Information Return of U.S. Persons With Respect 
                                                                                                                                                                OMB No. 1545-0123
Form 5471                                         to Certain Foreign Corporations
(Rev. December 2023)
                                         Go to www.irs.gov/Form5471 for instructions and the latest information.
                                                                                                                                                                Attachment 
Department of the Treasury     Information furnished for the foreign corporation’s annual accounting period (tax year required by                               Sequence No. 121
Internal Revenue Service     section 898) (see instructions) beginning                                , 20      , and ending                   , 20
Name of person filing this return                                                                          A Identifying number

Number, street, and room or suite no. (or P.O. box number if mail is not delivered to street address)      B Category of filer (See instructions. Check applicable box(es).):
                                                                                                           1a       1b    1c       2       3   4         5a     5b     5c
City or town, state, and ZIP code                                                                          C Enter the total percentage of the foreign corporation’s voting 
                                                                                                               stock you owned at the end of its annual accounting period              %
Filer’s tax year beginning                                    , 20      , and ending                                           , 20
D  Check box if this is a final Form 5471 for the foreign corporation . .   .  .     . .              . .   .   .   .   .    . .    .    .   . . .        . .   .   .   .      . .
E  Check if any excepted specified foreign financial assets are reported on this form (see instructions)        .   .   .    . .    .    .   . . .        . .   .   .   .      . .
F  Check the box if this Form 5471 has been completed using “Alternative Information” under Rev. Proc. 2019-40               . .    .    .   . . .        . .   .   .   .      . .
G  If the box on line F is checked, enter the corresponding code for “Alternative Information” (see instructions)   .        . .    .    .   . . .        . .   .   .
H  Person(s) on whose behalf this information return is filed:
                                                                                                                                                 (4) Check applicable box(es)
              (1) Name                                                  (2) Address                                 (3) Identifying number
                                                                                                                                               Shareholder      Officer        Director

Important: Fill in all applicable lines and schedules. All information                  must            be in English. All amounts             must      be stated in U.S. dollars 
           unless otherwise indicated.
1a Name and address of foreign corporation                                                                                           b(1) Employer identification number, if any

                                                                                                                                     b(2) Reference ID number (see instructions)

                                                                                                                                     b(3) Previous reference ID number(s), if any (see 
                                                                                                                                            instructions)

                                                                                                                                     c     Country under whose laws incorporated

   d Date of incorporation   e Principal place of business            f Principal business activity             g Principal business activity             h Functional currency code
                                                                        code number

2   Provide the following information for the foreign corporation’s accounting period stated above.
   a Name, address, and identifying number of branch office or agent (if any) in the   b If a U.S. income tax return was filed, enter:
     United States                                                                                      (i)  Taxable income or (loss)                    (ii) U.S. income tax paid  
                                                                                                                                                            (after all credits)

   c Name and address of foreign corporation’s statutory or resident agent in country  d Name and address (including corporate department, if applicable) of person (or 
     of incorporation                                                                                 persons) with custody of the books and records of the foreign corporation, and 
                                                                                                      the location of such books and records, if different

Schedule A         Stock of the Foreign Corporation
                                                                                                                    (b) Number of shares issued and outstanding
                         (a) Description of each class of stock                                            (i)  Beginning of annual                       (ii)  End of annual 
                                                                                                               accounting period                          accounting period

For Paperwork Reduction Act Notice, see instructions.                                                   Cat. No. 49958V                                     Form 5471 (Rev. 12-2023)

Form 5471 (Rev. 12-2023)                                                                                                                                   Page 2 
Schedule B      Shareholders of Foreign Corporation
Part I    U.S. Shareholders of Foreign Corporation (see instructions)
                                                 (b)  Description of each class of stock held by        (c)  Number of      (d)  Number of      (e)  Pro rata share  
    (a)  Name, address, and identifying          shareholder. Note: This description should             shares held at      shares held at        of subpart F 
          number of shareholder                            match the corresponding description          beginning of annual  end of annual       income (enter as 
                                                           entered in Schedule A, column (a).           accounting period   accounting period    a percentage)

