Form 5471 - Schedule O - Organization Or Reorganization Of Foreign Corporation, And Acquisitions And Dispositions Of Its Stock Page 2

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Schedule O (Form 5471) (Rev. 12-2012)
Page
(f)
(g)
Amount paid or value given
Name and address of person from whom shares were acquired
Section D—Disposition of Stock
(e)
(d)
Number of shares disposed of
(a)
(b)
(c)
Method
Name of shareholder disposing of stock
Class of stock
Date of disposition
(1)
(2)
(3)
of disposition
Directly
Indirectly
Constructively
(f)
(g)
Amount received
Name and address of person to whom disposition of stock was made
Section E—Organization or Reorganization of Foreign Corporation
(a)
(b)
(c)
Name and address of transferor
Identifying number (if any)
Date of transfer
(d)
(e)
Assets transferred to foreign corporation
Description of assets transferred by, or notes or
(3)
(1)
(2)
securities issued by, foreign corporation
Adjusted basis (if transferor was
Description of assets
Fair market value
U.S. person)
Section F—Additional Information
(a) If the foreign corporation or a predecessor U.S. corporation filed (or joined with a consolidated group in filing) a U.S. income tax return for
any of the last 3 years, attach a statement indicating the year for which a return was filed (and, if applicable, the name of the corporation filing
the consolidated return), the taxable income or loss, and the U.S. income tax paid (after all credits).
(b) List the date of any reorganization of the foreign corporation that occurred during the last 4 years while any U.S. person held 10% or
more in value or vote (directly or indirectly) of the corporation’s stock
▶
(c) If the foreign corporation is a member of a group constituting a chain of ownership, attach a chart, for each unit of which a shareholder
owns 10% or more in value or voting power of the outstanding stock. The chart must indicate the corporation’s position in the chain of
ownership and the percentages of stock ownership (see instructions for an example).
Schedule O (Form 5471) (Rev. 12-2012)

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