Form 8916-A - Supplemental Attachment To Schedule M-3 - 2017 Page 2

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Form 8916-A (2017)
Page
Part II
Interest Income
(a)
(b)
(c)
(d)
Interest Income Item
Income (Loss) per Income
Temporary
Permanent
Income (Loss) per
Statement
Difference
Difference
Tax Return
1
Tax-exempt interest
income
2
Interest income from hybrid
securities
3
Sale/lease interest income
Intercompany interest
4a
income — From outside tax
affiliated group
Intercompany interest
4b
income — From tax
affiliated group
5
Other interest income
6
Total interest income. Add
lines 1 through 5 in columns
a, b, c, and d. Enter total on
the applicable Schedule M-3.
See instructions.
Part III
Interest Expense
(a)
(b)
(c)
(d)
Interest Expense Item
Expense per Income
Temporary
Permanent
Deduction per Tax Return
Statement
Difference
Difference
1
Interest expense from
hybrid securities
2
Lease/purchase interest
expense
3a
Intercompany interest
expense — Paid to outside
tax affiliated group
3b
Intercompany interest
expense — Paid to tax
affiliated group
4
Other interest expense
5
Total interest expense. Add
lines 1 through 4 in columns
a, b, c, and d. Enter total on
the applicable Schedule M-3.
See instructions.
8916-A
Form
(2017)

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