Part II   Direct Shareholders of Foreign Corporation (see instructions)
(a) Name, address, and identifying number of shareholder.  (b)  Description of each class of stock held by shareholder.     (c)  Number of       (d)  Number of  
          Also, include country of incorporation           Note: This description should match the corresponding            shares held at       shares held at 
                or formation, if applicable.                         description entered in Schedule A, column (a).         beginning of annual   end of annual 
                                                                                                                            accounting period   accounting period

                                                                                                                                       Form 5471 (Rev. 12-2023)

Form 5471 (Rev. 12-2023)                                                                                                                         Page 3 
Schedule C                                   Income Statement (see instructions)
Important:                                Report  all  information  in  functional  currency  in  accordance  with  U.S.  generally  accepted  accounting 
principles (GAAP). Also, report each amount in U.S.                                 dollars translated from functional currency (using GAAP translation
rules). However, if the functional currency is the                                U.S. dollar, complete only the U.S. Dollars column. See instructions for 
special rules for dollar approximate separate transactions method (DASTM) corporations.
                                                                                                                             Functional Currency U.S. Dollars
                                          1a  Gross receipts or sales . .  .  .   . .  .     . . . . .  .     . . . .    1a 
                                          b   Returns and allowances    .  .  .   . .  .     . . . . .  .     . . . .    1b
                                          c   Subtract line 1b from line 1a . .   . .  .     . . . . .  .     . . . .    1c 
                                          2   Cost of goods sold  . .   .  .  .   . .  .     . . . . .  .     . . . .    2 
                                          3   Gross profit (subtract line 2 from line 1c)  . . . . . .  .     . . . .    3 
                                          4   Dividends .   . . .   .   .  .  .   . .  .     . . . . .  .     . . . .    4 
                                          5   Interest .  . . . .   .   .  .  .   . .  .     . . . . .  .     . . . .    5 
                            Income        6a  Gross rents   . . .   .   .  .  .   . .  .     . . . . .  .     . . . .    6a 
                                          b   Gross royalties and license fees  . . .  .     . . . . .  .     . . . .    6b
                                          7   Net gain or (loss) on sale of capital assets   . . . . .  .     . . . .    7 
                                          8a  Foreign currency transaction gain or loss—unrealized   .  .     . . . .    8a
                                          b   Foreign currency transaction gain or loss—realized   . .  .     . . . .    8b
                                          9   Other income (attach statement)     . .  .     . . . . .  .     . . . .    9
                                          10  Total income (add lines 3 through 9)  .  .     . . . . .  .     . . . .    10
                                          11  Compensation not deducted elsewhere  .         . . . . .  .     . . . .    11
                                          12a Rents     . . . . .   .   .  .  .   . .  .     . . . . .  .     . . . .    12a
                                          b   Royalties and license fees . .  .   . .  .     . . . . .  .     . . . .    12b
                                          13  Interest .  . . . .   .   .  .  .   . .  .     . . . . .  .     . . . .    13
                                          14  Depreciation not deducted elsewhere .    .     . . . . .  .     . . . .    14
                                          15  Depletion  .  . . .   .   .  .  .   . .  .     . . . . .  .     . . . .    15
            Deductions                    16  Taxes (exclude income tax expense (benefit))  .    . . .  .     . . . .    16
                                          17  Other deductions (attach statement—exclude income tax expense (benefit))   17
                                          18  Total deductions (add lines 11 through 17)     . . . . .  .     . . . .    18
                                          19  Net income or (loss) before unusual or infrequently occurring items, and 
                                              income tax expense (benefit) (subtract line 18 from line 10)  . . . . .    19
                                          20  Unusual or infrequently occurring items  .     . . . . .  .     . . . .    20
                                          21a Income tax expense (benefit)—current .   .     . . . . .  .     . . . .    21a 
            Net Income                    b   Income tax expense (benefit)—deferred    .     . . . . .  .     . . . .    21b
                                          22  Current year net income or (loss) per books (combine lines 19 through 21b) 22
                                          23a Foreign currency translation adjustments .     . . . . .  .     . . . .    23a
                                          b   Other     . . . . .   .   .  .  .   . .  .     . . . . .  .     . . . .    23b
                                          c   Income tax expense (benefit) related to other comprehensive income    .    23c
      Other                        Income 24  Other comprehensive income (loss), net of tax (line 23a plus line 23b less 
              Comprehensive                   line 23c)   . . . .   .   .  .  .   . .  .     . . . . .  .     . . . .    24
                                                                                                                                       Form 5471 (Rev. 12-2023)

