Final K-3                 Amended K-3 
Schedule K-3                               Partner’s Share of Income, Deductions,                                                                         OMB No. 1545-1668 
(Form 8865)                                Credits, etc.—International
Department of the Treasury          For calendar year 2022, or tax year beginning                    /    /   2022      , ending    /           /         2022
Internal Revenue Service                                                                 See separate instructions.
                                    Information About the Partnership                                       Information About the Partner 
A1   Partnership’s employer identification number (EIN) (if any)                                     C   Partner’s SSN or Taxpayer Identification Number (TIN) (Do not use the TIN of a 
                                                                                                        disregarded entity. See instructions.)
A2   Reference ID number (see instructions)

B   Partnership’s name, address, city, state, and ZIP code                                           D   Name, address, city, state, and ZIP code for partner entered in box C. See instructions.

E                                 Check to indicate the parts of Schedule K-3 that apply.
                                                                                                                                                            Yes No
                                  1 Does Part I apply? If “Yes,” complete and attach Part I . .    .  . . . .      .    . . .     . .         . . . . . . 1
                                  2 Does Part II apply? If “Yes,” complete and attach Part II .    .  . . . .      .    . . .     . .         . . . . . . 2
                                  3 Does Part III apply? If “Yes,” complete and attach Part III  . .  . . . .      .    . . .     . .         . . . . . . 3
                                  4 Does Part IV apply? If “Yes,” complete and attach Part IV  .   .  . . . .      .    . . .     . .         . . . . . . 4
                                  5 Does Part V apply? If “Yes,” complete and attach Part V  .     .  . . . .      .    . . .     . .         . . . . . . 5
                                  6 Does Part VI apply? If “Yes,” complete and attach Part VI  .   .  . . . .      .    . . .     . .         . . . . . . 6
                                  7 Does Part VII apply? If “Yes,” complete and attach Part VII    .  . . . .      .    . . .     . .         . . . . . . 7
                                  8 Does Part VIII apply? If “Yes,” complete and attach Part VIII  .  . . . .      .    . . .     . .         . . . . . . 8

                 For IRS Use Only 

For Paperwork Reduction Act Notice, see the Instructions for Schedule                              www.irs.gov/Form8865     Cat. No. 74770R         Schedule K-3 (Form 8865) 2022 
K-3 (Form 8865).

Schedule K-3 (Form 8865) 2022                                                                                                                                                        Page  2 
Name of partnership:                                                             EIN (if any):                    Reference ID number (see instr.):
Name of partner:                                                                                                                                     SSN or TIN:
Part I           Partner’s Share of Partnership's Other Current Year International Information
Check box(es) for additional specified attachments. See instructions.
  1. Gain on personal property sale            4. Foreign tax translation                      7. Form 8858 information                       10. Partner loan transactions
  2. Foreign oil and gas taxes                 5. High-taxed income                            8. Form 5471 information                       11. Dual consolidated loss
                                                                                                                                     ✣❈❅❃❋ ✢❏❘
  3. Splitter arrangements                     6. Section 267A disallowed deduction            9. Other forms                                 12. Other international items 
                                                                                                                                                   (attach description and statement)
Part II          Foreign Tax Credit Limitation
Section 1—Gross Income
                                                                                               Foreign Source
                     Description           (a) U.S.     source       (b) Foreign branch (c) Passive           (d) General (e) Other                  (f) Sourced     by     (g) Total     
                                                                                                                                                         partner
                                                                     category income    category income category income   (category code            )
1 Sales
A
B
C
2 Gross income from performance of services
A
B
C
3 Gross rental real estate income
A
B
C
4 Other gross rental income
A
B
C
5 Guaranteed payments  .         . . . .
6 Interest income
A
B
C
7 Ordinary dividends (exclude amount 
  on line 8)
A
B
C
                                                                                                                                                                Schedule K-3 (Form 8865) 2022

