You are on page 1of 8
ke 1 120-F U.S. Income Tax Return of a Foreign Corporation (OMB No, 1545-0123 baal Revere anes > Go to www.irs.gov/Form! 126F for insiractions and the latest information. aw Print 1 Name or accross change [1] Final return Co seracute ma attaches [1] Protective return © anny otborpaaien Te ieconmaten to snot Ute as tay hg is also subject to tax (1) Type of agent © Date incorporated (Name D_ {1) Location of corporation's primary books and records fly, province | (8) Adcress forse, and county) IF See the insirastions and enter the corporation's pineal (1) Business activity code number » _ 2) Business activity _ (8) Product or service ™ {@) 1 the corporation maintains an office or pace of business nthe [@ Check method of accounting: (i) L]Gash @) C1 Accrual United States, check here > Oe other speci ‘Computation of Tax Due or Overpayment 7 Taxtrom Secton |, Ine 17, page 3 1 2 Tax tom Section Il, Schedule J, line 9, page 5 2 3 Tax rom Section add lines 6 and 10 on page 6) 3 4 Total tax. Ada lines 1 through 3 4 5a 2018 overpayment crected to 2018 5a bb 2019 estimated tax payments 5b © Less 2018 refund applied for on Form 4465 se | 7 1d Combine lines 5a through Se ‘e Tax deposited with Form 7008, ‘ ° h Credit for tax pad on undistributed capital gains (attach Form 2439) Credit for federal ax paid on fuels (attach Form 4196), See instructions le |e |e|ele Refundable crest from Form 8827, line Se 1 USS. income tax paid oF withnels at source (acd line 12, page 3, and amounts from Forms 8288-A and 8805 (attach Forms 6288-A and 8805) 6 Estimated tax penalty (see instructions). Check if Form 2220 is attached Ole Use Only Firm's address Phone no, For Paperwork Reduction Act Notice, see separate instructions: Gute. tTa7oI Tom 1120-F 7019 Form 11204 18) Page 2. ‘additional Information (continued from page 7 Hid the corporation's method of accounting change from the preceding tax year? Ives, attach a statement with an explanation. 1 Did the corporation's method of determining income change from the preceding tax year? Iv ¥es, attach a statement with an explanation. J Did the corporation file a ULS. income tax retum for the preceding tax year? K (1) At any time during the tax year, was the ‘corporation engaged in a trade or business in the Unted States? (2) 1 Yes," is taxpayers trade or business within the Unted States solely the resut of a section 897 FIRPTAY sale or disposition? L_ Did the corporation have a permanent establishment in the United States fr purposes of any applicable tax treaty between the Unted States and a foreign county? Wes," enter the name of the foreign country M_ Did the corporation have any transactions with elated parties? IW -¥es," Form 5472 may have tobe fled (S00 insvuetions). Enter number of Forms 5472 attached Ns the corporation a controlled foreign corporation? {See section 957{a) or definition) (© Is the corporation @ personal service corporation? (See instructions for dentin) P__Entor tax-exempt interest received or accrued during the tax year (ee instructions) ® $, A: the end of the tax year, cid the corperation own, directly ot inlet, 50% oF more ofthe voting stack of 8 U.S. corporation? (See section 267(c) fr rales of attribution) Wy Yes." attach a statement showing (1) name and EIN of such U.S, corporation; (2) percentage owned, and (8) taxable income or (loss) before NOL and special deductions of such U.S. corporation for the tax year ending with or within your tax year. Ifthe corporation has an NOL forthe tax year and is ‘lecting to forego the carryback period, check here (e0e instructions) oO SS Entorthe avalable NOL carryover trom prior tax yeas. (2o not reduce it by ary deduction on ine 302, page ars Is the corporation a subsidiary in a parent-eubsiciary JAAIs the corporation required to fi controlled grou? lbDDoes the corporation have gross receiots of atleast $500 1 ¥es," enter the parent corporation’: () EN» 2) Name U_ (i)is the corporation a dealer under section 4757. (2) Did the corporation mark to market any securities ‘or commodities other than in a desler capacity? At the end of the tax