How to Calculate Form Line 15

Transcription

1 How to Calculate Form Line Comprehensive Example Mary Beth Lougen EA USTCP Chief Operating Officer Expat Tax Tools B.Lougen@f8621.com 1 (844) ext PAGE 1 OF 83

2 Save time. Serve your clients. Stop the headaches. Form 8621 Calculator makes reporting all of the elements of Passive Foreign Investment Company Income (PFICs) easier. According to the IRS, it can take an experienced tax professional more than 24 hours to complete Form Save yourself the time and frustration. Form 8621 Calculator can complete the form in under an hour and turns it into simple data entry. There are three different options for access that offer a different range of features. Choose the one that is right for your business. expattaxtools.com f8621.com

3 Flexible Pricing Form 8621 Calculator can be licensed based on your business size. It means you can get the solution that fits your needs and budget. Cloud Solution Small Server Large Server Server Fee* n/a $2,200 $4, Users $325 per User $325 per User Users $325 per User Users $750 per User $300 per User n/a Users $280 per User 301+ Users $265 per User *Server fee includes the first user license. All prices in USD. Canadian pricing is available. Security and Privacy You need to protect your client s personal and financial information. Form 8621 Calculator puts you in control of sensitive client details so you decide how the information is seen and stored. Cloud Solution Small Server Large Server Administrative Rights Limited to user administration Full Full Password Reset option Enabled Optional Optional Location of financial data Cloud server User s computer User s computer Location of sensitive client data n/a User s computer User s computer Client sensitive data is not collected System Administrator System Administrator The data can be limited by the The data can be limited by the Collecting and storing client SSN Clients identified by ID only* Optional Optional Collecting and storing client address Clients identified by ID only* Optional Optional Collecting and storing client bank Limited to last 4 digits No limitations No limitations account numbers Address of financial institution on Disabled Optional Optional Form 8621 Search client list Optional Optional Optional Print Client ID on reports Enabled Optional Optional Custom company code in Reference Enabled Enabled Enabled Numbers Keeping copy of PDF forms on server PDFs are generated on request, Optional Optional not saved to server System back-up Daily Manual Manual Maintenance Updates By Expat Tax Tools Updates installed by client Updates installed by client *Client ID is an alphanumeric identifier set by the User. For cloud users, no client information prints on the completed form. Server users can choose how much client information appears on the completed form. System Server Requirements Small Server Large Server Installation* By user By user Minimum Memory 8GB 16GB Minimum Hard Drive 50GB 50GB Hard Drive SSD drives recommended SSD drives recommended CPU Core i7 is recommended Core i7 is recommended Operating System Not OP dependent. System should run Apache web-server, PHP 5.4+ (with FastCGI) and a MySQL database Not OP dependent. System should run Apache web-server, PHP 5.4+ (with FastCGI) and a MySQL database * ETT provides an installation program for Microsoft Windows. Other operating systems require a custom installation. Access Form 8621 Calculator in these supported browsers: Internet Explorer 10+ l Chrome 22+ l Firefox 27+ l Safari 6+ Form 8621 Calculator provides importable grids for users of Prosystems fx, Global fx or CCH Axcess Tax Software and it can handle 150+ currencies. For more product information or to discuss licensing of Form 8621 Calculator, please contact: Mary Beth Lougen, EA, USTCP Ext 402 l b.lougen@expattaxtools.com

4 Transaction Summary - Imperial Dividend Income Pool Date Transaction Type Units CAD Purchase 1, , Dividend Reinvestment Purchase Dividend Reinvestment Return of Capital Distribution Purchase Dividend Reinvestment Purchase Dividend Reinvestment Dividend Reinvestment Dividend Reinvestment Dividend Reinvestment Dividend Reinvestment Dividend Reinvestment Dividend Reinvestment Dividend Reinvestment Dividend Reinvestment Sale Dividend Reinvestment Return of Capital Distribution Dividend Reinvestment Dividend Reinvestment Dividend Reinvestment Dividend Reinvestment Sale , Dividend Reinvestment Dividend Reinvestment Dividend Reinvestment Dividend Reinvestment Dividend Reinvestment Dividend Reinvestment Dividend Reinvestment Return of Capital Distribution Additional Information 2013 Annualized Distribution per unit: $ Fair Market Value (FMV) on Dec 31: $ 14, Fair Market Value (FMV) on Dec 31: $ 14, Fair Market Value (FMV) on Dec 31: $ 9, PAGE 4 OF 83

5 How to Calculate Form Line PDF Report - Completed Form & Calculations - Mary Beth Lougen EA USTCP Chief Operating Officer Expat Tax Tools B.Lougen@f8621.com 1 (844) ext PAGE 5 OF 83