Form 5471 (Rev. 12-2023)                                                                                                                 Page 4 
Schedule F Balance Sheet
Important: Report all amounts in U.S. dollars prepared and translated in accordance with U.S. GAAP. See instructions 
for an exception for DASTM corporations.
                                                                                                  (a)                               (b) 
                                                                                              Beginning of annual      End of annual  
                                     Assets                                                   accounting period     accounting period
1   Cash   . .  .        . . . . . .   .    . .   . .  .  . .  . . . . .      . .    .   1 
2a  Trade notes and accounts receivable .     .   . .  .  . .  . . . . .      . .    .   2a 
b   Less allowance for bad debts  .    .    . .   . .  .  . .  . . . . .      . .    .   2b (                             ) (                             )
3   Derivatives  .       . . . . . .   .    . .   . .  .  . .  . . . . .      . .    .   3 
4   Inventories .        . . . . . .   .    . .   . .  .  . .  . . . . .      . .    .   4
5   Other current assets (attach statement)  .    . .  .  . .  . . . . .      . .    .   5
6   Loans to shareholders and other related persons .     . .  . . . . .      . .    .   6
7   Investment in subsidiaries (attach statement)  .   .  . .  . . . . .      . .    .   7
8   Other investments (attach statement) .    .   . .  .  . .  . . . . .      . .    .   8
9a  Buildings and other depreciable assets .      . .  .  . .  . . . . .      . .    .   9a
b   Less accumulated depreciation      .    . .   . .  .  . .  . . . . .      . .    .   9b (                             ) (                             )
10a Depletable assets .      . . . .   .    . .   . .  .  . .  . . . . .      . .    . 10a
b   Less accumulated depletion .   .   .    . .   . .  .  . .  . . . . .      . .    . 10b  (                             ) (                             )
11  Land (net of any amortization) .   .    . .   . .  .  . .  . . . . .      . .    .   11
12  Intangible assets:
a   Goodwill  . .        . . . . . .   .    . .   . .  .  . .  . . . . .      . .    . 12a
b   Organization costs  .    . . . .   .    . .   . .  .  . .  . . . . .      . .    . 12b
c   Patents, trademarks, and other intangible assets  .   . .  . . . . .      . .    . 12c
d   Less accumulated amortization for lines 12a, 12b, and 12c    . . . .      . .    . 12d  (                             ) (                             )
13  Other assets (attach statement).   .    . .   . .  .  . .  . . . . .      . .    .   13
14  Total assets  .      . . . . . .   .    . .   . .  .  . .  . . . . .      . .    .   14
                         Liabilities and Shareholders’ Equity                                                                            
15  Accounts payable  .      . . . .   .    . .   . .  .  . .  . . . . .      . .    .   15
16  Other current liabilities (attach statement)  . .  .  . .  . . . . .      . .    .   16
17  Derivatives .        . . . . . .   .    . .   . .  .  . .  . . . . .      . .    .   17
18  Loans from shareholders and other related persons  .    .  . . . . .      . .    .   18
19  Other liabilities (attach statement)  . . .   . .  .  . .  . . . . .      . .    .   19
20  Capital stock:
a   Preferred stock .      . . . . .   .    . .   . .  .  . .  . . . . .      . .    . 20a
b   Common stock .         . . . . .   .    . .   . .  .  . .  . . . . .      . .    . 20b
21  Paid-in or capital surplus (attach reconciliation) .  . .  . . . . .      . .    .   21
22  Retained earnings .      . . . .   .    . .   . .  .  . .  . . . . .      . .    .   22
23  Less cost of treasury stock  . .   .    . .   . .  .  . .  . . . . .      . .    .   23 (                             ) (                             )
24  Total liabilities and shareholders’ equity  . . .  .  . .  . . . . .      . .    .   24
Schedule G Other Information
                                                                                                                                    Yes No
1   During the tax year, did the foreign corporation own at least a 10% interest, directly or indirectly, in any foreign
    partnership?  .      . . . . . .   .    . .   . .  .  . .  . . . . .      . .    . . .  . . . .       . .     . .  .
    If “Yes,” see the instructions for required statement.
2   During the tax year, did the foreign corporation own an interest in any trust? . . . .  . . . .       . .     . .  .
3   During the tax year, did the foreign corporation own any foreign entities that were disregarded as separate from
    their owner under Regulations sections 301.7701-2 and 301.7701-3 or did the foreign corporation own any foreign
    branches (see instructions)?   .   .    . .   . .  .  . .  . . . . .      . .    . . .  . . . .       . .     . .  .
    If “Yes,” you are generally required to attach Form 8858 for each entity or branch (see instructions).
4 a During  the  tax  year,  did  the  filer  pay  or  accrue  any  base  erosion  payment  under  section  59A(d)  to  the  foreign
    corporation or did the filer have a base erosion tax benefit under section 59A(c)(2) with respect to a base erosion
    payment made or accrued to the foreign corporation (see instructions)?  .   .    . . .  . . . .       . .     . .  .
    If “Yes,” complete lines 4b and 4c.
b   Enter the total amount of the base erosion payments     .  . . . . .      . .    . . .  . . $
c   Enter the total amount of the base erosion tax benefits  . . . . . .      . .    . . .  . . $
5 a During the tax year, did the foreign corporation pay or accrue any interest or royalty for which the deduction is not 
    allowed under section 267A?  .     .    . .   . .  .  . .  . . . . .      . .    . . .  . . . .       . .     . .  .
    If “Yes,” complete line 5b.
b   Enter the total amount of the disallowed deductions (see instructions)  . . .    . . .  . . $
                                                                                                              Form 5471 (Rev. 12-2023)

