Form 5713 (Schedule A) - International Boycott Factor Form
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1SCHEDULE A
International
(Form 5713)
Boycott Factor (Section 999(c)(1))
OMB No. 1545-0216
Complete only if you are not computing a loss of tax benefits using the specifically
(Rev. December 2004)
attributable taxes and income method on Schedule B (Form 5713)
Department of the Treasury
Attach to Form 5713.
See instructions on page 2.
Internal Revenue Service
Name
Identifying number
Name of country being boycotted (check one):
Israel
Other (identify)
Important: If you are involved in more than one boycott, use a separate Schedule A for each boycott and attach to Form 5713.
Purchases, sales, and payroll attributable to boycotting operations, by operation
Name of Country
Boycott purchases
Boycott sales
Boycott payroll
(1)
(2)
(3)
(4)
a
b
c
d
e
f
g
h
i
j
k
l
m
n
o
Total
1
Numerator of boycott factor (add totals of columns (2), (3), and (4))
2
Denominator of boycott factor:
a
Total purchases from countries other than United States
b
Total sales to or from countries other than United States
c
Total payroll paid or accrued for services performed in countries other
than United States
d
Total of lines 2a, b, and c
3
International boycott factor (divide line 1 by line 2d). Enter here and on Schedule C
(Form 5713) (see instructions)
For Paperwork Reduction Act Notice, see the Instructions for Form 5713.
Schedule A (Form 5713) (Rev. 12-2004)
Cat. No. 12050W
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