6 Form 8621 (Rev. December 2013) Department of the Treasury Internal Revenue Service Name of shareholder Information Return by a Shareholder of a Passive Foreign Investment Company or Qualified Electing Fund Information about Form 8621 and its separate instructions is at Identifying number (see instructions) OMB No Attachment Sequence No. 69 Number, street, and room or suite no. (If a P.O. box, see instructions.) City or town, state, and ZIP code or country Shareholder tax year: calendar year 2013 or other tax year beginning, 20 and ending, 20. Check type of shareholder filing the return: X Individual Corporation Partnership S Corporation Nongrantor Trust Estate Name of passive foreign investment company (PFIC) or qualified electing fund (QEF) Employer identification number (if any) Imperial Dividend Income Pool Address (Enter number, street, city or town, and country.) Reference ID number (see instructions) ETTWEBINAR001 Tax year of PFIC or QEF: calendar year 2013 or other tax year beginning, 20 and Part I Summary of Annual Information (See instructions.) Provide the following information with respect to all shares of the PFIC held by the shareholder: ending, Description of each class of shares held by the shareholder: Check if shares jointly owned with spouse. 2 Date shares acquired during the taxable year, if applicable: Multiple 3 Number of shares held at the end of the taxable year: 1, Value of shares held at the end of the taxable year (check the appropriate box, if applicable): (a) X $0-50,000 (b) $50, ,000 (c) $100, ,000 (d) $150, ,000 (e) If more than $200,000, list value: 5 Type of PFIC and amount of any excess distribution or gain treated as an excess distribution under section 1291, inclusion under section 1293, or inclusion or deduction under section 1296: (a) X Section 1291 $ 0 (b) Section 1293 (Qualified Electing Fund) $ (c) Section 1296 (Mark to Market) $ Part II Elections (See instructions.) A Election To Treat the PFIC as a QEF. I, a shareholder of a PFIC, elect to treat the PFIC as a QEF. Complete lines 6a through 7c of Part III. B Election To Extend Time For Payment of Tax. I, a shareholder of a QEF, elect to extend the time for payment of tax on the undistributed earnings and profits of the QEF until this election is terminated. Complete lines 8a through 9c of Part III to calculate the tax that may be deferred. C D E F Note: If any portion of line 6a or line 7a of Part III is includible under section 951, you may not make this election. Also, see sections 1294(c) and 1294(f) and the related regulations for events that terminate this election. Election To Mark-to-Market PFIC Stock. I, a shareholder of a PFIC, elect to mark-to-market the PFIC stock that is marketable within the meaning of section 1296(e). Complete Part IV. Deemed Sale Election. I, a shareholder on the first day of a PFIC s first tax year as a QEF, elect to recognize gain on the deemed sale of my interest in the PFIC. Enter gain or loss on line 15f of Part V. Deemed Dividend Election. I, a shareholder on the first day of a PFIC s first tax year as a QEF that is a controlled foreign corporation (CFC), elect to treat an amount equal to my share of the post-1986 earnings and profits of the CFC as an excess distribution. Enter this amount on line 15e of Part V. If the excess distribution is greater than zero, also complete line 16 of Part V. Election To Recognize Gain on Deemed Sale of PFIC. I, a shareholder of a former PFIC or a PFIC to which section 1297(d) applies, elect to treat as an excess distribution the gain recognized on the deemed sale of my interest in the PFIC on the last day of its last tax year as a PFIC under section 1297(a). Enter gain on line 15f of Part V. G H Deemed Dividend Election With Respect to a Section 1297(e) PFIC. I, a shareholder of a section 1297(e) PFIC, within the meaning of Regulations section (a), elect to make a deemed dividend election with respect to the Section 1297(e) PFIC. My holding period in the stock of the Section 1297(e) PFIC includes the CFC qualification date, as defined in Regulations section (d). Enter the excess distribution on line 15e, Part V. If the excess distribution is greater than zero, also complete line 16, Part V. Deemed Dividend Election With Respect to a Former PFIC. I, a shareholder of a former PFIC, within the meaning of Regulations section (a), elect to make a deemed dividend election with respect to the former PFIC. My holding period in the stock of the former PFIC includes the termination date, as defined in Regulations section (d). Enter the excess distribution on line 15e, Part V. If the excess distribution is greater than zero, also complete line 16, Part V. For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see separate instructions. Cat. No H Form 8621 (Rev ) CLIENT ID: 12 PAGE 6 OF 83

7 Form 8621 (Rev ) Page 2 Part III Income From a Qualified Electing Fund (QEF). All QEF shareholders complete lines 6a through 7c. If you are making Election B, also complete lines 8a through 9c. (See instructions.) 6a Enter your pro rata share of the ordinary earnings of the QEF a b Enter the portion of line 6a that is included in income under section 951 or that may be excluded under section 1293(g) b c Subtract line 6b from line 6a. Enter this amount on your tax return as ordinary income c 7a Enter your pro rata share of the total net capital gain of the QEF a b Enter the portion of line 7a that is included in income under section 951 or that may be excluded under section 1293(g) b c Subtract line 7b from line 7a. This amount is a net long-term capital gain. Enter this amount in Part II of the Schedule D used for your income tax return. (See instructions.) c 8a Add lines 6c and 7c a b Enter the total amount of cash and the fair market value of other property distributed or deemed distributed to you during the tax year of the QEF. (See instructions.)... 8b c Enter the portion of line 8a not already included in line 8c that is attributable to shares in the QEF that you disposed of, pledged, or otherwise transferred during the tax year.. 8c d Add lines 8b and 8c d e Subtract line 8d from line 8a, and enter the difference (if zero or less, enter amount in brackets) e Important: If line 8e is greater than zero, and no portion of line 6a or 7a is includible in income under section 951, you may make Election B with respect to the amount on line 8e. 9a Enter the total tax for the tax year (See instructions.) a b Enter the total tax for the tax year determined without regard to the amount entered on line 8e b c Subtract line 9b from line 9a. This is the deferred tax, the time for payment of which is extended by making Election B. See instructions c Part IV Gain or (Loss) From Mark-to-Market Election (See instructions.) 10a Enter the fair market value of your PFIC stock at the end of the tax year a b Enter your adjusted basis in the stock at the end of the tax year b c Subtract line 10b from line 10a. If a gain, do not complete lines 11 and 12. Include this amount as ordinary income on your tax return. If a loss, go to line c 11 Enter any unreversed inclusions (as defined in section 1296(d)) Enter the loss from line 10c, but only to the extent of unreversed inclusions on line 11. Include this amount as an ordinary loss on your tax return If you sold or otherwise disposed of any section 1296 stock (see instructions) during the tax year: a Enter the fair market value of the stock on the date of sale or disposition a b Enter the adjusted basis of the stock on the date of sale or disposition b c Subtract line 13b from line 13a. If a gain, do not complete line 14. Include this amount as ordinary income on your tax return. If a loss, go to line c 14a Enter any unreversed inclusions (as defined in section 1296(d)) a b Enter the loss from line 13c, but only to the extent of unreversed inclusions on line 14a. Include this amount as an ordinary loss on your tax return. If the loss on line 13c exceeds unreversed inclusions on line 14a, complete line 14c b c Enter the amount by which the loss on line 13c exceeds unreversed inclusions on line 14a. Include this amount on your tax return according to the rules generally applicable for losses provided elsewhere in the Code and regulations c Note. See instructions in case of multiple dispositions. Form 8621 (Rev ) CLIENT ID: 12 ETTWEBINAR001 / Pg. 2 PAGE 7 OF 83

