Form 926 - Return By A U.s. Transferor Of Property To A Foreign Corporation Page 2

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2
Form 926 (Rev. 12-2017)
Page
Information Regarding Transfer of Property (see instructions)
Part III
Section A—Cash, Stock, and Securities
(a)
(b)
(c)
(d)
(e)
Type of
Date of
Description of
Fair market value on
Cost or other
Gain recognized on
property
transfer
property
date of transfer
basis
transfer
Cash
Stock and
securities (other
than those that
qualify as eligible
property under
Regs. sec.
1.367(a)-2(b)(3))
9
Was cash the only property transferred? .
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Yes
No
If “Yes,” skip the remainder of Part III and go to Part IV.
10
Did the transferor transfer stock or securities subject to section 367(a) with respect to which a gain
recognition agreement was filed? .
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Yes
No
Section B
Property qualifying for Active Trade or Business exception under Regs. sec. 1.367(a)-2(a)(2)(i) and (ii)
(a)
(b)
(c)
(d)
(e)
Type of
Date of
Description of
Fair market value on
Cost or other
Gain recognized on
property
transfer
property
date of transfer
basis
transfer*
Tangible property
(not listed under
another category)
Working interest in
oil and gas property
(as described in
Regs. sec.
1.367(a)-2(b)(2)
and (f))
Financial asset (as
described in Regs.
sec. 1.367(a)-
2(b)(3))
Certain tangible
property to be
leased (see Regs.
sec. 1.367(a)-2(e))
Totals
* If property listed in this section is subject to depreciation recapture or branch loss recapture, see instructions.
926
Form
(Rev. 12-2017)

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