Schedule K-3 (Form 8865) 2022                                                                                                                                        Page  3 
Name of partnership:                                                   EIN (if any):               Reference ID number (see instr.):
Name of partner:                                                                                                                         SSN or TIN:
Part II          Foreign Tax Credit Limitation (continued)
Section 1—Gross Income (continued)
                                                                                     Foreign Source
                     Description        (a) U.S.     source(b) Foreign branch (c) Passive     (d) General     (e) Other                  (f) Sourced     by (g) Total     
                                                                                                                                             partner
                                                           category income    category income category income (category code            )
8  Qualified dividends
A
B
C
9  Reserved for future use .     . . . .
10 Royalties and license fees
A
B
C
11 Net short-term capital gain
A
B
C
12 Net long-term capital gain
A
B
C
13 Collectibles (28%) gain
A
B
C
14 Unrecaptured section 1250 gain
A
B
C
15 Net section 1231 gain
A
B
C
                                                                                                                                                    Schedule K-3 (Form 8865) 2022

Schedule K-3 (Form 8865) 2022                                                                                                                                        Page  4 
Name of partnership:                                                   EIN (if any):               Reference ID number (see instr.):
Name of partner:                                                                                                                         SSN or TIN:
Part II          Foreign Tax Credit Limitation (continued)
Section 1—Gross Income (continued)
                                                                                     Foreign Source
                     Description        (a) U.S.     source(b) Foreign branch (c) Passive     (d) General     (e) Other                  (f) Sourced     by (g) Total     
                                                                                                                                             partner
                                                           category income    category income category income (category code            )
16 Section 986(c) gain  .     .  . . . .
17 Section 987 gain .  .      .  . . . .
18 Section 988 gain .  .      .  . . . .
19 Reserved for future use
A
B
C
20 Other income (see instructions)
A
B
C
21 Reserved for future use
A
B
C
22 Reserved for future use
A
B
C
23 Reserved for future use
A
B
C
24  Total gross income (combine lines 1 
   through 23)  .    . .      .  . . . .
A
B
C
                                                                                                                                                    Schedule K-3 (Form 8865) 2022

Schedule K-3 (Form 8865) 2022                                                                                                                                              Page  5 
Name of partnership:                                                         EIN (if any):               Reference ID number (see instr.):
Name of partner:                                                                                                                               SSN or TIN:
Part II          Foreign Tax Credit Limitation (continued)
Section 2—Deductions
                                                                                           Foreign Source
                     Description              (a) U.S.     source(b) Foreign branch (c) Passive     (d) General     (e) Other                  (f) Sourced     by (g) Total     
                                                                                                                                                   partner
                                                                 category income    category income category income (category code            )
25 Expenses allocable to sales income  .
26 Expenses allocable to gross income 
   from performances of services     .  .
27 Net short-term capital loss .   . .  .
28 Net long-term capital loss  .   . .  .
29 Collectibles loss  .  .    .  . . .  .
30 Net section 1231 loss  .      . . .  .
31 Other losses  .     . .    .  . . .  .
32 Research & experimental (R&E) expenses
A  SIC code:                     . . .  .
B  SIC code:                     . . .  .
C  SIC code:                     . . .  .
33 Allocable rental expenses—
   depreciation, depletion, and amortization  
34 Allocable rental expenses—other than 
   depreciation, depletion, and amortization  
35 Allocable royalty and licensing 
   expenses—depreciation, depletion, 
   and amortization .    .    .  . . .  .
36 Allocable royalty and licensing 
   expenses—other than depreciation, 
   depletion, and amortization     . .  .
37 Depreciation not included on line 33 
   or 35  .      .   . . .    .  . . .  .
38 Charitable contributions      . . .  .
39 Interest expense specifically allocable 
   under Regulations section 1.861-10(e)  
40 Other interest expense specifically 
   allocable under Regulations section 
   1.861-10T         . . .    .  . . .  .
41 Other interest expense—business      .
42 Other interest expense—investment  .
43 Other interest expense—passive activity
44 Section 59(e)(2) expenditures, 
   excluding R&E expenses on line 32  .
45 Foreign taxes not creditable but 
   deductible        . . .    .  . . .  .
                                                                                                                                                          Schedule K-3 (Form 8865) 2022

