5471 Schedule Q CFC Income by CFC Income Groups

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SCHEDULE Q
(Form 5471)
(Rev. December 2023)
Department of the Treasury
Internal Revenue Service
Name of person filing Form 5471
Name of foreign corporation

TREASURY/IRS
AND OMB USE
ONLY DRAFT
August 24, 2023
DO NOT FILE
CFC Income by CFC Income Groups

OMB No. 1545-0123

Attach to Form 5471.
Go to www.irs.gov/Form5471 for instructions and the latest information.

Identifying number

Reference ID number (see instructions)

EIN (if any)

Complete a separate Schedule Q with respect to each applicable category of income (see instructions).
A Enter separate category code with respect to which this Schedule Q is being completed (see instructions for codes) . . .
B If category code “PAS” is entered on line A, enter the applicable grouping code (see instructions) . . . . . . . . . .
C If code “901j” is entered on line A, enter the country code for the sanctioned country (see instructions) . . . . . . . .
Complete a separate Schedule Q for U.S. source income and foreign source income (see instructions for an exception).
D Indicate whether this Schedule Q is being completed for:
U.S. source income or
Foreign source income
Complete a separate Schedule Q for FOGEI or FORI income.
E If this Schedule Q is being completed for FOGEI or FORI income, check this box . . . . . . . . . . . . . . .
(i)
(ii)
(iii)
(iv)
(v)
Enter amounts in functional currency
Country
Gross Income
Definitely Related
Related Person
Other Interest
of the foreign corporation (unless
Code
Expenses
Interest Expense
Expense
otherwise noted).
1
Subpart F Income Groups
a Dividends,
Interest,
Rents,
Royalties, & Annuities (Total) .
(1) Unit name:
(2) Unit name:
b Net Gain From Certain Property
Transactions (Total) . . . .
(1) Unit name:
(2) Unit name:
c Net Gain From Commodities
Transactions (Total) . . . .
(1) Unit name:
(2) Unit name:
d Net Foreign Currency Gain (Total)
(1) Unit name:
(2) Unit name:
e Income Equivalent to Interest (Total)
(1) Unit name:
(2) Unit name:

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(vi)
Research & Experimental
Expenses

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(vii)
Other Expenses
(attach statement)

f

Other Foreign Personal Holding
Company Income (Total) (attach
statement—see instructions) .
(1) Unit name:
(2) Unit name:
Important: See Computer-Generated Schedule Q in instructions.
For Paperwork Reduction Act Notice, see instructions.

Cat. No. 73414U

Schedule Q (Form 5471) (Rev. 12-2023)

TREASURY/IRS
AND OMB USE
ONLY DRAFT
August 24, 2023
DO NOT FILE

Page 2

Schedule Q (Form 5471) (Rev. 12-2023)
(viii)
Current Year Tax on
Reattributed Income
From Disregarded
Payments

1
a
(1)
(2)
b
(1)
(2)
c
(1)
(2)
d
(1)
(2)
e
(1)
(2)
f

(ix)
Current Year Tax on
All Other Disregarded
Payments

(x)
Other Current
Year Taxes

(xi)
Net Income
(column (ii) less
columns (iii) through (x))

(xii)
Foreign Taxes for
Which Credit Allowed
(U.S. Dollars)

(xiii)
Average Asset Value

(xiv)
High
Tax
Election

(xv)
Loss Allocation

(xvi)
Net Income After
Loss Allocation
(column (xi) minus
column (xv))

(1)
(2)
Important: See Computer-Generated Schedule Q in instructions.

Schedule Q (Form 5471) (Rev. 12-2023)

TREASURY/IRS
AND OMB USE
ONLY DRAFT
August 24, 2023
DO NOT FILE

Schedule Q (Form 5471) (Rev. 12-2023)

Enter amounts in functional currency
of the foreign corporation (unless
otherwise noted).

(i)
Country
Code

(ii)
Gross Income

(iii)
Definitely Related
Expenses

(iv)
Related Person
Interest Expense

(v)
Other Interest
Expense

Page

(vi)
Research & Experimental
Expenses

3

(vii)
Other Expenses
(attach statement)

1
Subpart F Income Groups
g Foreign Base Company Sales
Income (Total) . . . . . .
(1) Unit name:
(2) Unit name:
h Foreign Base Company Services
Income (Total) . . . . . .
(1) Unit name:
(2) Unit name:
i Full Inclusion Foreign Base
Company Income (Total) . . .
(1) Unit name:
(2) Unit name:
j Insurance Income (Total) . . .
(1) Unit name:
(2) Unit name:
k International Boycott Income .
l Bribes, Kickbacks, and Other
Payments . . . . . . . .
m Section 901(j) income . . . .
2
Recaptured Subpart F Income .
3
Tested Income Group (Total) .
(1) Unit name:
(2) Unit name:
4
Residual Income Group (Total) .
(1) Unit name:
(2) Unit name:
5
Total . . . . . . . . .
Important: See Computer-Generated Schedule Q in instructions.

Schedule Q (Form 5471) (Rev. 12-2023)

TREASURY/IRS
AND OMB USE
ONLY DRAFT
August 24, 2023
DO NOT FILE

Schedule Q (Form 5471) (Rev. 12-2023)
(viii)
Current Year Tax on
Reattributed Income
From Disregarded
Payments

1
g
(1)
(2)
h
(1)
(2)
i
(1)
(2)
j
(1)
(2)
k

(ix)
Current Year Tax on
All Other Disregarded
Payments

(x)
Other Current
Year Taxes

(xi)
Net Income
(column (ii) less
columns (iii) through (x))

(xii)
Foreign Taxes for
Which Credit Allowed
(U.S. Dollars)

(xiii)
Average Asset Value

(xiv)
High
Tax
Election

Page

(xv)
Loss Allocation

4

(xvi)
Net Income After
Loss Allocation
(column (xi) minus
column (xv))

l
m
2
3
(1)
(2)
4
(1)
(2)
5
Important: See Computer-Generated Schedule Q in instructions.

Schedule Q (Form 5471) (Rev. 12-2023)