SCHEDULE PH 
(Form 1120)                                 U.S. Personal Holding Company (PHC) Tax
(Rev. November 2015)                                                                                                                    OMB No. 1545-0123
Department of the Treasury                                       ▶ Attach to tax return. 
Internal Revenue Service           ▶ Information about Schedule PH (Form 1120) and its separate instructions is at www.irs.gov/form1120.
Name                                                                                                                          Employer identification number

Part I                  Undistributed Personal Holding Company Income  (see instructions)
                    1   Taxable income before net operating loss deduction and special deductions. Enter amount 
                        from Form 1120, line 28  .     . . . . . . .    . .     .       . . . . . .       .        . . . .    1 
                    2   Contributions deducted in figuring line 1. Enter amount from Form 1120, line 19 .            . . .    2 
                    3   Excess expenses and depreciation under section 545(b)(6). Enter amount from Part V, 
          Additions     line 2   .  . .   . . .  .     . . . . . . .    . .     .       . . . . . .       .        . . . .    3 
                    4   Total. Add lines 1 through 3  .  . . . . . .    . .     .       . . . . . .       .        . . . .    4 
                    5   Federal and foreign income, war profits, and excess profits taxes not deducted in figuring 
                        line 1 (attach schedule) .     . . . . . . .    . .     .       . . . . . .       .        . . . .    5 
                    6   Contributions deductible under section 545(b)(2). See instructions for limitation  .         . . .    6 
                    7   Net operating loss for the preceding tax year deductible under section 545(b)(4) .           . . .    7 
                    8 a Net capital gain from Schedule D (Form 1120), line 17  .        .   8a 
                    b  Less:  Income tax on this net capital gain (see section  
                        545(b)(5))  (attach computation)  .. . . . .    . .     .       .   8b                                8c 
                    9   Deduction for dividends paid (other than dividends paid after the end of the tax year). Enter 
                        amount from Part VI, line 5  .   . . . . . .    . .     .       . . . . . .       .        . . . .    9 
          Deductions
                    10  Total. Add lines 5 through 9  .  . . . . . .    . .     .       . . . . . .       .        . . . .    10 

                    11  Subtract line 10 from line 4  .  . . . . . .    . .     .       . . . . . .       .        . . . .    11 
                    12  Dividends  paid  after  the  end  of  the  tax  year  (other  than  deficiency  dividends  defined  in
                        section 547(d)), but not more than the smaller of line 11 or 20% of Part VI, line 1          . . .    12 
                    13  Undistributed PHC income.  Subtract line 12 from line 11 .        . . . . .       .        . . . .    13 
Note:  If the information in Part II and Part IV is not submitted with the return, the limitation period for assessment and 
                    collection of the PHC tax is any time within 6 years after the return is filed. See section 6501(f).
Part II                 Personal Holding Company Income  (see instructions)
14a                 Dividends .  .  . .   . . .  .     . . . . . . .    . .     .       .   14a
b  Less: Dividends excluded (under section 543(a)(1)(C))  .               .     .       .   14b                               14c
15a                 Interest .   .  . .   . . .  .     . . . . . . .    . .     .       .   15a
b  Less:  Amounts excluded (attach schedule)                   . . .    . .     .       .   15b                               15c
16                  Royalties (other than mineral, oil, gas, or copyright royalties)  . . . . . . .       .        . . . .    16 
17                  Annuities  . .  . .   . . .  .     . . . . . . .    . .     .       . . . . . .       .        . . . .    17 
18a                 Rents  . .   .  . .   . . .  .     . . . . . . .    . .     .       .   18a
b  Less:  Adjustments to rents (attach schedule)  .              . .    . .     .       .   18b                               18c
19a                 Mineral, oil, and gas royalties  . . . . . . . .    . .     .       .   19a
b  Less:                Adjustments  to  mineral,  oil,  and  gas  royalties  (attach 
                    schedule)  . .  . .   . . .  .     . . . . . . .    . .     .       .   19b                               19c
20                  Copyright royalties . . . .  .     . . . . . . .    . .     .       . . . . . .       .        . . . .    20 
21                  Produced film rents   . . .  .     . . . . . . .    . .     .       . . . . . .       .        . . . .    21 
22                  Compensation received for use of corporation property by 25% or more shareholder  .              . . .    22 
23                  Amounts received under personal service contracts and from their sale  .    . .       .        . . . .    23 
24                  Amounts includible in taxable income from estates and trusts        . . . . . .       .        . . . .    24 
25                  PHC income.  Add lines 14 through 24  .  . . . .    . .     .       . . . . . .       .        . . . .    25 
Part III                Tax on Undistributed Personal Holding Company Income (see instructions)
26                  PHC tax. Multiply the amount on line 13 by 20%. Enter the result here and on Schedule J (Form
                    1120), line 8, or on the proper line of the appropriate tax return  . . . . . .       .        . . . .    26 
For Paperwork Reduction Act Notice, see the Instructions for Form 1120.                   Cat. No. 11465P                Schedule PH (Form 1120) (Rev. 11-2015)

Schedule PH (Form 1120) (Rev. 11-2015)                                                                                              Page 2 
Part IV Stock Ownership Requirement Under Section 542(a)(2) 
        Enter the names and addresses of the individuals who together owned, directly or indirectly, at any time during 
        the last half of the tax year, more than 50% in value of the outstanding stock of the corporation.
                                                                                                              Highest percentage of shares 
                      (a)  Name                                              (b)  Address                     owned during last half of tax year
                                                                                                              (c)  Preferred   (d)  Common
1 
                                                                                                                        %                     % 

                                                                                                                        %                     % 

                                                                                                                        %                     % 

                                                                                                                        %                     % 

                                                                                                                        %                     % 

2 Add the amounts in columns (c) and (d) and enter the totals here         . .    . .     . . . .  .  ▶                 %                     % 
Part V  Excess of Expenses and Depreciation Over Income From Property Not Allowable 
        Under Section 545(b)(6)  (see instructions for Part I, line 3)
                                                                             (e)  Repairs, 
  (a)  Description of           (b)  Date (c)  Cost or   (d)  Depreciation insurance, and     (f)  Total of   (g)  Income from (h)  Excess 
        property                acquired  other basis      deduction       other expenses     columns (d)     rent or other    (col. (f) less 
                                                                             (section 162)      and (e)       compensation     col. (g))
                                                                           (attach schedule)
1 

2 Total excess of expenses and depreciation over rent or other compensation. Add the amounts in column 
  (h). Enter the total here and on Part I, line 3 . .  . .    . . .  .     . .    . .     . . . .  .    .   . .    . . .
  Note:  Attach a statement showing the names and addresses of persons from whom rent or other 
        compensation was received for the use of, or the right to use, each property.
Part VI Deduction for Dividends Paid Under Sections 561 and 562
1 Taxable dividends paid. Do not include dividends considered as paid in the preceding tax year 
  under section 563 or deficiency dividends as defined in section 547        .    . .     . . . .  .    .     1 

2 Consent dividends. Attach Forms 972 and 973          . .    . . .  .     . .    . .     . . . .  .    .     2 

3 Taxable distributions. Add lines 1 and 2  .  .    .  . .    . . .  .     . .    . .     . . . .  .    .     3 

4 Dividend carryover from first and second preceding tax years. Attach computation            . .  .    .     4 

5 Deduction for dividends paid.  Add lines 3 and 4. Enter the total here and on Part I, line 9  .       .     5 
                                                                                                   Schedule PH (Form 1120) (Rev. 11-2015)