Schedule K-3 (Form 8865) 2022                                                                                                                                                                   Page  6 
Name of partnership:                                                              EIN (if any):                    Reference ID number (see instr.):
Name of partner:                                                                                                                                              SSN or TIN:
Part II          Foreign Tax Credit Limitation (continued)
Section 2—Deductions (continued)
                                                                                                     Foreign Source
                     Description               (a) U.S.     source  (b) Foreign branch     (c) Passive         (d) General          (e) Other                 (f) Sourced     by (g) Total     
                                                                                                                                                                  partner
                                                                    category income      category income       category income (category code            )
46 Section 986(c) loss  .     .  . .   . .
47 Section 987 loss .   .     .  . .   . .
48 Section 988 loss .   .     .  . .   . .
49 Other allocable deductions (see 
   instructions)  .   . .     .  . .   . .
50 Other apportioned share of 
   deductions (see instructions)  .    . .
51 Reserved for future use .     . .   . .
52 Reserved for future use .     . .   . .
53 Reserved for future use .     . .   . .
54  Total deductions (combine lines 25 
   through 53)  .     . .     .  . .   . . 
55  Net income (loss) (subtract line 54 
   from line 24)  .   . .     .  . .   . . 
Part III         Other Information for Preparation of Form 1116 or 1118
Section 1—R&E Expenses Apportionment Factors
                                                                                           Foreign Source
                                                                                                                                 (e) Other
         Description               (a) U.S. source     (b) Foreign branch         (c) Passive            (d) General                                      (f) Sourced     by     (g) Total      
                                                                                                                             (category code    )              partner
                                                            category income     category income        category income
                                                                                                                             (country code     )
1  Gross receipts by SIC code
A  SIC code:
B  SIC code:
C  SIC code:
D  SIC code:
E  SIC code:
F  SIC code:
2  Exclusive apportionment with respect to total R&E expenses entered on Part II, line 32. Enter the following.
A  R&E expense with respect to activity performed in the United States
   (i)   SIC code:                     . .  .  .   . .      . .   . .   . . .   . .    . . .    .    . . . .   . . .       . . . .  .      . . .    .     .   .   .       2A(i)
   (ii)  SIC code:                     . .  .  .   . .      . .   . .   . . .   . .    . . .    .    . . . .   . . .       . . . .  .      . . .    .     .   .   .  2A(ii)
   (iii) SIC code:                     . .  .  .   . .      . .   . .   . . .   . .    . . .    .    . . . .   . . .       . . . .  .      . . .    .     .   .   .  2A(iii)
B  R&E expense with respect to activity performed outside the United States
   (i)   SIC code:                     . .  .  .   . .      . .   . .   . . .   . .    . . .    .    . . . .   . . .       . . . .  .      . . .    .     .   .   .       2B(i)
   (ii)  SIC code:                     . .  .  .   . .      . .   . .   . . .   . .    . . .    .    . . . .   . . .       . . . .  .      . . .    .     .   .   .  2B(ii)
   (iii) SIC code:                     . .  .  .   . .      . .   . .   . . .   . .    . . .    .    . . . .   . . .       . . . .  .      . . .    .     .   .   .  2B(iii)
                                                                                                                                                                          Schedule K-3 (Form 8865) 2022

