Fillable Form 8916-A - Supplemental Attachment To Schedule M-3

Form 8916-A (2017)

Page

Part II. Interest Income

Line 2

Report on line 2, column (a), total interest expense from

Line 1

periodic payments from transactions characterized as a

Report on line 1, column (a), tax-exempt interest income

lease for financial accounting and as a purchase for tax

defined under section 103. Complete columns (b) and (c), as

purposes. Report on line 2, column (d), total interest expense

applicable.

from periodic payments from transactions characterized as a

Line 2

purchase for financial accounting and as a lease for tax

purposes. Complete columns (b) and (c), as applicable. See

Report on line 2, column (a), the total amount of interest

the instructions for Schedule M-3, Part III, line 34 (Form

income included on Schedule M-3, Part I, line 11, from

1120), line 35 (Forms 1120-L and 1120-PC), or line 28

hybrid securities characterized as debt for financial

(Forms 1120S and 1065).

accounting and as equity for tax purposes. Report on line 2,

column (d), the total amount of interest income from hybrid

Line 3a

securities characterized as equity for financial accounting

Report on line 3a total intercompany interest expense

and as debt for tax purposes. Complete columns (b) and (c),

included on Schedule M-3, Part I, line 4 but not included on

as applicable. Report interest income from a debt that is

Schedule M-3, Part I, line 11. Report hybrid security interest

both a hybrid debt and a related party debt on line 2 and not

expense or deduction on line 1 and purchase/lease interest

on line 4a or 4b.

expense or deduction on line 2 and not on line 3a.

Line 3

Line 3b

Report on line 3, column (a), the total interest income from

Report on line 3b total intercompany interest expense to an

periodic payments from transactions characterized as a

entity within the tax affiliated group. Report hybrid security

lease for financial accounting and as a sale for tax purposes.

interest expense or deduction on line 1 and purchase/lease

Report on line 3, column (d), the total interest income from

interest expense or deduction on line 2 and not on line 3b.

periodic payments from transactions characterized as a sale

Note. Report interest expense from a debt that is both a

for financial accounting and as a lease for tax purposes.

hybrid debt and a related party debt on line 1 and not on line

Complete columns (b) and (c), as applicable. See the

3a or 3b.

instructions for sale versus lease for Schedule M-3, Part II,

Line 4

line 18 (Forms 1120 and 1120-L), line 17 (Form 1120-PC), or

line 16 (Forms 1120S and 1065).

Report on line 4 total interest expense not required to be

Line 4a

reported on lines 1 through 3b.

Line 5

Report on line 4a total intercompany interest income from an

entity included on Schedule M-3, Part I, line 4 but not

Line 5 must equal the amounts for all columns reported on

included on Schedule M-3, Part I, line 11. Report hybrid

Schedule M-3 (Form 1120), Part III, line 8; Schedule M-3

security interest income on line 2 and sale/lease interest

(Forms 1120-PC and 1120-L), Part III, line 36; Schedule M-3

income on line 3 and not on line 4a.

(Form 1065), Part III, line 27; or Schedule M-3 (Form 1120S),

Line 4b

Part III, line 26. See the instructions for the applicable

Schedule M-3.

Report on line 4b total intercompany interest income from an

entity within the tax affiliated group. Report hybrid security

Paperwork Reduction Act Notice. We ask for the

interest income on line 2 and sale/lease interest income on

information on this form to carry out the Internal Revenue

line 3 and not on line 4b.

laws of the United States. You are required to give us the

Note. Report interest income from a debt that is both a

information. We need it to ensure that you are complying

hybrid debt and a related party debt on line 2 and not on line

with these laws and to allow us to figure and collect the right

4a or 4b.

amount of tax.

Line 5

You are not required to provide the information requested

on a form that is subject to the Paperwork Reduction Act

Report on line 5 total interest income not required to be

unless the form displays a valid OMB control number. Books

reported on lines 1 through 4b.

or records relating to a form or its instructions must be

Line 6

retained as long as their contents may become material in

Line 6 must equal the amount for all columns reported on

the administration of any Internal Revenue law. Generally,

Schedule M-3, Part II, line 13 (Forms 1120, 1120-L, and

tax returns and return information are confidential, as

1120-PC) or line 11 (Forms 1120S and 1065). See the

required by section 6103.

instructions for the applicable Schedule M-3.

The time needed to complete and file this form will vary

Part III. Interest Expense

depending on individual circumstances. The estimated

burden for business taxpayers filing this form is approved

Line 1

under OMB control number 1545-0123 and is included in the

Report on line 1, column (a), total interest expense from

estimates shown in the instructions for their business income

hybrid securities characterized as debt for financial

tax return.

accounting and as equity for tax purposes. Report on line 1,

If you have comments concerning the accuracy of these

column (d), total interest expense from hybrid securities

time estimates or suggestions for making this form simpler,

characterized as equity for financial accounting and as debt

we would be happy to hear from you. See the instructions

for tax purposes. Complete columns (b) and (c), as

for the tax return with which this form is filed.

applicable. Report interest expense from a debt that is both

a hybrid debt and a related party debt on line 1 and not on

line 3a or 3b.

Form 8916-A - Supplemental Attachment To Schedule M-3 - 2017 Page 4

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