year, dd any individual, partnership, corporation, estate, or trust own, directly or indirectly, 80% ‘or more of the corporation's voting stack? (See section 267 (© ferrules of atibution) If "Yes," attach a statement showing the name and Identiving number (De net include any information already entered in tem T) Enter percentage owned > (11 the corporation taking a position on this return that a U.S. tax treaty overrles or modifies an internal Revenue law ofthe United States, thereby causing a reduction of tax? If "Yes," the corporation 's generally required to complete and attach Form 8823. See Form 8823 for exceptions. Note: Faiure to disclose a teaty-based retum positon may resutin a $10,000 penalty (see section 6712). (2) the corporation claiming treaty benefits pursuant to, or otherwise fling ts rtum pursuant to, a Competent Authority determination or an Advance Pricing Agreement? If "Yes." attach a copy of the Competent Authority determination letter of Advance Pricing Agreement to yout return. During the tax year, did the corparation own any entity that was disregarded as an entity separate from is owner under Regulations sections 301.7701-2 and 301.7701-37 I1-¥es, attach a statement Ising the name, county under whose laws the emity was ganzed, ana EIN (tary of exch such ety. (1) Did a partrership allocate to the corporation a cisvibutve share of income ‘rom a. drectly owned partnership interest, any of which is ECI or treated as ECI by the partnership or the partner? Wes," attach Schedule P, See instructions, (2) During the tax year, di the corperation own, drectly or indirectly, at least a 10% interest, in any foreign partnership? tes,” s0e instructions for required attachment (1) Has the corporation engaged In any transactions the results of which are subject to the arm's-length stancard Under section 482 and ts reguitions? (2) Has the corporation recognized any interoraneh amounts? I1-¥es, attach statement (ge instructions) ‘Schedule UTP (Form 1120), Uncertain Tax Poston Statement (eee instructions)? l1-¥es." complete and attach Schedule UTP. JBE.During the corporation's tax year, cid the corporation make any payments that would requ i to fle Forms 1042 and 1042-S under chapter 3 (sections 1441 through 1464) of chapter 4 (sections 1471 through 1474) of the Code? |ccs the corporation fnckiding the home office or any branch) ‘8 qualfed dervatives dealer (QD0)? (1 1F-Yes" attach Schedule @ (Form 1120-5 (oe instructions) (2) 1-Yes enter the QL-EIN millon in any of the 3 preceding tax years (see sections, S8A(eK2) an (2)? I1-Yes." complete and attach For 8881 IEE During the tax year, did the corporation pay or accrue any Interest or royalty for which a deduction is not allowed Under section 267A (see instructions)? I1-Yes," enter the total amount of the sallowed deductions ms Yes Tom T120-F 7019) Form 11204 18) ‘additional Information (continued from page 2) FF Did the corporation have an election under section 163) for any real property trade or business or any farming business in effect during the tax year (eee instructions)? GG Does the corporation satity one or more of the following (see instructions)? (1) The corporation owns 2 pass-through entity with ccurrest, or prior year caryover excess Business interest (2) Tre corporton’s aggregate average annual ross receipts (detemined under section 448) forthe 3 tax years preceding the cunt tax year are more than $26 millon and the corperation has business interest expense (3) The comeration is a tax sheter and the corporation has business interest expense, Ie," te any, complete and attach Form 8990. IHDuring tho tax year, did the corporation aispose of an rectly orincirectly engaged in interest in a partnership tha {trade or business within the United States? I ts the corporation attaching Form 8986 to certly as Qualiied Oppertunty Fund? It=¥es," enter amount from Form 8986, ine 14 8. Yes ‘SECTION I—Income From U.S. Sources Not Effectively Connected With the Conduct of a Trade or Business in the United States—Do not report items property withheld and reported on Form 1042-8. See