Form 5471 (Rev. 12-2023)                                                                                                                 Page 5 
Schedule G Other Information (continued)
                                                                                                                                         Yes No
6 a  Is the filer claiming a foreign-derived intangible income (FDII) deduction (under section 250) with respect to any
     transactions with the foreign corporation?  . . . .  .    .   . .   . . .     .  .    . . . .   . . . .  . .  .
     If “Yes,” complete lines 6b, 6c, and 6d. See instructions.
b    Enter the amount of gross receipts derived from all sales of general property to the foreign corporation that the
     filer included in its computation of foreign-derived deduction eligible income (FDDEI) .  . . $
c    Enter the amount of gross receipts derived from all sales of intangible property to the foreign corporation that the
     filer included in its computation of FDDEI  . . . .  .    .   . .   . . .     .  .    . . . . $
d    Enter  the  amount  of  gross  receipts  derived  from  all  services  provided  to  the  foreign  corporation  that  the  filer 
     included in its computation of FDDEI . .    . . . .  .    .   . .   . . .     .  .    . . . . $
7    During the tax year, was the foreign corporation a participant in any cost sharing arrangement?  .  . .  . .  .
     If the answer to question 7 is “Yes,” complete a separate Schedule G-1 for each cost sharing arrangement in
     which the foreign corporation was a participant during the tax year.
8    From  April  25,  2014,  to  December  31,  2017,  did  the  foreign  corporation  purchase  stock  or  securities  of  a 
     shareholder  of  the  foreign  corporation  for  use  in  a  triangular  reorganization  (within  the  meaning  of  Regulations
     section 1.358-6(b)(2))?   . . . . .    .    . . . .  .    .   . .   . . .     .  .    . . . .   . . . .  . .  .
9 a  Did the foreign corporation receive any intangible property in a prior year or the current tax year for which the U.S. 
     transferor is required to report a section 367(d) annual income inclusion for the tax year? .   . . . .  . .  .
     If “Yes,” go to line 9b.
b    Enter in functional currency the amount of the earnings and profits reduction pursuant to section 367(d)(2)(B) for 
     the tax year .      . . . . . . . .    .    . . . .  .    .   . .   . . .     .  .    . . . .
10   During  the  tax  year,  was  the  foreign  corporation  an  expatriated  foreign  subsidiary  under  Regulations  section
     1.7874-12(a)(9)?      . . . . . . .    .    . . . .  .    .   . .   . . .     .  .    . . . .   . . . .  . .  .
     If “Yes,” see instructions and attach statement.
11   During the tax year, did the foreign corporation participate in any reportable transaction as defined in Regulations
     section 1.6011-4?  .    . . . . . .    .    . . . .  .    .   . .   . . .     .  .    . . . .   . . . .  . .  .
     If “Yes,” attach Form(s) 8886 if required by Regulations section 1.6011-4(c)(3)(i)(G).
12   During the tax year, did the foreign corporation pay or accrue any foreign tax that was disqualified for credit under 