8 Form 8621 (Rev ) Page 3 Part V Distributions From and Dispositions of Stock of a Section 1291 Fund (See instructions.) Complete a separate Part V for each excess distribution (see instructions). 15 a Enter your total distributions from the section 1291 fund during the current tax year with respect to the applicable stock. If the holding period of the stock began in the current tax year, see instructions a b Enter the total distributions (reduced by the portions of such distributions that were excess distributions but not included in income under section 1291(a)(1)(B)) made by the fund with respect to the applicable stock for each of the 3 years preceding the current tax year (or if shorter, the portion of the shareholder s holding period before the current tax year) b c Divide line 15b by 3. (See instructions if the number of preceding tax years is less than 3.) c d Multiply line 15c by 125% (1.25) d e Subtract line 15d from line 15a. This amount, if more than zero, is the excess distribution with respect to the applicable stock. If zero or less and you did not dispose of stock during the tax year, do not complete the rest of Part V. See instructions if you received more than one distribution during the current tax year. Also, see instructions for rules for reporting a nonexcess distribution on your income tax return e 0. f Enter gain or loss from the disposition of stock of a section 1291 fund or former section 1291 fund. If a gain, complete line 16. If a loss, show it in brackets and do not complete line f 16 a Attach a statement for each distribution and disposition. Show your holding period for each share of stock or block of shares held. Allocate the excess distribution to each day in your holding period. Add all amounts that are allocated to days in each tax year. b Enter the total of the amounts determined in line 16a that are allocable to the current tax year and tax years before the foreign corporation became a PFIC (pre-pfic tax years). Enter these amounts on your income tax return as other income 16b 0. c Enter the aggregate increases in tax (before credits) for each tax year in your holding period (other than the current tax year and pre-pfic years). (See instructions.) c 0. d Foreign tax credit. (See instructions.) d 0. e Subtract line 16d from line 16c. Enter this amount on your income tax return as additional tax. (See instructions.). 16e 0. f Determine interest on each net increase in tax determined on line 16e using the rates and methods of section Enter the aggregate amount of interest here. (See instructions.) f 0. Part VI Status of Prior Year Section 1294 Elections and Termination of Section 1294 Elections Complete a separate column for each outstanding election. Complete lines 25 and 26 only if there is a partial termination of the section 1294 election. (i) (ii) (iii) (iv) (v) (vi) 17 Tax year of outstanding election Undistributed earnings to which the election relates. 19 Deferred tax Interest accrued on deferred tax (line 19) as of the filing date 21 Event terminating election. 22 Earnings distributed or deemed distributed during the tax year Deferred tax due with this return Accrued interest due with this return Deferred tax outstanding after partial termination of election. 26 Interest accrued after partial termination of election.. ** SEE CALCULATION STATEMENT (REF. ID ETTWEBINAR001) FOR LINES 15b TO 15d CALCULATION DETAILS 153. ** Form 8621 (Rev ) CLIENT ID: 12 ETTWEBINAR001 / Pg. 3 PAGE 8 OF 83

9 Form 8621 Calculation Statement Imperial Dividend Income Pool Reference ID Number: ETTWEBINAR001 CURRENT YEAR HOLDINGS Block Number Allocation to Blocks Date Transaction Beginning of Year Number of Units Additions Transaction Amount (USD) Return of Capital Adjustments Sale: Number of Units Number of Units End of Year Cost Base 1 11/15/13 Purchase 1, , , , /29/13 Reinvestment /02/13 Purchase /20/13 Reinvestment DISTRIBUTED & REINVESTED EARNINGS $ 86 USD Reinvestment on 11/29/ : : : /15/13 11/29/13 1, $ 16 USD Reinvestment on 12/20/ : : : /15/13 12/20/13 1, /29/13 12/20/ /02/13 12/20/ $ 52 USD Distribution on 12/31/ : : : /15/13 12/31/13 1, /29/13 12/31/ /02/13 12/31/ /20/13 12/31/ EXCESS DISTRIBUTION SUMMARY Line 15a Line 15b Line 15c Line 15d Line 15e Line 15f Line 16b Line 16c Line 16d Line 16e Line 16f CLIENT ID: 12 ETTWEBINAR001 / Pg. 4 PAGE 9 OF 83

10 Form 8621 Calculation Statement Imperial Dividend Income Pool Reference ID Number: ETTWEBINAR CARRYOVER CALCULATION - ADJUSTED DISTRIBUTIONS PER UNIT 2013 DISTRIBUTIONS PER UNIT ADJUSTMENT Calculating in Original Currency Units Distribution Adjustment Adjusted Distribution Distribution Per Share 1, , , Average Adjusted Annual Distributions Per Unit: CLIENT ID: 12 ETTWEBINAR001 / Pg. 5 PAGE 10 OF 83

11 How to Calculate Form Line Calculations, Forms Guide & Tax Software Entry Guide - Mary Beth Lougen EA USTCP Chief Operating Officer Expat Tax Tools B.Lougen@f8621.com 1 (844) ext PAGE 11 OF 83

12 PREVIEW ONLY / DO NOT FILE CURRENT YEAR HOLDINGS Hide DetailsShow Details Block Number Allocation to Blocks Number of Securities Transaction amount Date Transaction Type Beginning of Year Additions (USD) Adjustments Return of Capital After Adjustments # of Securities Cost Base 1 11/15/13 Purchase 1, , , , /29/13 Reinvestment /02/13 Purchase /20/13 Reinvestment DISTRIBUTED & REINVESTED EARNINGS $ USD Reinvestment on 11/29/ : : : /15/13 11/29/13 1, $ USD Reinvestment on 12/20/ : : : /15/13 12/20/13 1, /29/13 12/20/ /02/13 12/20/ $ USD Distribution on 12/31/ : : : /15/13 12/31/13 1, /29/13 12/31/ /02/13 12/31/ /20/13 12/31/ EXCESS DISTRIBUTION SUMMARY Line 15a Line 15b Line 15c Line 15d Line 15e Line 15f Line 16b Line 16c Line 16d Line 16e Line 16f CARRYOVER CALCULATION ADJUSTED DISTRIBUTIONS PER UNIT (LINE 15B) 2013 Distributions Per Unit Adjustment Calculating in Original Currency Distribution Units Adjustment Adjusted Distribution Adjusted Distribution Per Share , , , Total Adjusted Annual Distributions Per Unit: PAGE 12 OF 83

13 PREVIEW ONLY / DO NOT FILE 102. Form 8621, Line 15a ETTWEBINAR PAGE 13 OF 83

14 13 X Imperial Dividend Income Pool ETTWEBINAR PREVIEW ONLY / DO NOT FILE X X 0. Class Multiple 1, PAGE 14 OF 83

15 PREVIEW ONLY / DO NOT FILE PAGE 15 OF 83

16 153. ** 0. PREVIEW ONLY / DO NOT FILE ** SEE CALCULATION STATEMENT (REF. ID ETTWEBINAR001) FOR LINES 15b TO 15d CALCULATION DETAILS PAGE 16 OF 83