Schedule K-3 (Form 8865) 2022                                                                                                                                                               Page  7 
Name of partnership:                                                         EIN (if any):                       Reference ID number (see instr.):
Name of partner:                                                                                                                                        SSN or TIN:
Part III         Other Information for Preparation of Form 1116 or 1118 (continued)
Section 2—Interest Expense Apportionment Factors
                                                                                              Foreign Source
                                                                                                                                  (e) Other
                     Description               (a) U.S. source    (b) Foreign branch (c) Passive category (d) General category                          (f) Sourced by       (g) Total
                                                                                                                               (category code     )         partner
                                                                  category income          income             income
                                                                                                                               (country code      )
1  Total average value of assets  .   .   .
2  Sections 734(b) and 743(b) 
   adjustment to assets—average value .
3  Assets attracting directly allocable 
   interest expense under Regulations 
   section 1.861-10(e)  .     .  . .  .   .
4  Other assets attracting directly 
   allocable interest expense under 
   Regulations section 1.861-10T      .   .
5  Assets excluded from apportionment 
   formula       .   . . .    .  . .  .   .
6a Total assets used for apportionment 
   (subtract the sum of lines 3, 4, and 5 
   from the sum of lines 1 and 2)  .  .   .
b  Assets attracting business interest 
   expense  .        . . .    .  . .  .   .
c  Assets attracting investment interest 
   expense  .        . . .    .  . .  .   .
d  Assets attracting passive activity 
   interest expense  .   .    .  . .  .   .
7  Basis in stock of 10%-owned 
   noncontrolled foreign corporations 
   (see attachment) .    .    .  . .  .   .
8  Basis in stock of CFCs (see attachment)
Section 3—Foreign-Derived Intangible Income (FDII) Deduction Apportionment Factors
                                                                                                  Foreign Source
                                                                                                                               (d) Other
                         Description                     (a) U.S. source (b) Passive category     (c) General category                              (e) Sourced      by      (f) Total      
                                                                                  income                  income       (category code         )         partner
                                                                                                                       (country code          )
1  Foreign-derived gross receipts     .   . .  .   .
2  Cost of goods sold  .      .  . .  .   . .  .   .
3  Partnership deductions allocable to foreign-
   derived gross receipts .      . .  .   . .  .   .
4  Other partnership deductions apportioned to 
   foreign-derived gross receipts .   .   . .  .   .
                                                                                                                                                                     Schedule K-3 (Form 8865) 2022

Schedule K-3 (Form 8865) 2022                                                                                                                                     Page  8 
Name of partnership:                                                 EIN (if any):                    Reference ID number (see instr.):
Name of partner:                                                                                                                       SSN or TIN:
Part III         Other Information for Preparation of Form 1116 or 1118 (continued)
Section 4—Foreign Taxes
                                                                     (b) Section 951A category income                    (c) Foreign branch category income
                                   
                         Description              (a) Type     of taxU.S.          Foreign            U.S.                             Foreign             Partner
1 Direct (section 901 or 
  903) foreign taxes:           Paid   Accrued
A
B
C
D
E
F
2 Reduction of taxes (total)
A Taxes on foreign mineral income  .   . .    .  .
B Reserved for future use .     .  . . . .    .  .
C International boycott provisions  .  . .    .  .
D Failure-to-file penalties  .  .  . . . .    .  .
E Taxes with respect to splitter arrangements  . .
F Taxes on foreign corporate distributions  . .  .
G Other  .       .   . . .    . .  . . . .    .  .
3 Foreign tax redeterminations
A 
  Related tax year:  
  Date tax paid:  
  Contested tax        . .    . .  . . . .    .
B 
  Related tax year: 
  Date tax paid: 
  Contested tax        . .    . .  . . . .    .
C 
  Related tax year: 
  Date tax paid: 
  Contested tax        . .    . .  . . . .    .
4 Reserved for future use .     .  . . . .    .  .
5 Reserved for future use .     .  . . . .    .  .
6 Reserved for future use .     .  . . . .    .  .
                                                                                                                                                  Schedule K-3 (Form 8865) 2022

Schedule K-3 (Form 8865) 2022                                                                                                                                         Page  9 
Name of partnership:                                                    EIN (if any):                  Reference ID number (see instr.):
Name of partner:                                                                                                                             SSN or TIN:
Part III         Other Information for Preparation of Form 1116 or 1118 (continued)
Section 4—Foreign Taxes (continued)
                      (d) Passive category income                                     (e) General category income                         (f) Other
                                                                                                                                                             (g) Total
                 U.S.              Foreign             Partner          U.S.                   Foreign            Partner               (category code    )           
1
 A
 B
 C
 D
 E
 F
2
 A
 B
 C
 D
 E
 F
 G
3
 A
 B
 C
4
5
6
Section 5—Other Tax Information
                                                                               Foreign Source
                                                                                                                  (f) Other
  Description         (a) U.S. source      (b) Section 951A (c) Foreign branch (d) Passive     (e) General                                (g) Sourced     by (h) Total     
                                                                                                                  (category code        )     partner 
                                           category income     category income category income category income
                                                                                                                  (country code         )
1 Section 743(b) 
  positive income 
  adjustment         .
2 Section 743(b) 
  negative income 
  adjustment         .
3 Reserved for 
  future use .       .
4 Reserved for 
  future use .       .
                                                                                                                                                        Schedule K-3 (Form 8865) 2022

