Schedule S (Form 1120-F) - Exclusion Of Income From The International Operation Of Ships Or Aircraft Under Section 883 - 2017 Page 2
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Schedule S (Form 1120-F) 2017
Page
10
For each class of stock relied on to meet the “regularly traded test” of Regulations section 1.883-2(d), indicate:
a (i) The days during the tax year of the corporation in which the class of stock was closely held, without regard to the
exception in Regulations section 1.883-2(d)(3)(ii)
▶
(ii) The total percentage of the vote and value of the class of stock that is owned by 5% shareholders during
such days
▶
%
b
For all qualified shareholders on which the corporation intends to rely to satisfy the closely-held exception test of
Regulations section 1.883-2(d)(3)(ii), and who own stock in the closely-held block (directly, indirectly, or by applying the
attribution rules of Regulations section 1.883-4(c)), enter:
(i) The total number of qualified shareholders, as defined in Regulations section 1.883-4(b)(1)
▶
(ii) The total percentage of the value of the shares of the class of stock owned, directly or indirectly, by such qualified
shareholders by country of residence (see instructions):
Country code (see instructions)
Percentage
(iii) The days during the tax year of the corporation that such qualified shareholders owned, directly or indirectly, their shares in
the closely-held block of stock
▶
Part III
Stock Ownership Test for Controlled Foreign Corporations (CFC)
11 a Enter the percentage of the value of all outstanding shares of the CFC that is owned by all “qualified U.S. persons” identified in
the qualified ownership statements required under Regulations section 1.883-3(c)(2), applying the attribution of ownership rules
of Regulations section 1.883-3(b)(4)
▶
%
b Enter the percentage of the value of all outstanding shares of the CFC that is owned by the “qualified U.S. persons” referred to
on line 11a above as bearer shares maintained in a dematerialized or immobilized book-entry system
▶
%
12
Enter the period during which such qualified U.S. persons held such stock (see instructions)
▶
13
Enter the period during which the foreign corporation was a CFC (see instructions)
▶
14
Yes
No
Is the CFC directly held by qualified U.S. persons? .
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Part IV
Qualified Shareholder Stock Ownership Test
15
Check the box if more than 50% of the value of the outstanding shares of the corporation is owned (or treated as owned by
reason of Regulations section 1.883-4(c)) by qualified shareholders for each category of income for which the exemption is
claimed
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16
With respect to all qualified shareholders relied on to satisfy the 50% ownership test of Regulations section 1.883-4(a):
a Enter the total number of such qualified shareholders as defined in Regulations section 1.883-4(b)(1)
▶
b Enter the total percentage of the value of the outstanding shares owned, applying the attribution rules of Regulations section
1.883-4(c), by such qualified shareholders by country of residence or organization, whichever is applicable.
Country code (see instructions)
Percentage
Total
c Enter the percentage of the value of the outstanding shares that is owned by the qualified shareholders as bearer shares
maintained in a dematerialized or immobilized book-entry system
▶
%
d Enter the period during the tax year of the foreign corporation that such stock was held by qualified shareholders
▶
Schedule S (Form 1120-F) 2017
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