 |
File Created | 2019-12-11 |