Schedule K-3 (Form 8865) 2022                                                                                                                                                           Page  10 
Name of partnership:                                                                EIN (if any):                         Reference ID number (see instr.):
Name of partner:                                                                                                                                                SSN or TIN:
Part IV          Information on Partner’s Section 250 Deduction With Respect to Foreign-Derived Intangible Income (FDII)
Section 1—Information To Determine Deduction Eligible Income (DEI) and Qualified Business Asset Investment (QBAI) on Form 8993
1  Net income (loss)     .    . . . . .   .  . . .   . . . .     . . . .            . . . .       .  . . . . .        .   . .  . . .     .   .  .    .     .  . . .      1
2a DEI gross receipts  .      . . . . .   .  . . .   . . . .     . . . .            . . . .       .  . . . . .        .   . .  . . .     .   .  .    .     .  . . .      2a
b  DEI cost of goods sold (COGS)    . .   .  . . .   . . . .     . . . .            . . . .       .  . . . . .        .   . .  . . .     .   .  .    .     .  . . .      2b
c  DEI properly allocated and apportioned deductions . . . .     . . . .            . . . .       .  . . . . .        .   . .  . . .     .   .  .    .     .  . . .      2c
3  Section 951(a) inclusions  .   . . .   .  . . .   . . . .     . . . .            . . . .       .  . . . . .        .   . .  . . .     .   .  .    .     .  . . .      3
4  CFC dividends  .      .    . . . . .   .  . . .   . . . .     . . . .            . . . .       .  . . . . .        .   . .  . . .     .   .  .    .     .  . . .      4
5  Financial services income  .   . . .   .  . . .   . . . .     . . . .            . . . .       .  . . . . .        .   . .  . . .     .   .  .    .     .  . . .      5
6  Domestic oil and gas extraction income  . . . .   . . . .     . . . .            . . . .       .  . . . . .        .   . .  . . .     .   .  .    .     .  . . .      6
7  Foreign branch income  .     . . . .   .  . . .   . . . .     . . . .            . . . .       .  . . . . .        .   . .  . . .     .   .  .    .     .  . . .      7
8  Partnership QBAI      .    . . . . .   .  . . .   . . . .     . . . .            . . . .       .  . . . . .        .   . .  . . .     .   .  .    .     .  . . .      8
Section 2—Information To Determine Foreign-Derived Deduction Eligible Income on Form 8993 (see instructions)
                                                                                                  (a) Foreign-derived       (b) Foreign-derived            (c) Foreign-derived (d) Total 
                                                                                                  income from all sales of  income from all sales of income from all services  (add columns (a) 
                                                                                                  general property          intangible property                                through (c))
9  Gross receipts      . .    . . . . .   .  . . .   . . . .     . . . .            . . .
10 COGS .        .   . . .    . . . . .   .  . . .   . . . .     . . . .            . . .
11 Allocable deductions       . . . . .   .  . . .   . . . .     . . . .            . . .
12 Other apportioned deductions .   . .   .  . . .   . . . .     . . . .            . . . .       .  . . . . .        .   . .  . . .     .   .  .    .     .  . . .      12
Section 3—Other Information for Preparation of Form 8993
                                                                                                                                 (a) DEI                       (b) FDDEI       (c) Total
13 Interest deductions
A  Interest expense specifically allocable under Regulations section 1.861-10(e)  . . . . .       .  . . . . .        .
B  Other interest expense specifically allocable under Regulations section 1.861-10T  . . .       .  . . . . .        .
C  Other interest expense  .    . . . .   .  . . .   . . . .     . . . .            . . . .       .  . . . . .        .
14 Interest expense apportionment factors 
A  Total average value of assets  . . .   .  . . .   . . . .     . . . .            . . . .       .  . . . . .        .
B  Sections 734(b) and 743(b) adjustment to assets—average value . . . .            . . . .       .  . . . . .        .
C  Assets attracting directly allocable interest expense under Regulations section 1.861-10(e)  . .  . . . . .        .
D  Other assets attracting directly allocable interest expense under Regulations section 1.861-10T   . . . . .        .
E  Assets excluded from apportionment formula  . .   . . . .     . . . .            . . . .       .  . . . . .        .
F  Total assets used for apportionment (the sum of lines 14C, 14D, and 14E subtracted from the sum of lines 14A and 14B)  
   R&E expenses apportionment factors
15 Gross receipts by SIC code
A  SIC code:                    . . . .   .  . . .   . . . .     . . . .            . . . .       .  . . . . .        .
B  SIC code:                    . . . .   .  . . .   . . . .     . . . .            . . . .       .  . . . . .        .
C  SIC code:                    . . . .   .  . . .   . . . .     . . . .            . . . .       .  . . . . .        .
16 R&E expenses by SIC code
A  SIC code:                    . . . .   .  . . .   . . . .     . . . .            . . . .       .  . . . . .        .   . .  . . .     .   .  .    .     .  . . .      16A
B  SIC code:                    . . . .   .  . . .   . . . .     . . . .            . . . .       .  . . . . .        .   . .  . . .     .   .  .    .     .  . . .      16B
C  SIC code:                    . . . .   .  . . .   . . . .     . . . .            . . . .       .  . . . . .        .   . .  . . .     .   .  .    .     .  . . .      16C
                                                                                                                                                                               Schedule K-3 (Form 8865) 2022