17 INCOME/DEDUCTIONS DIVIDENDS DETAILS Warning! Make the following entries under the Dividends section if there was no slips issued for this fund, otherwise enter the slip information 1 Dividends (Schedule B) TSJ Payer Name Ordinary Dividends Foreign Country Code Foreign Income Code T Form 8621, Line 15a ETTWEBINAR CA 2 FOREIGN 8621 PART 1 PFIC or QEF Information 2 Name of PFIC or QEF line 1 Imperial Dividend Income Pool 3 line 2 Unknown / #CAD 4 Employer Identification Number (NOT Applicable) Address of PFIC or QEF Street address City State Zip or Postal Code 9 Foreign country Canada 10 Foreign province 14 Foreign Country Code CA 15 Foreign Income Code Passive Income 16 Reference ID Number ETTWEBINAR Additional Information Required Class of Stock Shares at Beginning of Year Changes During Year Date of Change Shares at Year End- Override Value of Shares Held Year End /15/ /29/ /02/ /20/ Jointly Owned ** Note that the CCH tax software rounds the number of units to the nearest number which may results in an inaccurate or negative number of units at the end of the year. Adjustments may be required. PART 12 Distributions / Dispositions from Section 1291 Fund 1 of 1 1 Total distributions from the section 1291 fund during the year Total distributions made by the fund for each of the 3 years preceding the current tax year 3 Number of prior years if fewer than 3 4 Gain or loss from disposition of section 1291 fund stock 5 Excess Distribution override 0 6 Holding period beginning date 11/15/ PFIC applicable date 8 Holding period ending date 12/31/ Distribution number 1 PART 13 Section 1291 Distribution Detail Distribution Number Current Year Distribution Foreign Tax Credit Excess Distribution Alloc. to Each Day in Holding Period OR Foreign Tax Credit Alloc. to Each Year in Holding Period OR Amount Allocated to Current Tax Year and Pre PFIC years OR Tax Increase Override Foreign Tax Credit - Override Interest Override PAGE 17 OF 83

18 How to Calculate Form Line PDF Report - Completed Form & Calculations - Mary Beth Lougen EA USTCP Chief Operating Officer Expat Tax Tools B.Lougen@f8621.com 1 (844) ext PAGE 18 OF 83

19 Form 8621 (Rev. December 2014) Department of the Treasury Internal Revenue Service Name of shareholder Information Return by a Shareholder of a Passive Foreign Investment Company or Qualified Electing Fund Information about Form 8621 and its separate instructions is at Identifying number (see instructions) OMB No Attachment Sequence No. 69 Number, street, and room or suite no. (If a P.O. box, see instructions.) City or town, state, and ZIP code or country Shareholder tax year: calendar year 2014 or other tax year beginning, 20 and ending, 20. Check type of shareholder filing the return: X Individual Corporation Partnership S Corporation Nongrantor Trust Estate Name of passive foreign investment company (PFIC) or qualified electing fund (QEF) Employer identification number (if any) Imperial Dividend Income Pool Address (Enter number, street, city or town, and country.) Reference ID number (see instructions) ETTWEBINAR001 Tax year of PFIC or QEF: calendar year 2014 or other tax year beginning, 20 and Part I Summary of Annual Information (See instructions.) Provide the following information with respect to all shares of the PFIC held by the shareholder: ending, Description of each class of shares held by the shareholder: Check if shares jointly owned with spouse. 2 Date shares acquired during the taxable year, if applicable: Multiple 3 Number of shares held at the end of the taxable year: 1, Value of shares held at the end of the taxable year (check the appropriate box, if applicable): (a) X $0-50,000 (b) $50, ,000 (c) $100, ,000 (d) $150, ,000 (e) If more than $200,000, list value: 5 Type of PFIC and amount of any excess distribution or gain treated as an excess distribution under section 1291, inclusion under section 1293, or inclusion or deduction under section 1296: (a) X Section 1291 $ 413 (b) Section 1293 (Qualified Electing Fund) $ (c) Section 1296 (Mark to Market) $ Part II Elections (See instructions.) A Election To Treat the PFIC as a QEF. I, a shareholder of a PFIC, elect to treat the PFIC as a QEF. Complete lines 6a through 7c of Part III. B Election To Extend Time For Payment of Tax. I, a shareholder of a QEF, elect to extend the time for payment of tax on the undistributed earnings and profits of the QEF until this election is terminated. Complete lines 8a through 9c of Part III to calculate the tax that may be deferred. C D E F Note: If any portion of line 6a or line 7a of Part III is includible under section 951, you may not make this election. Also, see sections 1294(c) and 1294(f) and the related regulations for events that terminate this election. Election To Mark-to-Market PFIC Stock. I, a shareholder of a PFIC, elect to mark-to-market the PFIC stock that is marketable within the meaning of section 1296(e). Complete Part IV. Deemed Sale Election. I, a shareholder on the first day of a PFIC s first tax year as a QEF, elect to recognize gain on the deemed sale of my interest in the PFIC. Enter gain or loss on line 15f of Part V. Deemed Dividend Election. I, a shareholder on the first day of a PFIC s first tax year as a QEF that is a controlled foreign corporation (CFC), elect to treat an amount equal to my share of the post-1986 earnings and profits of the CFC as an excess distribution. Enter this amount on line 15e of Part V. If the excess distribution is greater than zero, also complete line 16 of Part V. Election To Recognize Gain on Deemed Sale of PFIC. I, a shareholder of a former PFIC or a PFIC to which section 1297(d) applies, elect to treat as an excess distribution the gain recognized on the deemed sale of my interest in the PFIC on the last day of its last tax year as a PFIC under section 1297(a). Enter gain on line 15f of Part V. G H Deemed Dividend Election With Respect to a Section 1297(e) PFIC. I, a shareholder of a section 1297(e) PFIC, within the meaning of Regulations section (a), elect to make a deemed dividend election with respect to the Section 1297(e) PFIC. My holding period in the stock of the Section 1297(e) PFIC includes the CFC qualification date, as defined in Regulations section (d). Enter the excess distribution on line 15e, Part V. If the excess distribution is greater than zero, also complete line 16, Part V. Deemed Dividend Election With Respect to a Former PFIC. I, a shareholder of a former PFIC, within the meaning of Regulations section (a), elect to make a deemed dividend election with respect to the former PFIC. My holding period in the stock of the former PFIC includes the termination date, as defined in Regulations section (d). Enter the excess distribution on line 15e, Part V. If the excess distribution is greater than zero, also complete line 16, Part V. For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see separate instructions. Cat. No H Form 8621 (Rev ) CLIENT ID: 12 PAGE 19 OF 83

