5472 Information Return of a 25% Foreign-Owned US Corporation

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Form

5472

(Rev. December 2021)

Information Return of a 25% Foreign-Owned U.S. Corporation or a
Foreign Corporation Engaged in a U.S. Trade or Business
(Under Sections 6038A and 6038C of the Internal Revenue Code)
▶

Department of the Treasury
Internal Revenue Service

Part I

OMB No. 1545-0123

Go to www.irs.gov/Form5472 for instructions and the latest information.

For tax year of the reporting corporation beginning

,

, and ending

,

Note: Enter all information in English and money items in U.S. dollars.

Reporting Corporation (see instructions). All reporting corporations must complete Part I.

DRAFT AS OF
July 16, 2021
DO NOT FILE

1a Name of reporting corporation

1b Employer identification number
1c Total assets

Number, street, and room or suite no. (If a P.O. box, see instructions.)

City or town, state, and ZIP code (If a foreign address, see instructions.)
1d Principal business activity ▶
1f Total value of gross payments made or received
reported on this Form 5472. See instructions.
$
1i Check here if this is a
consolidated filing of
Form 5472
. . ▶
1m Date of incorporation

1g Total number of Forms 5472
filed for the tax year

1j Check here if this is the initial year for
which the U.S. reporting corporation
is filing a Form 5472 . . . . ▶

$
1e Principal business activity code ▶
1h Total value of gross payments made or received
reported on all Forms 5472. See instructions.

$
1k Total numbers of Part VIII
attached to Form 5472

1n Country(ies) under whose laws the reporting
corporation files an income tax return as a resident

1l Country of incorporation

1o Principal country(ies) where business is conducted

2

Check here if, at any time during the tax year, any foreign person owned, directly or indirectly, at least 50% of (a) the total voting power of all
classes of the stock of the reporting corporation entitled to vote, or (b) the total value of all classes of stock of the reporting corporation ▶

3

Check here if the reporting corporation is a foreign-owned domestic disregarded entity (foreign-owned U.S. DE) treated as a corporation for
purposes of section 6038A. See instructions
. . . . . . . . . . . . . . . . . . . . . . . . . . . ▶

Part II

25% Foreign Shareholder (see instructions)
Check here if any direct (or ultimate indirect) 25% foreign shareholder listed in Part II is a surrogate foreign
corporation under section 7874(a)(2)(B). ▶

4a Name and address of direct 25% foreign shareholder
4b(1) U.S. identifying number, if any

4b(2) Reference ID number (see instructions)

4c Principal country(ies) where
business is conducted

4d Country of citizenship,
organization, or incorporation

4b(3) Foreign taxpayer identification number (FTIN), if any
(see instructions)

4e Country(ies) under whose laws the direct 25% foreign
shareholder files an income tax return as a resident

5a Name and address of direct 25% foreign shareholder
5b(1) U.S. identifying number, if any

5b(2) Reference ID number (see instructions)

5c Principal country(ies) where
business is conducted

5d Country of citizenship,
organization, or incorporation

5b(3) FTIN, if any (see instructions)

5e Country(ies) under whose laws the direct 25% foreign
shareholder files an income tax return as a resident

6a Name and address of ultimate indirect 25% foreign shareholder
6b(1) U.S. identifying number, if any

6b(2) Reference ID number (see instructions)

6c Principal country(ies) where
business is conducted

6d Country of citizenship,
organization, or incorporation

6b(3) FTIN, if any (see instructions)

6e Country(ies) under whose laws the ultimate indirect 25% foreign
shareholder files an income tax return as a resident

7a Name and address of ultimate indirect 25% foreign shareholder
7b(1) U.S. identifying number, if any

7b(2) Reference ID number (see instructions)

7c Principal country(ies) where
business is conducted

7d Country of citizenship,
organization, or incorporation

For Paperwork Reduction Act Notice, see instructions.

7b(3) FTIN, if any (see instructions)

7e Country(ies) under whose laws the ultimate indirect 25% foreign
shareholder files an income tax return as a resident
Cat. No. 49987Y

Form 5472 (Rev. 12-2021)

Page 2
Related Party (see instructions). All reporting corporations must complete this question and the rest of Part III.
Check applicable box: Is the related party a
foreign person or
U.S. person?