instructions. Report al gross transportation income subject to 4% tax online 9. Report ather column a) income items only i nat properly withheld and reported en Form 1042°5. The rate of tax on these gross income tems |s 30% or such lower rate spectfied by tax treaty. Ne deductions are alowed against these types of income, Enter ‘veaty rates where applicable. the corporation is claiming a lower treaty rate, also complete item W on page 2. multiple treaty rates apply ta type af income for example, subsilary and partfale dividends or duidends recevved by disregarded entities) attach 3 statement showing the amounts, tax rates, and withnalding for each Name of veaty county, any @ r @ Aste oftaxie) | Amun af tax tb 7 1 Inerest 2a Dividends (excluding payments received by Q0Ds in their equity derivatives dealer ccapacty) 2b Dividend equivalents (excluding payments received by QDDs in ther equity derivatives sealer capacity) Rents Royaties Annuities Gains fom disposal of timber, coal, or domestic an ore with a retained economic interest (attach supporting staternent) 7 Gains ftom sale or exchange of patents, ‘copyrights, ete, 8 Fiduciary distrbutions fatach supperting statement) 9 Gross transportation income (see instructions) 10 Other items of income un Teal page 12 _ Total, Enter here and include online Si, page 1 > . 13 | the corporation fiscally transparent under the laws of the foreign jurisdiction with respect to any item of income listed above? Ves." attach a statement that provides the information requested above with respect to each such item af income. Dives CNo Fom 120-F far) Form 11204 gore) SECTION ll— Income Effectively Connected With the Conduct of a Trade or Business in the United States, (see instructions) Impertant: Filn all applicable Ines and schedules. you heed more space, s ‘Assembling the Return ih the instructions “a Gross reebisor aes Less returns and alowances | Te par [16 2 Cost ot goods sld attach Form 1125-0 2 Gross prof subtract he 2 fom Ine 1) 2 4 Dividends (Schedule, tne 18) 4 | 5 ierest 5 B| 6 Gross rents 6 £| 7 cross royatios 7 Capital gin net income fatach Schedule O (Form 1120) @ 8 Net gain or (oss rom For 4787, Pat ine 17 (attach For 4787) ° 40 other income (see instructions attach staternen) 10 11 Total income. Add ines 3 Wvough 10 > [a F]12 Compensation of offers (se instructions attach Form 1125-6) 12 $13. Sates and wages tess employment crc) Fas B] 14 epais ard maienance 14 | 15 aac dents (or bad debs over $500,000, attach ast of debtors and amounts) 15 Sl a6 Rents 16 5] 47 Taxes and licenses 17 B10 interest expense trom Schedule ne 25 (se instucton) rn | 19 chartabie contributions 19 20° Depreition rm Frm 4562 not cisimed on Form 1125-A a elsewhere on return attach For 4562) 20 =| 21 Depleton 21 B| 22 advertsng 22 5 | 28 Pension, profit-sharing, otc. plans 23 | 24 Employes beret programs 24 | 25. Reserved for tute use 25 | 28 Deductorsalcated nd pportored to EC rom Sched, ine 20 (6s suction) 26 Bar otner deduction (attach statement} a | 28 Total deductions, Addiines 12 twough 27 > [ae 5 | 29 Taxable income belore NOL deduction and special deductions fubtrac ne 28 trom ne 11) > [as B20 Less: a Net operating loss deduction (se instructions} 30 3 b Special deductions (Schedule. ine 12) 0b eS © Add lines 30a and 30b 306 Bi Tavable income or (oss). Subvact ne 300 rom the 28 3 Tom 1120-F 779) Form 11204 ors) ‘SECTION Il Income Effectively Connected (continued) EERIE Dividends and Special Deductions (see instructions The Conduct of a Trade or Business In the United States wm |) Special deauctens: (2) Diente va de 1. Dividends from less-than-20%-owned domestic corporations (other than debttinanced stock) 50 2 Dividends from 20%-or-more-owned domestic corporations (other than debt-financed stock) 6 3 Dividends on cerainde-nanced stock of domestic and eregn corporation seton 246) nator 4 Dividends on certain preferred stock of less-than-20%-owned public utities 3S 5 Dividends on certain preferred stock of 20%-or-more-owned public utes 5 Dividends trom less-than-20%-owned foreign corporations 7 8 Dividends fom 20%-or-ore-owned