20 Form 8621 (Rev ) Page 2 Part III Income From a Qualified Electing Fund (QEF). All QEF shareholders complete lines 6a through 7c. If you are making Election B, also complete lines 8a through 9c. (See instructions.) 6a Enter your pro rata share of the ordinary earnings of the QEF a b Enter the portion of line 6a that is included in income under section 951 or that may be excluded under section 1293(g) b c Subtract line 6b from line 6a. Enter this amount on your tax return as ordinary income c 7a Enter your pro rata share of the total net capital gain of the QEF a b Enter the portion of line 7a that is included in income under section 951 or that may be excluded under section 1293(g) b c Subtract line 7b from line 7a. This amount is a net long-term capital gain. Enter this amount in Part II of the Schedule D used for your income tax return. (See instructions.) c 8a Add lines 6c and 7c a b Enter the total amount of cash and the fair market value of other property distributed or deemed distributed to you during the tax year of the QEF. (See instructions.)... 8b c Enter the portion of line 8a not already included in line 8b that is attributable to shares in the QEF that you disposed of, pledged, or otherwise transferred during the tax year.. 8c d Add lines 8b and 8c d e Subtract line 8d from line 8a, and enter the difference (if zero or less, enter amount in brackets) e Important: If line 8e is greater than zero, and no portion of line 6a or 7a is includible in income under section 951, you may make Election B with respect to the amount on line 8e. 9a Enter the total tax for the tax year (See instructions.) a b Enter the total tax for the tax year determined without regard to the amount entered on line 8e b c Subtract line 9b from line 9a. This is the deferred tax, the time for payment of which is extended by making Election B. See instructions c Part IV Gain or (Loss) From Mark-to-Market Election (See instructions.) 10a Enter the fair market value of your PFIC stock at the end of the tax year a b Enter your adjusted basis in the stock at the end of the tax year b c Subtract line 10b from line 10a. If a gain, do not complete lines 11 and 12. Include this amount as ordinary income on your tax return. If a loss, go to line c 11 Enter any unreversed inclusions (as defined in section 1296(d)) Enter the loss from line 10c, but only to the extent of unreversed inclusions on line 11. Include this amount as an ordinary loss on your tax return If you sold or otherwise disposed of any section 1296 stock (see instructions) during the tax year: a Enter the fair market value of the stock on the date of sale or disposition a b Enter the adjusted basis of the stock on the date of sale or disposition b c Subtract line 13b from line 13a. If a gain, do not complete line 14. Include this amount as ordinary income on your tax return. If a loss, go to line c 14a Enter any unreversed inclusions (as defined in section 1296(d)) a b Enter the loss from line 13c, but only to the extent of unreversed inclusions on line 14a. Include this amount as an ordinary loss on your tax return. If the loss on line 13c exceeds unreversed inclusions on line 14a, complete line 14c b c Enter the amount by which the loss on line 13c exceeds unreversed inclusions on line 14a. Include this amount on your tax return according to the rules generally applicable for losses provided elsewhere in the Code and regulations c Note. See instructions in case of multiple sales or dispositions. Form 8621 (Rev ) CLIENT ID: 12 ETTWEBINAR001 / Pg. 2 PAGE 20 OF 83

21 Form 8621 (Rev ) Page 3 Part V Distributions From and Dispositions of Stock of a Section 1291 Fund (See instructions.) Complete a separate Part V for each excess distribution and disposition (see instructions). 15 a Enter your total distributions from the section 1291 fund during the current tax year with respect to the applicable stock. If the holding period of the stock began in the current tax year, see instructions a b Enter the total distributions (reduced by the portions of such distributions that were excess distributions but not included in income under section 1291(a)(1)(B)) made by the fund with respect to the applicable stock for each of the 3 years preceding the current tax year (or if shorter, the portion of the shareholder s holding period before the current tax year) b c Divide line 15b by 3. (See instructions if the number of preceding tax years is less than 3.) c d Multiply line 15c by 125% (1.25) d e Subtract line 15d from line 15a. This amount, if more than zero, is the excess distribution with respect to the applicable stock. If there is an excess distribution, complete line 16. If zero or less and you did not dispose of stock during the tax year, do not complete the rest of Part V. See instructions if you received more than one distribution during the current tax year. Also, see instructions for rules for reporting a nonexcess distribution on your income tax return e f Enter gain or loss from the disposition of stock of a section 1291 fund or former section 1291 fund. If a gain, complete line 16. If a loss, show it in brackets and do not complete line f 16 a If there is a positive amount on line 15e or 15f (or both), attach a statement for each excess distribution and disposition. Show your holding period for each share of stock or block of shares held. Allocate the excess distribution or gain to each day in your holding period. Add all amounts that are allocated to days in each tax year. b Enter the total of the amounts determined in line 16a that are allocable to the current tax year and tax years before the foreign corporation became a PFIC (pre-pfic years). Enter these amounts on your income tax return as other income 16b 364. c Enter the aggregate increases in tax (before credits) for each tax year in your holding period (other than the current tax year and pre-pfic years). (See instructions.) c 19. d Foreign tax credit. (See instructions.) d 0. e Subtract line 16d from line 16c. Enter this amount on your income tax return as additional tax. (See instructions.). 16e 19. f Determine interest on each net increase in tax determined on line 16e using the rates and methods of section Enter the aggregate amount of interest here. (See instructions.) f 1. Part VI Status of Prior Year Section 1294 Elections and Termination of Section 1294 Elections Complete a separate column for each outstanding election. Complete lines 25 and 26 only if there is a partial termination of the section 1294 election. (i) (ii) (iii) (iv) (v) (vi) 17 Tax year of outstanding election Undistributed earnings to which the election relates. 19 Deferred tax Interest accrued on deferred tax (line 19) as of the filing date 21 Event terminating election. 22 Earnings distributed or deemed distributed during the tax year Deferred tax due with this return Accrued interest due with this return Deferred tax outstanding after partial termination of election. 26 Interest accrued after partial termination of election.. ** SEE CALCULATION STATEMENT (REF. ID ETTWEBINAR001) FOR LINES 15b TO 15d CALCULATION DETAILS 1,526. ** 413. Form 8621 (Rev ) CLIENT ID: 12 ETTWEBINAR001 / Pg. 3 PAGE 21 OF 83

