SCHEDULE C                                                                Foreign Tax Redeterminations
(Form 1116)
(December 2021)                For calendar year 20         , or other tax year beginning                        , 20     , and ending                             , 20           . OMB No. 1545-0121
                                                                                   ▶ See separate instructions. 
Department of the Treasury                                  ▶ Go to www.irs.gov/Form1116 for instructions and the latest information.
Internal Revenue Service
Name                                                                                                                                                                                Identifying number as shown 
                                                                                                                                                                                    on page 1 of your tax return

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

Part I   Increase in Amount of Foreign Taxes Accrued (see instructions)
Enter redetermined amounts by payor for each separate relation back year (starting with the most recent) followed by a subtotal for each relation back year. 
  1. U.S. Tax Year of Taxpayer                        2a. Name of Payor                     2b. EIN or             3. Country or U.S. Possession               4. Date Additional   5. Foreign Tax Year 
     to Which Tax Relates                             (see instructions)                    Reference ID              to Which Tax Is Paid              Foreign Tax Was Paid        to Which Tax Relates 
     (relation back year)                                                                 Number of Payor          (enter code—see instructions)               (MM/DD/YYYY)           (MM/DD/YYYY)
       (MM/DD/YYYY)
                                (1)
A                               (2)
                                (3)                                                                                                                                                              
                                (1)
B                               (2)
                                (3)
         6. Payor’s Income           7. Additional Tax           8. Additional Tax        9. Conversion Rate       10. Additional Tax      11. U.S. Dollar Tax   12. Revised Tax Accrued 13. Check Box if 
         Subject to Tax in the          Accrued in                 Accrued in             of Local Currency      Accrued in U.S. Dollars of Payor Reported on        (add column 10      Contested Tax 
         Foreign Jurisdiction        Local Currency in      Functional Currency             to U.S. Dollars        (divide column 7      Original/Amended Return     and column 11)      (see instructions)
            (see instructions)     Which the Tax Is Payable        of Payor                                        by column 9)
  (1)
A (2)
  (3)
Subtotal by Relation       Back Year of Taxpayer      (add amounts in     columns 10, 11, and 12)      .    .  ▶                                                                                      
  (1)
B (2)
  (3)
Subtotal by Relation Back Year of Taxpayer (add amounts in columns 10, 11, and 12)  .                       .  ▶
For Privacy Act and Paperwork Reduction Act Notice, see the separate instructions.                                           Cat. No. 75187Q                                Schedule C (Form 1116) (12-2021)

Schedule C (Form 1116) (12-2021)                                                                                                                                                                        Page 2
Part II  Decrease in Amount of Foreign Taxes Paid or Accrued (see instructions) 
Enter redetermined amounts by payor for each separate relation back year (starting with the most recent) followed by a subtotal for each relation back year. 
  1. U.S. Tax Year of Taxpayer                      2a. Name of Payor                   2b. EIN or               3. Country or U.S. Possession      4. Date Foreign Tax 
    to Which Tax Relates                            (see instructions)                  Reference ID               From Which Tax Was                        Was Refunded or          5. Foreign Tax Year 
     (relation back year)                                                           Number of Payor              Refunded or Deemed Refunded                 Deemed Refunded          to Which Tax Relates 
         (MM/DD/YYYY)                                                                                            (enter code—see instructions)                (MM/DD/YYYY)              (MM/DD/YYYY)
                                                                                                                                                             (see instructions)
                                 (1)
A                                (2)
                                 (3)                                                                                                                                                            
                                 (1)
B                                (2)
                                 (3)
         6. Payor’s Income           7. Tax Refunded         8. Refunded Amount     9. Conversion Rate       10. Refunded Amount         11. U.S. Dollar Tax      12. Revised Tax       13. Check Box if 
         Subject to Tax in the       or Deemed Refunded      in Functional Currency of Local Currency            in U.S. Dollars         of Payor Reported on     Paid or Accrued       Section 905(c)(2) 
         Foreign Jurisdiction        in Local Currency in            of Payor           to U.S. Dollars      (divide column 7         Original/Amended Return     (subtract column 10   Two Year Rule 
            (see instructions)      Which the Tax Is Payable                                                     by column 9)                                     from column 11)                 Applies 
                                                                                                                                                                                        (see instructions)
  (1)
A (2)
  (3)
Subtotal by Relation     Back Year of Taxpayer      (add amounts in     columns 10, 11, and 12)      .  .  ▶                                                                                             
  (1)
B (2)
  (3)
Subtotal by Relation Back Year of Taxpayer (add amounts in columns 10, 11, and 12)  .                   .  ▶
Part III Change in Foreign Taxes Paid or Accrued
Enter the information below for the change to the total amount of foreign taxes paid or accrued and the foreign tax credits (FTCs) claimed for each relation back year.
            1. Relation Back Year                   2. Redetermined Foreign Taxes       3. Foreign Taxes Paid or Accrued              4. Amount of FTC Claimed                 5. Amount of FTC Claimed 
              (MM/DD/YYYY)                                   Paid or Accrued              per Original/Amended Return                 per Original/Amended Return              After Redetermination
A
B
Part IV  Change in U.S. Tax Liability
Enter the information below for the change in U.S. tax liability for each relation back year and other affected year (see instructions). 
                          1. Relation Back Year or Affected Tax Year                        2. Total Redetermined                     3. Total U.S. Tax Liability                   4. Difference 
                                     (MM/DD/YYYY)                                             U.S. Tax Liability                      per Original/Amended Return      (subtract column 3 from column 2)
A
B
                                                                                                                                                                               Schedule C (Form 1116) (12-2021)