foreign corporations Subtotal. Adaline 1 trough 7 Se instustions fr itaton La 8 Divkends trom foreign corporations not included on tne 3 6,07 10 16-DISC and former DISC dividends not nlaed on ne, 2, or eton 245) 11 ote ddends 12 Deduction er dividends pad on certain pofored stock of publ utes 18 Tota dvidend. Ad clon i Ios 8 rough 1, Enter ere ard on ne 4 page & 14_Total special deductions. A cols Ines @ and 12 Ener ere and on tne 205 paged > Tax Computation (eee instructions) “1 Check the corporation is a member ofa controled group (alach Schedule O (Frm 1720) > Oo 2 Income tax 2 3 Base erosion minimum tax amount attach Form 8991) 3 4 Add tines 2 and 3 4 5a. Foreign tax crit attach Form 1118) Sa bb General business creit attach Form 2800) 5b {© Crest for prior year minimum tax attach Form 8827) Se ols ‘9 Excess interest Subtract lne 8 from line Ze W zero or less, enter -0- o b If the foreign corporation is a bank, enter the excess interest treated as interest on deposts (se instructions for rule for computing this amount), Otherwise, enter -0- o « Subtract line 8 from tne 98 8 10 Tax on excess interest. Multiply tne Sc by 80% (0.80) (or lower treaty rate i the corporation is qualfed resident or otherwise qualiis for treaty berets). (See instructions) Enter here and include online 3, page 1 ‘Also complete item W on page 2 10 Part Ill—Additional Information 11s the corporation claiming reduction in or exemption from, the branch profits tax due to: '2.Acomplete termination ofall US. trades or businesses? b The tax 18 Iquidation or reorganization of a foreign corporation? © The tax 12 incorporation ofa U.S, vade or business? 1 11a or 1th applies and the transferee isa domestic corporation, attach Form 8848. If 11¢ apples, attach the sta by Temporary Regulations section 1.88¢-2T(A)6). Yes No ment required Tom T120-F g019) Form 11204 ore) Note: Check if completing on® __[1US. basis or Balance Sheets per Books bb Other curent non-US. assets" © Other cunent US. assets" on 108 Ma 2 1a “ 6 168 7 Li worawide basis Assets o @ @ cash ‘Trade notes and accounts receivable Less allowance for bad debs I U.S. government obigations Tax-exempt secures (see instructions) Interbranch current assets" Loans to shareholders Mortgage and rel estate loans Other loans and investments—non-U.S. Other loans and investments US. assets* Bulldings and other depreciable assets Less accumulated depreciation I Depletabe assets Less accumulated depletion I Land net of any amortization) Intangible assets (amortzable only) Less accumulated amortization I Assets held in trust Other non-cutrentinteroranch assets” Other non-cutrent non-US. assets” Other non-current U.S, assets” Total assets % ° Liabilities ‘Accounts payable Mortgages, notes, bonds payable in less than 1 year Interbranch Habities” Third-party labites” Other current labilties” Loans from shareholders Mortgages, notes, bonds payable in 1 year or Interbranch labios” ‘Third-party labiltes* LUabiities held in trust Other interoranch labiltes” Other thed-party Habits” B eseeee Equity Capital stock: a Preferred stock 'b Common stock ‘Adaitional paid-in capital Retained eamings— Appropriate Retained eamings—Unappropriated Adjustments to shareholders’ equity” Less cost of treasury stock. I ? Total iabities and shareholders’ equly Tom T120-F 779) ESIENIMII Overpayment Resulting From Tax Deducted and Withheld Under Chapters Sanda "Total Chapt 3 and 4 payments. ter te aroun fom page Tn 5 7 2 Enter the tax amount trom page 1, tine 1 2 {3 Enter the portion of the tax amount shown on page 7, ine 2, pertaining to income ‘associated with amounts deducted and withneld under sections 144 and 1446 (eee instructions for general guidelines) 3 4 Total Chapter 3 and 4 tax, Combine es 2 and 3 4 5 Tentative overpayment resulting from tax deducted and withheld under Chapters 3 and 4, Subtract tne 4 from ine 1 5 6 Enter the amount from page 1, ine 63 6 7. Overpayment resulting from tax deducted and withheld under Chapters 3 and 4. Enter the smaller ofline 5 or tne 6. Erter the result here and on page 1, line 8 z Fom 120-F far)

You might also like