22 Form 8621 (Rev ) Page 3 Part V Distributions From and Dispositions of Stock of a Section 1291 Fund (See instructions.) Complete a separate Part V for each excess distribution and disposition (see instructions). 15 a Enter your total distributions from the section 1291 fund during the current tax year with respect to the applicable stock. If the holding period of the stock began in the current tax year, see instructions a b Enter the total distributions (reduced by the portions of such distributions that were excess distributions but not included in income under section 1291(a)(1)(B)) made by the fund with respect to the applicable stock for each of the 3 years preceding the current tax year (or if shorter, the portion of the shareholder s holding period before the current tax year) b c Divide line 15b by 3. (See instructions if the number of preceding tax years is less than 3.) c d Multiply line 15c by 125% (1.25) d e Subtract line 15d from line 15a. This amount, if more than zero, is the excess distribution with respect to the applicable stock. If there is an excess distribution, complete line 16. If zero or less and you did not dispose of stock during the tax year, do not complete the rest of Part V. See instructions if you received more than one distribution during the current tax year. Also, see instructions for rules for reporting a nonexcess distribution on your income tax return e f Enter gain or loss from the disposition of stock of a section 1291 fund or former section 1291 fund. If a gain, complete line 16. If a loss, show it in brackets and do not complete line f 16 a If there is a positive amount on line 15e or 15f (or both), attach a statement for each excess distribution and disposition. Show your holding period for each share of stock or block of shares held. Allocate the excess distribution or gain to each day in your holding period. Add all amounts that are allocated to days in each tax year. b Enter the total of the amounts determined in line 16a that are allocable to the current tax year and tax years before the foreign corporation became a PFIC (pre-pfic years). Enter these amounts on your income tax return as other income 16b c Enter the aggregate increases in tax (before credits) for each tax year in your holding period (other than the current tax year and pre-pfic years). (See instructions.) c d Foreign tax credit. (See instructions.) d e Subtract line 16d from line 16c. Enter this amount on your income tax return as additional tax. (See instructions.). 16e f Determine interest on each net increase in tax determined on line 16e using the rates and methods of section Enter the aggregate amount of interest here. (See instructions.) f Part VI Status of Prior Year Section 1294 Elections and Termination of Section 1294 Elections Complete a separate column for each outstanding election. Complete lines 25 and 26 only if there is a partial termination of the section 1294 election. (i) (ii) (iii) (iv) (v) (vi) 17 Tax year of outstanding election Undistributed earnings to which the election relates. 19 Deferred tax Interest accrued on deferred tax (line 19) as of the filing date 21 Event terminating election. 22 Earnings distributed or deemed distributed during the tax year Deferred tax due with this return Accrued interest due with this return Deferred tax outstanding after partial termination of election. 26 Interest accrued after partial termination of election.. (11.) Form 8621 (Rev ) CLIENT ID: 12 ETTWEBINAR001 / Pg. 4 PAGE 22 OF 83

23 Form 8621 Calculation Statement Imperial Dividend Income Pool Reference ID Number: ETTWEBINAR001 CURRENT YEAR HOLDINGS Block Number Allocation to Blocks Date Transaction Beginning of Year Number of Units Additions Transaction Amount (USD) Return of Capital Adjustments Sale: Number of Units Number of Units End of Year Cost Base 1 11/15/13 Purchase 1, , ( ) , /29/13 Reinvestment /02/13 Purchase /20/13 Reinvestment /02/14 Purchase /31/14 Reinvestment /03/14 Purchase /28/14 Reinvestment /31/14 Reinvestment /30/14 Reinvestment /30/14 Reinvestment /30/14 Reinvestment /31/14 Reinvestment /29/14 Reinvestment /30/14 Reinvestment /31/14 Reinvestment /28/14 Reinvestment SECTION 1291 SALES Purchase Date Sale Date Units in Block Units Sold Units Left Basis Sale Price Gain / Loss Line 15f 11/15/13 11/21/14 1, DISTRIBUTED & REINVESTED EARNINGS $ 66 USD Reinvestment on 01/31/ : : : /15/13 01/31/14 1, /29/13 01/31/ /02/13 01/31/ /20/13 01/31/ /02/14 01/31/ $ 89 USD Reinvestment on 02/28/ : : : /15/13 02/28/14 1, Excess: $ Total Days: Excess Per Day: CLIENT ID: 12 ETTWEBINAR001 / Pg. 5 PAGE 23 OF 83

24 Form 8621 Calculation Statement Imperial Dividend Income Pool Reference ID Number: ETTWEBINAR001 ** /29/13 02/28/ Excess: $ Total Days: Excess Per Day: ** /02/13 02/28/ Excess: $ Total Days: Excess Per Day: ** /20/13 02/28/ Excess: $ Total Days: Excess Per Day: ** /02/14 02/28/ /31/14 02/28/ /03/14 02/28/ $ 89 USD Reinvestment on 03/31/ : : : /15/13 03/31/14 1, Excess: $ Total Days: Excess Per Day: ** /29/13 03/31/ Excess: $ Total Days: Excess Per Day: ** /02/13 03/31/ CLIENT ID: 12 ETTWEBINAR001 / Pg. 6 PAGE 24 OF 83

25 Form 8621 Calculation Statement Imperial Dividend Income Pool Reference ID Number: ETTWEBINAR001 Excess: $ Total Days: Excess Per Day: ** /20/13 03/31/ Excess: $ Total Days: Excess Per Day: ** /02/14 03/31/ /31/14 03/31/ /03/14 03/31/ /28/14 03/31/ $ 89 USD Reinvestment on 04/30/ : : : /15/13 04/30/14 1, /29/13 04/30/ /02/13 04/30/ /20/13 04/30/ /02/14 04/30/ /31/14 04/30/ /03/14 04/30/ /28/14 04/30/ /31/14 04/30/ $ 93 USD Reinvestment on 05/30/ : : : /15/13 05/30/14 1, Excess: $ Total Days: Excess Per Day: ** /29/13 05/30/ Excess: $ Total Days: Excess Per Day: ** CLIENT ID: 12 ETTWEBINAR001 / Pg. 7 PAGE 25 OF 83

26 Form 8621 Calculation Statement Imperial Dividend Income Pool Reference ID Number: ETTWEBINAR001 12/02/13 05/30/ Excess: $ Total Days: Excess Per Day: ** /20/13 05/30/ Excess: $ Total Days: Excess Per Day: ** /02/14 05/30/ /31/14 05/30/ /03/14 05/30/ /28/14 05/30/ /31/14 05/30/ /30/14 05/30/ $ 99 USD Reinvestment on 06/30/ : : : /15/13 06/30/14 1, Excess: $ Total Days: Excess Per Day: ** /29/13 06/30/ Excess: $ Total Days: Excess Per Day: ** /02/13 06/30/ Excess: $ Total Days: Excess Per Day: ** /20/13 06/30/ CLIENT ID: 12 ETTWEBINAR001 / Pg. 8 PAGE 26 OF 83

