2013
Schedule TTP
Massachusetts
Department of
Tax Treaty Positions
Revenue
For calendar year 2013 or taxable period beginning
2013 and ending
Taxpayer’s name
Federal Identification number (if none, enter “Foreign”)
Massachusetts return being filed:
355
355U
355S
63FI
P.S. 1
Taxpayer’s U.S. address
City/Town
State
Zip
Taxpayer’s address in country of residence
Has taxpayer filed U.S. Form 1120F?:
Yes
No
Is taxpayer filing one or more U.S. Form(s) 8833 with the IRS?:
Yes
No
If relying on multiple treaties, enter each treaty separately.
Treaty Information.
Name of treaty country
Type of treaty
Applicable article(s)
Income tax
Other
IRS Code provision(s) overruled or modified by treaty-based position
Provisions of the limitation-on-benefits article, if any, in the treaty that the taxpayer relies on to prevent application of the article
Explain the treaty-based return position taken
Income to be excluded by application of the treaties identified above.
Income Exclusions.
1 Interest . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
2 Royalties . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
3 Other FDAP gains, profits and income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
4 Other non-FDAP Income to be excluded . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
5 Total income to be excluded by application of treaties. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
ombined Report Filers Only
Name of principal reporting corporation
Federal Identification number
Amount of income excluded from return that is derived (directly or indirectly) from intangible property or service-related activities, the costs of which gener-
ally are deductible for federal income tax purposes against the business income of other members of the Massachusetts combined group. List amounts
separately and identify the other member(s) claiming the deduction. See instructions.
Payer’s name
Federal Identification number
Amount
Reason for inclusion of the member claiming the benefit in the combined return (check one):
Member is incorporated in U.S.
Member is a non-U.S. corporation that is taxable on its income in Massachusetts
Member is a non-U.S. corporation, not described in the question above, with an average of property, payroll and sales in the U.S. of 20% or more
Member is a non-U.S. corporation, not described in the questions above, that derives at least 20% of gross income from services to other members of
the group