1116 Schedule C Foreign Tax Redeterminations

U.S. Tax-Exempt Income Tax Return

f1116_schedule_c--2022-12-00

Forms, Schedules, and Instructions for Return of Exempt Organizations From Income Tax Under Section 501(c), 527, or 4947(a)(1)

OMB: 1545-0047

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SCHEDULE C
(Form 1116)

Foreign Tax Redeterminations
For calendar year 20

(Rev. December 2022)

, or other tax year beginning

, 20

, and ending

, 20

.

OMB No. 1545-0121

See separate instructions.
Go to www.irs.gov/Form1116 for instructions and the latest information.

Department of the Treasury
Internal Revenue Service
Name

Identifying number as shown
on page 1 of your tax return

Use a separate Schedule C (Form 1116) for each applicable category of income listed below. See instructions. Check only one box on each schedule.
a
Section 951A category income
Passive category income
Section 901(j) income
Lump-sum distributions
c
e
g
b
d
f
Foreign branch category income
General category income
Certain income re-sourced by treaty
h If box e is checked, enter the country code for the sanctioned country. See instructions . . . . . . . . . . . . . . . . . . . . . . .
i If box f is checked, enter the country code for the treaty country. See instructions . . . . . . . . . . . . . . . . . . . . . . . . .

Part I

Increase in Amount of Foreign Taxes Accrued (see instructions)

Enter redetermined amounts by payor for each separate relation back year (starting with the most recent) followed by a subtotal for each relation back year.
2a. Name of Payor
(see instructions)

1. U.S. Tax Year
of Taxpayer to
Which Tax Relates
(relation back year)
(MM/DD/YYYY)

A

B

3. Country or
U.S. Possession
to Which Tax
Is Paid
(enter code—
see instructions)

2b. EIN or Reference ID Number
of Payor

4. Date
Additional
Foreign Tax
Was Paid
(MM/DD/YYYY)

5. Foreign
Tax Year
to Which
Tax Relates
(MM/DD/YYYY)

(1)
(2)
(3)
(1)
(2)
(3)
6. Payor’s Income
Subject to Tax in the
Foreign Jurisdiction
(see instructions)

7. Additional Tax
Accrued in
Local Currency
in Which the
Tax Is Payable

(1)
(2)
(3)
Subtotal by Relation Back Year of Taxpayer
(add amounts in columns 10, 11, and 12) . . .
(1)
B (2)
(3)
Subtotal by Relation Back Year of Taxpayer
(add amounts in columns 10, 11, and 12) . . .

8. Additional Tax
Accrued in
Functional Currency
of Payor

10. Additional Tax
Accrued in
U.S. Dollars
(divide column 7
by column 9)

9. Conversion Rate
of Local Currency
to U.S. Dollars

11. U.S. Dollar
Tax of Payor
Reported on
Original/Amended Return

12. Revised Tax Accrued 13. Reference ID Number
(add column 10
for Contested Tax,
and column 11)
if Applicable
(see instructions)

A

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For Privacy Act and Paperwork Reduction Act Notice, see the separate instructions.

Cat. No. 75187Q

Schedule C (Form 1116) (Rev. 12-2022)

Page 2

Schedule C (Form 1116) (Rev. 12-2022)

Part II

Decrease in Amount of Foreign Taxes Paid or Accrued (see instructions)

Enter redetermined amounts by payor for each separate relation back year (starting with the most recent) followed by a subtotal for each relation back year.
4. Date
Foreign Tax
Was Refunded
or Deemed
Refunded
(MM/DD/YYYY)
(see instructions)

5. Foreign
Tax Year
to Which
Tax Relates
(MM/DD/YYYY)

(1)
(2)
(3)
(1)
(2)
(3)

A

B

6. Payor’s Income
Subject to Tax in the
Foreign Jurisdiction
(see instructions)

A

3. Country or
U.S. Possession
From Which Tax
Was Refunded
or Deemed
Refunded
(enter code—
see instructions)

2b. EIN or
Reference ID Number
of Payor

2a. Name of Payor
(see instructions)

1. U.S. Tax Year
of Taxpayer to
Which Tax Relates
(relation back year)
(MM/DD/YYYY)

7. Tax Refunded
or Deemed Refunded
in Local Currency in
Which the Tax Is Payable

8. Refunded Amount
in Functional Currency
of Payor

9. Conversion Rate
of Local Currency
to U.S. Dollars

10. Refunded Amount
in U.S. Dollars
(divide column 7
by column 9)

11. U.S. Dollar Tax
of Payor Reported on
Original/Amended Return

12. Revised Tax
Paid or Accrued
(subtract column 10
from column 11)

13. Check Box if
Section 905(c)(2)
Two Year Rule
Applies
(see instructions)

(1)
(2)
(3)

Subtotal by Relation Back Year of Taxpayer (add amounts in columns 10, 11, and 12) .
(1)
B (2)
(3)

.

Subtotal by Relation Back Year of Taxpayer (add amounts in columns 10, 11, and 12) .

.

Part III

Change in Foreign Taxes Paid or Accrued

Enter the information below for the change to the total amount of foreign taxes paid or accrued and the foreign tax credits (FTCs) claimed for each relation back year.
1. Relation Back Year
(MM/DD/YYYY)

2. Redetermined Foreign Taxes
Paid or Accrued

3. Foreign Taxes Paid or Accrued
per Original/Amended Return

4. Amount of FTC Claimed
per Original/Amended Return

5. Amount of FTC Claimed
After Redetermination

A
B

Part IV

Change in U.S. Tax Liability

Enter the information below for the change in U.S. tax liability for each relation back year and other affected year (see instructions).
1. Relation Back Year or Affected Tax Year
(MM/DD/YYYY)

2. Total Redetermined
U.S. Tax Liability

3. Total U.S. Tax Liability
per Original/Amended Return

4. Difference
(subtract column 3 from column 2)

A
B
Schedule C (Form 1116) (Rev. 12-2022)

Page 3

Schedule C (Form 1116) (Rev. 12-2022)

Part V

Annual Reporting for Contested Taxes—Do Not Complete Part V For Tax Year 2022

Beginning with the 2023 tax year, taxpayers will enter the information below for each contested foreign tax liability for which the taxpayer has previously made an election under
Regulations section 1.905-1(d)(4) to claim a provisional foreign tax credit.
1. Relation Back Year
(MM/DD/YYYY)

2. Name of Payor
(see instructions)

3. Reference ID Number
for the Contested Tax

4. Country or
U.S. Possession
to Which Tax
Was Paid
(enter code—
see instructions)

(1)
(2)
(3)
(4)
(5)
5. Amount of Contested Tax
Provisionally Claimed as Credit

6. Contest
Ongoing

7. Contest
Resolved

8. Date Contest
Resolved
(MM/DD/YYYY)

9. Tax Refunded or
Additional Tax Paid, if Any
(see instructions)

(1)
(2)
(3)
(4)
(5)
Schedule C (Form 1116) (Rev. 12-2022)


File Typeapplication/pdf
File TitleSchedule C (Form 1116) (Rev. December 2022)
SubjectFillable
AuthorSE:W:CAR:MP
File Modified2023-01-17
File Created2023-01-17

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