5471 Schedule M Transactions Between Controlled Foreign Corporation and

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SCHEDULE M
(Form 5471)

Transactions Between Controlled Foreign Corporation
and Shareholders or Other Related Persons

(Rev. December 2021)
Department of the Treasury
Internal Revenue Service
Name of person filing Form 5471

OMB No. 1545-0123

Attach to Form 5471.
▶ Go to www.irs.gov/Form5471 for instructions and the latest information.
▶

Identifying number

Name of foreign corporation

EIN (if any)

Reference ID number (see instructions)

DRAFT AS OF
June 17, 2021
DO NOT FILE

Important: Complete a separate Schedule M for each controlled foreign corporation. Enter the totals for each type of transaction that occurred during
the annual accounting period between the foreign corporation and the persons listed in columns (b) through (f). All amounts must be stated in U.S.
dollars translated from functional currency at the average exchange rate for the foreign corporation’s tax year. See instructions.
Enter the relevant functional currency and the exchange rate used throughout this schedule
(b) U.S. person
filing this return

(a) Transactions
of
foreign corporation

▶

(e) 10% or more U.S.
(c) Any domestic
(d) Any other foreign
(f) 10% or more U.S.
shareholder of
corporation or
corporation or
shareholder of any
controlled foreign
partnership controlled partnership controlled corporation (other
corporation
by U.S. person filing by U.S. person filing than the U.S. person
controlling the
this return
this return
foreign
corporation
filing this return)

1 Sales of stock in trade (inventory) . . .
2 Sales of tangible property other than stock
in trade . . . . . . . . . .
3 Sales of property rights
trademarks, etc.)
. . . .

(patents,
. . .

4 Platform contribution transaction payments
received . . . . . . . . . .
5 Cost sharing transaction payments received

6 Compensation received for technical,
managerial, engineering, construction, or
like services . . . . . . . . .
7 Commissions received . . . . . .
8 Rents, royalties, and license fees received
9 Hybrid dividends received (see instructions)
10 Dividends received (exclude hybrid dividends,
deemed distributions under subpart F, and
distributions of previously taxed income) .
11 Interest received . .
12 Premiums received
reinsurance . . .

. . . . .
for insurance
. . . . .

.
or
.

13 Loan guarantee fees received . . . .
14 Other amounts received (attach statement)
15 Add lines 1 through 14 . . . . . .
16 Purchases of stock in trade (inventory) .
17 Purchases of tangible property other than
stock in trade
. . . . . . . .
18 Purchases of property rights (patents,
trademarks, etc.)
. . . . . . .
19 Platform contribution transaction payments
paid . . . . . . . . . . .
20 Cost sharing transaction payments paid .
21 Compensation paid for technical, managerial,
engineering, construction, or like services .
22
23
24
25
26
27
28
29

Commissions paid . . . . . . .
Rents, royalties, and license fees paid .
Hybrid dividends paid (see instructions) .
Dividends paid (exclude hybrid dividends paid)
Interest paid . . . . . . . . .
Premiums paid for insurance or reinsurance
Loan guarantee fees paid . . . . .
Other amounts paid (attach statement) .

30 Add lines 16 through 29

.

.

.

.

.

For Paperwork Reduction Act Notice, see the Instructions for Form 5471.

Cat. No. 49963O

Schedule M (Form 5471) (Rev. 12-2021)

Schedule M (Form 5471) (Rev. 12-2021)

Page

(a) Transactions
of
foreign corporation

2

Identifying number

Name of person filing Form 5471

(b) U.S. person
filing this return

(e) 10% or more U.S.
(c) Any domestic
(d) Any other foreign
(f) 10% or more U.S.
shareholder of
corporation or
corporation or
shareholder of any
controlled foreign
partnership controlled partnership controlled corporation (other
corporation
by U.S. person filing by U.S. person filing than the U.S. person
controlling the
this return
this return
foreign
corporation
filing this return)

DRAFT AS OF
June 17, 2021
DO NOT FILE

31 Accounts Payable . . . . . . .
32 Amounts borrowed (enter the maximum loan
balance during the year)—see instructions

33 Accounts Receivable . . . . . .
34 Amounts loaned (enter the maximum loan
balance during the year)—see instructions

Schedule M (Form 5471) (Rev. 12-2021)