Schedule K-3 (Form 8865) 2022                                                                                                                                                Page  11 
Name of partnership:                                                 EIN (if any):                 Reference ID number (see instr.):
Name of partner:                                                                                                                              SSN or TIN:
Part V           Distributions From Foreign Corporations to Partnership
                     (a) Name of distributing foreign corporation       (b) EIN or              (c) Date of distribution    (d) Functional currency of       (e) Amount of distribution 
                                                                     reference ID number                                    distributing foreign corporation in functional currency
A
B
C
D
E
F
G
H
I
J
K
L
M
N
O
 (f) Amount of E&P distribution (g) Spot rate (functional         (h) Amount of distribution (i) Amount of E&P distribution    (j) Qualified foreign            (k) Reserved for 
    in functional currency      currency to U.S. dollars)            in U.S. dollars            in U.S. dollars                   corporation                      future use
A
B
C
D
E
F
G
H
I
J
K
L
M
N
O
                                                                                                                                                             Schedule K-3 (Form 8865) 2022

Schedule K-3 (Form 8865) 2022                                                                                                                                                          Page  12 
Name of partnership:                                                           EIN (if any):                         Reference ID number (see instr.):
Name of partner:                                                                                                                                             SSN or TIN:
Part VI          Information on Partner’s Section 951(a)(1) and Section 951A Inclusions
a Separate category (enter code)     . . . . .     .  . .     . . . .     . .  .   . .  .    .  . . .       . .  .   . . . . .       .  .   . .          . . . . .  
b If box is checked, this is completed with respect to U.S. source income . .  .   . .  .    .  . . .       . .  .   . . . . .       .  .   . .          . . . . . .        . .  . . . . .  

                                                                                             (d) Partner’s share 
                     (a) Name of CFC               (b) EIN or       (c) Ending of CFC        of CFC items through    (e) Partner’s share of           (f) Partner’s section   (g) Tested income
                                           reference ID number            tax year           its ownership in          subpart F income        951(a)(1)(B) inclusion
                                                                                               the partnership 

A
B
C
D
E
F
G
H
I
J
K
1 Partner’s total (sum for all CFCs) . . . . .     .  . .     . . . .     . .  .   . .  .    .  . . .       . .  .   