Form 5472 (Rev. 12-2021)

Part III

8a Name and address of related party
8b(1) U.S. identifying number, if any

8b(2) Reference ID number (see instructions)

8b(3) FTIN, if any (see instructions)

DRAFT AS OF
July 16, 2021
DO NOT FILE

8c Principal business activity ▶

8d Principal business activity code ▶

8e Relationship—Check boxes that apply:
Related to reporting corporation
Related to 25% foreign shareholder
25% foreign shareholder
8f Principal country(ies) where business is conducted
8g Country(ies) under whose laws the related party files an income tax return as a
resident

Part IV

Monetary Transactions Between Reporting Corporations and Foreign Related Party (see instructions)
Caution: Part IV must be completed if the “foreign person” box is checked in the heading for Part III.
If estimates are used, check here. ▶

9
10

Sales of stock in trade (inventory) . . . . . .
Sales of tangible property other than stock in trade .

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9
10

11
12
13a

Platform contribution transaction payments received .
Cost sharing transaction payments received . . . .
Rents received (for other than intangible property rights)

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11
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13a

b
14
15

Royalties received (for other than intangible property rights) . . . . . . . . . . . . . . .
Sales, leases, licenses, etc., of intangible property rights (for example, patents, trademarks, secret formulas) .
Consideration received for technical, managerial, engineering, construction, scientific, or like services . . .

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13b
14
15

16
17
18

Commissions received . . . . . . . . . .
Amounts borrowed (see instructions) a Beginning balance
Interest received . . . . . . . . . . . .

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b Ending balance or monthly average ▶
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19
20
21

Premiums received for insurance or reinsurance .
Loan guarantee fees received . . . . . .
Other amounts received (see instructions) . . .

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19
20
21

22
23
24

Total. Combine amounts on lines 9 through 21 . . .
Purchases of stock in trade (inventory) . . . . . .
Purchases of tangible property other than stock in trade

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22
23
24

25
26
27a

Platform contribution transaction payments paid . .
Cost sharing transaction payments paid . . . .
Rents paid (for other than intangible property rights) .

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25
26
27a

b
28
29

Royalties paid (for other than intangible property rights) . . . . . . . . . . . . . . . . . .
Purchases, leases, licenses, etc., of intangible property rights (for example, patents, trademarks, secret formulas)
Consideration paid for technical, managerial, engineering, construction, scientific, or like services . . . . .

27b
28
29

30
31
32

Commissions paid
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Amounts loaned (see instructions) a Beginning balance
Interest paid . . . . . . . . . . . . .

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b Ending balance or monthly average ▶
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30
31b
32

33
34
35
36

Premiums paid for insurance or reinsurance .
Loan guarantee fees paid
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Other amounts paid (see instructions) . . .
Total. Combine amounts on lines 23 through 35

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Part V

Part VI

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17b
18

33
34
35
36

Reportable Transactions of a Reporting Corporation That Is a Foreign-Owned U.S. DE (see instructions)
Describe on an attached separate sheet any other transaction as defined by Regulations section 1.482-1(i)(7),
such as amounts paid or received in connection with the formation, dissolution, acquisition, and disposition
of the entity, including contributions to and distributions from the entity, and check here. ▶
Nonmonetary and Less-Than-Full Consideration Transactions Between the Reporting Corporation
and the Foreign Related Party (see instructions)
Describe these transactions on an attached separate sheet and check here. ▶
Form 5472 (Rev. 12-2021)

Form 5472 (Rev. 12-2021)

Part VII
37
38a
b
c
39

Page

3

Additional Information. All reporting corporations must complete Part VII.

Does the reporting corporation import goods from a foreign related party? . . . . . . . . . . . . .
If “Yes,” is the basis or inventory cost of the goods valued at greater than the customs value of the imported goods?
If “Yes,” attach a statement explaining the reason or reasons for such difference.

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Yes
Yes

No
No

If the answers to questions 37 and 38a are “Yes,” were the documents used to support this treatment of the imported
goods in existence and available in the United States at the time of filing Form 5472? . . . . . . . . . . .

Yes

No

During the tax year, was the foreign parent corporation a participant in any cost sharing arrangement (CSA)? .

