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SCHEDULE S Exclusion of Income From the International OMB No. 1545-0123
(Form 1120-F)
Operation of Ships or Aircraft Under Section 883
▶
Department of the Treasury Attach to Form 1120-F. 2021
Internal Revenue Service ▶ Go to www.irs.gov/Form1120F for instructions and the latest information.
Name of corporation Employer identification number
Part I Qualified Foreign Corporation
1a Enter the name of the qualified foreign country in which the foreign corporation was organized ▶
b Check one (and only one) of the following boxes to indicate the type of equivalent exemption granted by the foreign country
listed on line 1a above.
Domestic law
Exchange of notes
Income tax convention
c Enter the applicable authority of the equivalent exemption type indicated on line 1b (see instructions) ▶
2 Enter the gross income in each of the following categories of qualified income for which the exemption is being claimed.
Note: If an amount is not readily determinable, enter a reasonable estimate. If an estimate is used on any of the lines below,
check here ▶
a Income from the carriage of passengers and cargo . . . . . . . . . . . . . . . . . 2a
b Time or voyage (full) charter income of a ship or wet lease income of an aircraft . . . . . . . . 2b
c Bareboat charter income of a ship or dry lease income of an aircraft . . . . . . . . . . . 2c
d Incidental bareboat charter income of a ship or incidental dry lease income of an aircraft . . . . . 2d
e Incidental container-related income . . . . . . . . . . . . . . . . . . . . . . 2e
f Income incidental to the international operation of ships or aircraft other than incidental income
included on lines 2d and 2e above. . . . . . . . . . . . . . . . . . . . . . . 2f
g Capital gains derived by a qualified foreign corporation engaged in the international operation of ships
or aircraft from the sale, exchange or other disposition of a ship, aircraft, container or related
equipment or other moveable property used by that qualified foreign corporation in the international
operation of ships or aircraft . . . . . . . . . . . . . . . . . . . . . . . . . 2g
h Income from participation in a pool, partnership, strategic alliance, joint operating agreement,
code-sharing arrangement, international operating agency, or other joint venture described in
Regulations section 1.883-1(e)(2) . . . . . . . . . . . . . . . . . . . . . . . 2h
Stock ownership test of Regulations section 1.883-1(c)(2):
3 Check one (and only one) of the following boxes to indicate the test under which the stock ownership test of Regulations
section 1.883-1(c)(2) was satisfied.
The publicly-traded test of Regulations section 1.883-2(a). Complete Part II.
The CFC stock ownership test of Regulations section 1.883-3(a). Complete Part III.
The qualified shareholder stock ownership test of Regulations section 1.883-4(a). Complete Part IV.
4 Check the box if any of the shares of the foreign corporation’s stock or the stock of any direct, indirect, or constructive
shareholder are issued in bearer form. . . . . . . . . . . . . . . . . . . . . . . . . . . .
5 If the box on line 4 is checked:
a Check the box on this line 5a if none of the bearer shares (other than bearer shares maintained in a dematerialized or
immobilized book-entry system) were relied on to satisfy any of the stock ownership tests described in Regulations section
1.883-1(c)(2) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
b Check the box on this line 5b if any of the bearer shares were maintained in a dematerialized or immobilized book-entry system
and were relied on to satisfy any of the stock ownership tests described in Regulations section 1.883-1(c)(2) . . . .
Part II Stock Ownership Test for Publicly-Traded Corporations
6 Enter the name of the country in which the stock is primarily traded ▶
7 Enter the name of the securities market(s) on which the stock is listed ▶
8 Enter a description of each class of stock relied on to meet the “regularly traded test” of Regulations section 1.883-2(d) (see
instructions for description requirements) ▶
9 Do one or more 5% shareholders (see instructions for definition) own in the aggregate 50% or more
of the vote and value of the outstanding shares of any class of stock for more than half the number of days during
the tax year? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
If “Yes,” complete line 10.
If “No,” skip line 10.
For Paperwork Reduction Act Notice, see the Instructions for Form 1120-F. Cat. No. 50766D Schedule S (Form 1120-F) 2021
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