     section 901(m)? .     . . . . . . .    .    . . . .  .    .   . .   . . .     .  .    . . . .   . . . .  . .  .
13   During the tax year, did the foreign corporation pay or accrue foreign taxes to which section 909 applies, or treat 
     foreign taxes that were previously suspended under section 909 as no longer suspended?  .       . . . .  . .  .
14   Did you answer “Yes” to any of the questions in the instructions for line 14?  . .    . . . .   . . . .  . .  .
     If “Yes,” enter the corresponding code(s) from the instructions and attach statement
15   Does the foreign corporation have interest expense disallowed under section 163(j) (see instructions)? . . .  .
     If “Yes,” enter the amount  . . . .    .    . . . .  .    .   . .   . . .     .  .    . . . .   $
16   Does the foreign corporation have previously disallowed interest expense under section 163(j) carried forward to 
     the current tax year (see instructions)?  . . . . .  .    .   . .   . . .     .  .    . . . .   . . . .  . .  .
     If “Yes,” enter the amount  . . . .    .    . . . .  .    .   . .   . . .     .  .    . . . .   $
17 a Did any extraordinary reduction with respect to a controlling section 245A shareholder occur during the tax year 
     (see instructions)?  .  . . . . . .    .    . . . .  .    .   . .   . . .     .  .    . . . .   . . . .  . .  .
b    If the answer to question 17a is “Yes,” was an election made to close the tax year such that no amount is treated
     as an extraordinary reduction amount or tiered extraordinary reduction amount (see instructions)?   . .  . .  .
18a  Did the filer have any loan to or from the foreign corporation to which the safe-haven rate rules of Regulations
     section 1.482-2(a)(2)(iii)(B) are applicable, and for which the filer used a rate of interest within the relevant safe-
     haven range (100% to 130% of the applicable Federal rate (AFR) for the relevant term)? .    .   . . . .  . .  .
b    Did  the  filer  have  any  loan  to  or  from  the  foreign  corporation  to  which  the  safe-haven  rate  rules  of  Regulations 
     section 1.482-2(a)(2)(iii)(B) are applicable, and for which the filer used a rate of interest outside the relevant safe-
     haven range (100% to 130% of the applicable Federal rate (AFR) for the relevant term)?    . .   . . . .  . .  .
19a  Did the filer issue a covered debt instrument in any of the transactions described in Regulations section 1.385-3(b)
     (2) with respect to the foreign corporation during the tax year, or, did the filer issue or refinance indebtedness 
     owed  to  the  foreign  corporation  during  the  36  months  before  or  after  the  date  of  a  distribution  or  acquisition
     described in Regulations section 1.385-3(b)(3)(i) made by the filer of this Form 5471, and either the issuance or 
     refinance of indebtedness, or the distribution or acquisition, occurred during the tax year?  . . . . .  . .  .
b    If the answer to question 19a is “Yes,” provide the following.
     (1) The amount of such transaction(s), distribution(s), and acquisition(s)  . .  .    . . . . $
     (2) The amount of such related party indebtedness  . .    .   . .   . . .     .  .    . . . .   $