27 Form 8621 Calculation Statement Imperial Dividend Income Pool Reference ID Number: ETTWEBINAR001 Excess: $ Total Days: Excess Per Day: ** /02/14 06/30/ /31/14 06/30/ /03/14 06/30/ /28/14 06/30/ /31/14 06/30/ /30/14 06/30/ /30/14 06/30/ $ 95 USD Reinvestment on 07/31/ : : : /15/13 07/31/14 1, Excess: $ Total Days: Excess Per Day: ** /29/13 07/31/ Excess: $ Total Days: Excess Per Day: ** /02/13 07/31/ Excess: $ Total Days: Excess Per Day: ** /20/13 07/31/ Excess: $ Total Days: Excess Per Day: ** /02/14 07/31/ /31/14 07/31/ CLIENT ID: 12 ETTWEBINAR001 / Pg. 9 PAGE 27 OF 83

28 Form 8621 Calculation Statement Imperial Dividend Income Pool Reference ID Number: ETTWEBINAR001 02/03/14 07/31/ /28/14 07/31/ /31/14 07/31/ /30/14 07/31/ /30/14 07/31/ /30/14 07/31/ $ 101 USD Reinvestment on 08/29/ : : : /15/13 08/29/14 1, Excess: $ Total Days: Excess Per Day: ** /29/13 08/29/ Excess: $ Total Days: Excess Per Day: ** /02/13 08/29/ Excess: $ Total Days: Excess Per Day: ** /20/13 08/29/ Excess: $ Total Days: Excess Per Day: ** /02/14 08/29/ /31/14 08/29/ /03/14 08/29/ /28/14 08/29/ /31/14 08/29/ /30/14 08/29/ /30/14 08/29/ /30/14 08/29/ CLIENT ID: 12 ETTWEBINAR001 / Pg. 10 PAGE 28 OF 83

29 Form 8621 Calculation Statement Imperial Dividend Income Pool Reference ID Number: ETTWEBINAR001 07/31/14 08/29/ $ 90 USD Reinvestment on 09/30/ : : : /15/13 09/30/14 1, /29/13 09/30/ /02/13 09/30/ /20/13 09/30/ /02/14 09/30/ /31/14 09/30/ /03/14 09/30/ /28/14 09/30/ /31/14 09/30/ /30/14 09/30/ /30/14 09/30/ /30/14 09/30/ /31/14 09/30/ /29/14 09/30/ $ 90 USD Reinvestment on 10/31/ : : : /15/13 10/31/14 1, /29/13 10/31/ /02/13 10/31/ /20/13 10/31/ /02/14 10/31/ /31/14 10/31/ /03/14 10/31/ /28/14 10/31/ /31/14 10/31/ /30/14 10/31/ /30/14 10/31/ /30/14 10/31/ /31/14 10/31/ /29/14 10/31/ /30/14 10/31/ $ 92 USD Reinvestment on 11/28/ : : : /15/13 11/28/ Excess: $ Total Days: Excess Per Day: CLIENT ID: 12 ETTWEBINAR001 / Pg. 11 PAGE 29 OF 83

30 Form 8621 Calculation Statement Imperial Dividend Income Pool Reference ID Number: ETTWEBINAR001 ** /29/13 11/28/ Excess: $ Total Days: Excess Per Day: ** /02/13 11/28/ Excess: $ Total Days: Excess Per Day: ** /20/13 11/28/ Excess: $ Total Days: Excess Per Day: ** /02/14 11/28/ /31/14 11/28/ /03/14 11/28/ /28/14 11/28/ /31/14 11/28/ /30/14 11/28/ /30/14 11/28/ /30/14 11/28/ /31/14 11/28/ /29/14 11/28/ /30/14 11/28/ /31/14 11/28/ $ 524 USD Distribution on 12/31/ : : : /15/13 12/31/ Excess: $ Total Days: Excess Per Day: ** /29/13 12/31/ CLIENT ID: 12 ETTWEBINAR001 / Pg. 12 PAGE 30 OF 83

31 Form 8621 Calculation Statement Imperial Dividend Income Pool Reference ID Number: ETTWEBINAR001 Excess: $ Total Days: Excess Per Day: ** /02/13 12/31/ Excess: $ Total Days: Excess Per Day: ** /20/13 12/31/ Excess: $ Total Days: Excess Per Day: ** /02/14 12/31/ /31/14 12/31/ /03/14 12/31/ /28/14 12/31/ /31/14 12/31/ /30/14 12/31/ /30/14 12/31/ /30/14 12/31/ /31/14 12/31/ /29/14 12/31/ /30/14 12/31/ /31/14 12/31/ /28/14 12/31/ EXCESS DISTRIBUTION SUMMARY Line 15a Line 15b Line 15c Line 15d Line 15e Line 15f Line 16b Line 16c Line 16d Line 16e Line 16f 1, CLIENT ID: 12 ETTWEBINAR001 / Pg. 13 PAGE 31 OF 83

32 Form 8621 Calculation Statement Imperial Dividend Income Pool Reference ID Number: ETTWEBINAR CARRYOVER CALCULATION - ADJUSTED DISTRIBUTIONS PER UNIT 2014 DISTRIBUTIONS PER UNIT ADJUSTMENT Calculating in Original Currency Units Distribution Adjustment Adjusted Distribution Distribution Per Share 1, , , , , , , , , , , , Average Adjusted Annual Distributions Per Unit: CLIENT ID: 12 ETTWEBINAR001 / Pg. 14 PAGE 32 OF 83

33 How to Calculate Form Line Calculations, Forms Guide & Tax Software Entry Guide - Mary Beth Lougen EA USTCP Chief Operating Officer Expat Tax Tools B.Lougen@f8621.com 1 (844) ext PAGE 33 OF 83

34 PREVIEW ONLY / DO NOT FILE CURRENT YEAR HOLDINGS Hide DetailsShow Details Block Number Allocation to Blocks Number of Securities Transaction amount Date Transaction Type Beginning of Year Additions (USD) Return of Capital Adjustments Sale # of Securities After Adjustments # of Securities Cost Base 1 11/15/13 Purchase 1, , ( ) , /29/13 Reinvestment /02/13 Purchase /20/13 Reinvestment /02/14 Purchase /31/14 Reinvestment /03/14 Purchase /28/14 Reinvestment /31/14 Reinvestment /30/14 Reinvestment /30/14 Reinvestment /30/14 Reinvestment /31/14 Reinvestment /29/14 Reinvestment /30/14 Reinvestment /31/14 Reinvestment /28/14 Reinvestment SECTION 1291 SALES Purchase Date Sale Date Days Held Securities in Block Securities Sold Securities Left Basis Sale Price Gain / Loss Line 15f 11/15/13 11/21/ , DISTRIBUTED & REINVESTED EARNINGS $ USD Reinvestment on 01/31/ : : : /15/13 01/31/14 1, /29/13 01/31/ /02/13 01/31/ /20/13 01/31/ /02/14 01/31/ $ USD Reinvestment on 02/28/ : : : /15/13 02/28/14 1, ** /29/13 02/28/ ** /02/13 02/28/ ** /20/13 02/28/ ** /02/14 02/28/ /31/14 02/28/ /03/14 02/28/ $ USD Reinvestment on 03/31/ : : : PAGE 34 OF 83