  (h) Tested loss             (i) Partner’s share of    (j) Partner’s share of       (k) Partner’s share of      (l) Partner’s share of     (m) Partner’s share of            (n) Partner’s share of 
                                     tested income              tested loss        Qualified Business Asset          the tested loss        tested interest income          tested interest expense
                                                                                     Investment (QBAI)               QBAI amount

A
B
C
D
E
F
G
H
I
J
K
1
                                                                                                                                                                        Schedule K-3 (Form 8865) 2022

Schedule K-3 (Form 8865) 2022                                                                                                                                              Page  13
Name of partnership:                                                    EIN (if any):             Reference ID number (see instr.):
Name of partner:                                                                                                                            SSN or TIN:
Part VII         Information To Complete Form 8621
Section 1—General Information on Passive Foreign Investment Company (PFIC), Qualified Electing Fund (QEF), or Qualifying Insurance Corporation (QIC)
                                                                           General Information
                     (a) Name of PFIC             (b) EIN or                                   (c) Address of PFIC                      (d) Beginning of           (e) Ending of 
                                                  reference ID number                                                                   PFIC tax year              PFIC tax year

                                          Summary of Annual Information                                                             Information Regarding Elections
                                                                                                                      (j) Box is 
                                                                                                                      checked if        (k) Box is      (l) Box is     (m) Box is 
                                                                                                                      foreign           checked if PFIC checked if 
                                          (g) Dates PFIC                (h) Partner’s share of (i) Partner’s share of corporation has   has indicated   PFIC is also   checked if 
                 (f) Description of each  shares acquired                  total number of        total value of      documented its    its shares are  a controlled   PFIC meets 
                                                                                                                      eligibility to be 
                     class of PFIC shares during tax year               PFIC shares held by    PFIC shares held by    treated as a      “marketable      foreign       the income 
                                          (if applicable)               partnership at end of  partnership at end of  qualifying        stock” within   corporation    test or asset 
                                                                           tax year               tax year            insurance         the meaning     (CFC) within   test of section 
                                                                                                                      corporation       of section      the meaning of 1297(a) for the 
                                                                                                                      under section     1296(e).        section 957.   tax year.
                                                                                                                      1297(f)(2).

                                                                                                                                                        Schedule K-3 (Form 8865) 2022

Schedule K-3 (Form 8865) 2022                                                                                                                                                        Page  14
Name of partnership:                                                   EIN (if any):                             Reference ID number (see instr.):
Name of partner:                                                                                                                                      SSN or TIN:
Part VII         Information To Complete Form 8621 (continued)
Section 2—Additional Information on PFIC or QEF
                       General Information                             QEF Information                                 Mark-to-Market Information                        Section 1291 and Other 
                                                                                                                                                                               Information
                                                                                                                 (e) Partner’s share of   (f) Partner’s share of 
         (a) Name of PFIC                  (b) EIN or          (c) Partner’s share of (d) Partner’s share of net fair market value of             fair market value of      (g) Dates PFIC shares 
                                           reference ID number ordinary earnings             capital gain        PFIC shares held by      PFIC shares held by                  were acquired
                                                                                                                 partnership at beginning partnership at end of 
                                                                                                                    of tax year                      tax year

                                                                    Section 1291 and Other Information

(h) Partner’s share of                                                                                              (m) Partner’s share of        (n) Partner’s share of 
amount of cash and fair                    (j) Partner’s share of   (k) Partner’s share of   (l) Dates PFIC         amount realized by            partnership’s tax basis   (o) Partner’s share of 
market value of property      (i) Dates of total creditable foreign total distributions from shares disposed of        partnership on             in PFIC shares on dates      gain (loss) on 
distributed by PFIC           distribution taxes attributable to    PFIC in preceding        during tax year        disposition of PFIC           of disposition (including    disposition by 
during the current tax                     distribution by PFIC        3 tax years           (if applicable)           shares                     partner-specific          partnership of PFIC 
year (if applicable)                                                                                                                                  adjustments)             shares