Yes

No

Yes

No

Yes

No

Yes

No

Yes

No

DRAFT AS OF
July 16, 2021
DO NOT FILE
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If the answer to question 39 is “Yes,” complete Part VIII for each CSA in which the foreign corporation was a participant
during the tax year.
40a
b

During the tax year, did the reporting corporation pay or accrue any interest or royalty for which the deduction is not
allowed under section 267A? See instructions . . . . . . . . . . . . . . . . . . . . . . .
If “Yes,” enter the total amount of the disallowed deductions .

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$

41a

Does the reporting corporation claim a foreign-derived intangible income (FDII) deduction (under section 250) with respect
to amounts listed in Part IV? . . . . . . . . . . . . . . . . . . . . . . . . . . . .

b

If “Yes,” enter the amount of gross income derived from sales, leases, exchanges, or other dispositions (but not licenses)
of property to the foreign related party that the reporting corporation included in its computation of foreign-derived
deduction eligible income (FDDEI). See instructions . . . . . . . . . . . . . . . . . . . . $

c

If “Yes,” enter the amount of gross income derived from a license of property to the foreign related party that the reporting
corporation included in its computation of FDDEI. See instructions . . . . . . . . . . . . . . . . $

d

If “Yes,” enter the amount of gross income derived from services provided to the foreign related party that the reporting
corporation included in its computation of FDDEI. See instructions . . . . . . . . . . . . . . . $

42

Did the reporting corporation have any loan to or from the foreign related party, to which the safe-haven rate rules of
Regulations section 1.482-2(a)(2)(iii)(B) are applicable, and for which the reporting corporation used a rate of interest within
the safe-haven range of Regulations section 1.482-2(a)(2)(iii)(B)(1) (100% to 130% of the AFR for the relevant term)? . .

43a

Did the reporting corporation make at least one distribution or acquisition (as defined by Regulations section 1.385-3)
during the period including the tax year and the preceding 3 tax years, or, during the period beginning 36 months before
the date of the respective acquisition or distribution and ending 36 months afterward, did the reporting corporation issue or
refinance indebtedness owed to a related party? . . . . . . . . . . . . . . . . . . . . . .
If the answer to question 43a is “Yes,” provide the following.
(1) The amount of such distribution(s) and acquisition(s) . . . . . . . . . . . . . . . . . . $
(2) The amount of such related party indebtedness . . . . . . . . . . . . . . . . . . . . $

b

Part VIII

Cost Sharing Arrangement (CSA)

Note: Complete a separate Part VIII for each CSA in which the reporting corporation was a participant during the tax year. Report all amounts in U.S.
dollars. (See instructions.)
44

Provide a brief description of the CSA with respect to which this Part VIII is being completed.

45
46
47

During the course of the tax year, did the reporting corporation become a participant in the CSA?
Was the CSA in effect before January 5, 2009? . . . . . . . . . . . . . . .
What was the foreign participant’s share of reasonably anticipated benefits for the CSA? . . .

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48 a

Enter the total amount of stock-based compensation deductions claimed by the reporting corporation .

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b
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49a
b

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Enter the total amount of deductions for stock-based compensation that was granted during the term of the CSA and, at
date of grant, is directly identified with, or reasonably allocable to, the intangible development activity under the CSA $
Was there any stock-based compensation granted during the term of the CSA to individuals who performed functions in
business activities that generate cost shared intangibles that was not treated as directly identified with, or reasonably
allocable to, the intangible development activity?
. . . . . . . . . . . . . . . . . . . . .
Enter the total amount of intangible development costs for the CSA . . . . . . . . . . . . . . . $

Yes
Yes

No
No
%

Yes

No

Enter the amount of intangible development costs allocable to the foreign participant based on the foreign participant’s
reasonably anticipated benefits share . . . . . . . . . . . . . . . . . . . . . . . . $

Part IX

Base Erosion Payments and Base Erosion Tax Benefits Under Section 59A (see instructions)

50
51
52

Amounts defined as base erosion payments under section 59A(d) . . . . . . . . . . . . . . .
Amount of base erosion tax benefits under section 59A(c)(2) . . . . . . . . . . . . . . . .
Amount of total qualified derivative payments as described in section 59A(h) made by the reporting corporation .

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53

Reserved for future use .

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Form 5472 (Rev. 12-2021)