Form Rev-802 - Schedule C-6 Add-Back For Intangible Expenses Or Cost And Related Interest

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FILL IN FORM USING ALL CAPS.
DO NOT USE DASHES (-) OR SLASHES (/) IN ANY FIELD. ENTER DATES AS MMDDYYYY. USE WHOLE DOLLARS ONLY.
8020015105
REV-802
PAGE 1 OF 2
(02-16)
SCHEDULE C-6 ADD-BACK FOR INTANGIBLE
MMDDYYYY
EXPENSES OR COST AND RELATED INTEREST
TAX YEAR
BEGINNING
START
TAX YEAR
CORPORATION NAME
REVENUE ID
ENDING
PAYMENTS MADE DIRECTLY OR INDIRECTLY TO AN AFFILIATED ENTITY
PART I.
Entity HQ
Intangible
Related
Affiliated Entity Name
FEIN
Entity Jurisdiction
Jurisdiction
Expenses
Interest Expense
1.
1a.
1b.
2.
2a.
2b
3.
3a.
3b.
4.
4a.
4b.
5. TOTAL PAYMENTS
5a.
5b.
Exclusion of payments:
6. Tax avoidance was not principal purpose and was done at arm's length rates and terms.
6a.
6b.
7. Affiliated entity domiciled in a foreign nation that has in force a comprehensive income tax
treaty with the U.S. Government. (Complete Part II.)
7a.
7b.
8. Affiliated entity was a conduit for the intangible expenses or cost/related interest paid
directly or indirectly by the taxpayer to an unaffiliated entity. (Complete Part III.)
8a.
8b.
9. Total Amount Excluded from Total Intangible Expenses or Cost/Related Interest Payments
9a.
9b.
10. Add-back of Intangible Expenses or Cost/Related Interest Payments
10a.
10b.
11. TOTAL INTANGIBLE EXPENSES AND RELATED INTEREST EXPENSE
11.
TRANSACTIONS WITH FOREIGN ENTITIES
PART II.
Foreign Affiliate
Domestic Affiliate
Intangible
Related
Foreign Affiliated Entity Name
Jurisdiction
FEIN
Expenses
Interest Expense
1.
1a.
1b.
2.
2a.
2b
3.
3a.
3b.
4.
4a.
4b.
5. TOTAL EXCLUDED
5a.
5b.
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