                                                                                                                                                                       Schedule K-3 (Form 8865) 2022 

Schedule K-3 (Form 8865) 2022                                                                                                                                           Page  15 
Name of partnership:                                                         EIN (if any):                      Reference ID number (see instr.):
Name of partner:                                                                                                                                 SSN or TIN:
Part VIII        Partner’s Information for Base Erosion and Anti-Abuse Tax (Section 59A)
Section 1—Applicable Taxpayer (see instructions)
                                                    Description                                                 (a) Total          (b) Total ECI gross      (c) Total non-ECI gross 
                                                                                                                                                 receipts       receipts
1   Gross receipts for section 59A(e) .    .    . . . . . .     . . . .    . .    .         . . . . . .      .
2   Gross receipts for the first preceding year . . . . . .     . . . .    . .    .         . . . . . .      .
3   Gross receipts for the second preceding year    . . . .     . . . .    . .    .         . . . . . .      .
4   Gross receipts for the third preceding year   . . . . .     . . . .    . .    .         . . . . . .      .
5   Amounts included in the denominator of the base erosion percentage as described in Regulations section 
    1.59A-2(e)(3)  . .        . . . . .    .    . . . . . .     . . . .    . .    .         . . . . . .      .
Section 2—Base Erosion Payments and Base Erosion Tax Benefits (see instructions)
                                                    Description                                                 (a) Total          (b) Total base erosion   (c) Total base erosion 
                                                                                                                                                 payments       tax benefits
6   Reserved for future use  .    . . .    .    . . . . . .     . . . .    . .    .         . . . . . .      .
7   Reserved for future use  .    . . .    .    . . . . . .     . . . .    . .    .         . . . . . .      .
8   Purchase or creations of property rights for intangibles (patents, trademarks, etc.)  . . . . . . .      .
9   Rents, royalties, and license fees  .  .    . . . . . .     . . . .    . .    .         . . . . . .      .
10a Compensation/consideration paid for services not excepted by section 59A(d)(5)  .       . . . . . .      .
b   Compensation/consideration paid for services excepted by section 59A(d)(5)  . .         . . . . . .      .
11  Interest expense  .       . . . . .    .    . . . . . .     . . . .    . .    .         . . . . . .      .
12  Payments for the purchase of tangible personal property  .  . . . .    . .    .         . . . . . .      .
13  Premiums and/or other considerations paid or accrued for insurance and reinsurance as covered by 
    sections 59A(d)(3) and 59A(c)(2)(A)(iii)  . . . . . . .     . . . .    . .    .         . . . . . .      .
14a Nonqualified derivative payments  .    .    . . . . . .     . . . .    . .    .         . . . . . .      .
b   Qualified derivative payments excepted by section 59A(h)  . . . . .    . .    .         . . . . . .      .
15  Payments reducing gross receipts made to surrogate foreign corporation . .    .         . . . . . .      .
16  Other payments—specify: 
17  Base erosion tax benefits related to payments reported on lines 6 through 16, on which tax is imposed by 
    section 871 or 881, with respect to which tax has been withheld under section 1441 or 1442 at the 30% 
    (0.30) statutory withholding tax rate  .    . . . . . .     . . . .    . .    .         . . . . . .      .
18  Portion of base erosion tax benefits reported on lines 6 through 16, on which tax is imposed by section 
    871 or 881, with respect to which tax has been withheld under section 1441 or 1442 at reduced 
    withholding rate pursuant to income tax treaty. Multiply ratio of percentage withheld divided by 30% (0.30) 
    times tax benefit. See instructions  . .    . . . . . .     . . . .    . .    .         . . . . . .      .
19  Total base erosion tax benefits (subtract the sum of lines 17 and 18 from the sum of lines 8 through 16)  .
20  Reserved for future use  .    . . .    .    . . . . . .     . . . .    . .    .         . . . . . .      .
21  Reserved for future use  .    . . .    .    . . . . . .     . . . .    . .    .         . . . . . .      .
22  Reserved for future use  .    . . .    .    . . . . . .     . . . .    . .    .         . . . . . .      .
                                                                                                                                                            Schedule K-3 (Form 8865) 2022