                                                                                                              Form 5471 (Rev. 12-2023)

Form 5471 (Rev. 12-2023)                                                                                                     Page 6 
Schedule I Summary of Shareholder’s Income From Foreign Corporation (see instructions)
If item H on page 1 is completed, a separate Schedule I must be filed for each Category 4, 5a, or 5b filer for whom reporting is 
furnished on this Form 5471. This Schedule I is being completed for:

Name of U.S. shareholder                                                         Identifying number 
1 a Section 964(e)(4) subpart F dividend income from the sale of stock of a lower-tier foreign corporation
    (see instructions)  . . .  . .   . . . .     .   .    . .    .  . . . .  . . . .      . . . . . .       1a
b   Section 245A(e)(2) subpart F income from hybrid dividends of tiered corporations (see instructions) .   1b
c   Subpart F income from tiered extraordinary disposition amounts not eligible for subpart F exception
    under section 954(c)(6) .  . .   . . . .     .   .    . .    .  . . . .  . . . .      . . . . . .       1c
d   Subpart F income from tiered extraordinary reduction amounts not eligible for subpart F exception
    under section 954(c)(6) .  . .   . . . .     .   .    . .    .  . . . .  . . . .      . . . . . .       1d
e   Section 954(c) Subpart F Foreign Personal Holding Company Income (enter result from Worksheet A)        1e
f   Section 954(d) Subpart F Foreign Base Company Sales Income (enter result from Worksheet A)  .   .                   1f
g   Section 954(e) Subpart F Foreign Base Company Services Income (enter result from Worksheet A)  .        1g
h   Other subpart F income (enter result from Worksheet A)       .  . . . .  . . . .      . . . . . .       1h
2   Earnings invested in U.S. property (enter the result from Worksheet B) . . . . .      . . . . . .                   2 
3   Reserved for future use  . . .   . . . .     .   .    . .    .  . . . .  . . . .      . . . . . .                   3 
4   Factoring income  .   . .  . .   . . . .     .   .    . .    .  . . . .  . . . .      . . . . . .                   4
    See instructions for reporting amounts on lines 1, 2, and 4 on your income tax return. 
5a  Section 245A eligible dividends (see instructions) .  . .    .  . . . .  . . . .      . . . . . .       5a
b   Extraordinary disposition amounts (see instructions) .  .    .  . . . .  . . . .      . . . . . .       5b
c   Extraordinary reduction amounts (see instructions)    . .    .  . . . .  . . . .      . . . . . .       5c
d   Section 245A(e) dividends (see instructions) .   .    . .    .  . . . .  . . . .      . . . . . .       5d
e   Dividends not reported on line 5a, 5b, 5c, or 5d .    . .    .  . . . .  . . . .      . . . . . .       5e
6   Exchange gain or (loss) on a distribution of previously taxed earnings and profits  . . . . . . .                   6
                                                                                                                             Yes No
7a  Was any income of the foreign corporation blocked?      .    .  . . . .  . . . .      . . . . . .     .             . . .
b   Did any such income become unblocked during the tax year (see section 964(b))? .      . . . . . .     .             . . .
If the answer to either question is “Yes,” attach an explanation.
8 a Did this U.S. shareholder have an extraordinary disposition (ED) account with respect to the foreign corporation at 
    any time during the tax year (see instructions)? .    . .    .  . . . .  . . . .      . . . . . .     .             . . .
b   If the answer to question 8a is “Yes,” enter the U.S. shareholder’s ED account balance at the beginning of the CFC year
    $                    and at the end of the tax year $                 . Provide an attachment detailing any changes from the
    beginning to the ending balances.
c   Enter the CFC’s aggregate ED account balance with respect to all U.S. shareholders at the beginning of the CFC year
    $                    and at the end of the tax year $                 . Provide an attachment detailing any changes from the
    beginning to the ending balances.
9   Enter the sum of the hybrid deduction accounts with respect to stock of the foreign corporation (see instructions) $
                                                                                                            Form 5471 (Rev. 12-2023)