5471 Schedule I-1 Information for Global Intangible Low-Taxed Income

Note: The draft you are looking for begins on the next page.

Caution: DRAFT—NOT FOR FILING
This is an early release draft of an IRS tax form, instructions, or publication,
which the IRS is providing for your information. Do not file draft forms and do
not rely on draft forms, instructions, and publications for filing. We do not
release draft forms until we believe we have incorporated all changes (except
when explicitly stated on this coversheet). However, unexpected issues
occasionally arise, or legislation is passed—in this case, we will post a new draft
of the form to alert users that changes were made to the previously posted draft.
Thus, there are never any changes to the last posted draft of a form and the
final revision of the form. Forms and instructions generally are subject to OMB
approval before they can be officially released, so we post only drafts of them
until they are approved. Drafts of instructions and publications usually have
some changes before their final release.
Early release drafts are at IRS.gov/DraftForms and remain there after the
final release is posted at IRS.gov/LatestForms. All information about all forms,
instructions, and pubs is at IRS.gov/Forms.
Almost every form and publication has a page on IRS.gov with a friendly
shortcut. For example, the Form 1040 page is at IRS.gov/Form1040; the Pub.
501 page is at IRS.gov/Pub501; the Form W-4 page is at IRS.gov/W4; and the
Schedule A (Form 1040/SR) page is at IRS.gov/ScheduleA. If typing in a link
above instead of clicking on it, be sure to type the link into the address bar of
your browser, not a Search box.
If you wish, you can submit comments to the IRS about draft or final forms,
instructions, or publications at IRS.gov/FormsComments. We cannot respond to
all comments due to the high volume we receive and may not be able to
consider many suggestions until the subsequent revision of the product.
If you have comments on reducing paperwork and respondent (filer) burden,
with respect to draft or final forms, please respond to the relevant information
collection through the Federal Register process; for more info, click here.

SCHEDULE I-1
(Form 5471)

Information for Global Intangible Low-Taxed Income
OMB No. 1545-0123

(Rev. December 2021)
Department of the Treasury
Internal Revenue Service

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

▶

Identifying number

Name of person filing Form 5471

DRAFT AS OF
July 8, 2021
DO NOT FILE

Name of foreign corporation

Reference ID number (see instructions)

EIN (if any)

Separate Category (Enter code–see instructions.)

.

.

.

.

.

.

.

.

.

.

.

.

Functional
Currency

1
2

Gross income (see instructions if cost of goods sold exceed gross
receipts) . . . . . . . . . . . . . . . . . . .

Exclusions (see instructions if cost of goods sold exceed gross receipts)
2a
a Effectively connected income . . . .
b Subpart F income . . . . . . . .
2b
c High-tax exception income per section
954(b)(4) . . . . . . . . . . .
2c
d Related party dividends . . . . . .
2d
e Foreign oil and gas extraction income .
2e
3
Total exclusions (combine lines 2a through 2e) . . . . . .
Gross income less total exclusions (line 1 minus line 3) (see
4
instructions) . . . . . . . . . . . . . . . . . .
5
6
7
8
9a
b
c
d

Deductions properly allocable to amount on line 4 . . . . .
Tested income (loss) (line 4 minus line 5) (see instructions) . . .
Tested foreign income taxes . . . . . . . . . . . .
Qualified business asset investment (QBAI) . . . . . . . .
Interest expense included on line 5 . .
9a
Qualified interest expense . . . . .
9b
Tested loss QBAI amount . . . . .
9c
Tested interest expense (line 9a minus the sum of line 9b and 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- . . . . . . . .

. .
. .
minus
. .

.
10a
.
10b
line 10b). If zero or less,
. . . . . . . . .

For Paperwork Reduction Act Notice, see instructions.

.

.

.

.

.

▶

Conversion
Rate

U.S. Dollars

1

3

4
5
6
7
8

9d

10c

Cat. No. 71400M

Schedule I-1 (Form 5471) (Rev. 12-2021)