35 11/15/13 03/31/14 1, ** /29/13 03/31/ ** /02/13 03/31/ ** /20/13 03/31/ ** /02/14 03/31/ /31/14 03/31/ /03/14 03/31/ /28/14 03/31/ $ USD Reinvestment on 04/30/ : : : /15/13 04/30/14 1, /29/13 04/30/ /02/13 04/30/ /20/13 04/30/ /02/14 04/30/ /31/14 04/30/ /03/14 04/30/ /28/14 04/30/ /31/14 04/30/ $ USD Reinvestment on 05/30/ : : : /15/13 05/30/14 1, ** /29/13 05/30/ ** /02/13 05/30/ ** /20/13 05/30/ ** /02/14 05/30/ /31/14 05/30/ /03/14 05/30/ /28/14 05/30/ /31/14 05/30/ /30/14 05/30/ $ USD Reinvestment on 06/30/14 PAGE 35 OF 83

36 2013: : : /15/13 06/30/14 1, ** /29/13 06/30/ ** /02/13 06/30/ ** /20/13 06/30/ ** /02/14 06/30/ /31/14 06/30/ /03/14 06/30/ /28/14 06/30/ /31/14 06/30/ /30/14 06/30/ /30/14 06/30/ $ USD Reinvestment on 07/31/ : : : /15/13 07/31/14 1, ** /29/13 07/31/ ** /02/13 07/31/ ** /20/13 07/31/ ** /02/14 07/31/ /31/14 07/31/ /03/14 07/31/ /28/14 07/31/ /31/14 07/31/ /30/14 07/31/ /30/14 07/31/ /30/14 07/31/ $ USD Reinvestment on 08/29/ : : : /15/13 08/29/14 1, PAGE 36 OF 83

37 ** /29/13 08/29/ ** /02/13 08/29/ ** /20/13 08/29/ ** /02/14 08/29/ /31/14 08/29/ /03/14 08/29/ /28/14 08/29/ /31/14 08/29/ /30/14 08/29/ /30/14 08/29/ /30/14 08/29/ /31/14 08/29/ $ USD Reinvestment on 09/30/ : : : /15/13 09/30/14 1, /29/13 09/30/ /02/13 09/30/ /20/13 09/30/ /02/14 09/30/ /31/14 09/30/ /03/14 09/30/ /28/14 09/30/ /31/14 09/30/ /30/14 09/30/ /30/14 09/30/ /30/14 09/30/ /31/14 09/30/ /29/14 09/30/ $ USD Reinvestment on 10/31/ : : : /15/13 10/31/14 1, /29/13 10/31/ /02/13 10/31/ /20/13 10/31/ /02/14 10/31/ /31/14 10/31/ /03/14 10/31/ /28/14 10/31/ /31/14 10/31/ /30/14 10/31/ /30/14 10/31/ /30/14 10/31/ /31/14 10/31/ /29/14 10/31/ /30/14 10/31/ $ USD Reinvestment on 11/28/ : : : /15/13 11/28/ ** PAGE 37 OF 83

38 11/29/13 11/28/ ** /02/13 11/28/ ** /20/13 11/28/ ** /02/14 11/28/ /31/14 11/28/ /03/14 11/28/ /28/14 11/28/ /31/14 11/28/ /30/14 11/28/ /30/14 11/28/ /30/14 11/28/ /31/14 11/28/ /29/14 11/28/ /30/14 11/28/ /31/14 11/28/ $ USD Distribution on 12/31/ : : : /15/13 12/31/ ** /29/13 12/31/ ** /02/13 12/31/ ** /20/13 12/31/ ** /02/14 12/31/ /31/14 12/31/ /03/14 12/31/ /28/14 12/31/ /31/14 12/31/ /30/14 12/31/ /30/14 12/31/ /30/14 12/31/ /31/14 12/31/ /29/14 12/31/ /30/14 12/31/ /31/14 12/31/ /28/14 12/31/ EXCESS DISTRIBUTION SUMMARY Line 15a Line 15b Line 15c Line 15d Line 15e Line 15f Line 16b Line 16c Line 16d Line 16e Line 16f 1, PAGE 38 OF 83

39 2015 CARRYOVER CALCULATION ADJUSTED DISTRIBUTIONS PER UNIT (LINE 15B) 2014 Distributions Per Unit Adjustment Calculating in Original Currency Distribution Units Adjustment Adjusted Distribution Adjusted Distribution Per Share , , , , , , , , , , , , Total Adjusted Annual Distributions Per Unit: PAGE 39 OF 83

40 PREVIEW ONLY / DO NOT FILE 985. (11.) STATEMENT LINE X 1291TAX. 19. X 1291INT. 1. STATEMENT LINE 21 Form 8621, Line 16b ETTWEBINAR001 / Excess allocated to current year or pre PFIC periods 364. TOTAL 364. Form 8621, Line 15a ETTWEBINAR Form 8621, Line 15d ETTWEBINAR PAGE 40 OF 83

41 (11.) X PAGE 41 OF 83

42 X SHS Imperial Dividend Income Pool 11/15/13 11/21/ (11.) (11.) PAGE 42 OF 83

43 14 X Imperial Dividend Income Pool ETTWEBINAR PREVIEW ONLY / DO NOT FILE X X 413. Class Multiple 1, PAGE 43 OF 83

44 PREVIEW ONLY / DO NOT FILE PAGE 44 OF 83

45 1,526. ** 413. PREVIEW ONLY / DO NOT FILE ** SEE CALCULATION STATEMENT (REF. ID ETTWEBINAR001) FOR LINES 15b TO 15d CALCULATION DETAILS PAGE 45 OF 83

46 (11.) PREVIEW ONLY / DO NOT FILE PAGE 46 OF 83

47 INCOME/DEDUCTIONS DIVIDENDS DETAILS 1 Dividends (Schedule B) TSJ Payer Name Ordinary Dividends Foreign Country Code Foreign Income Code T Form 8621, Line 15a ETTWEBINAR CA 2 T Form 8621, Line 15d ETTWEBINAR CA 2 INCOME GAINS AND LOSSES PART 1 Stocks, Securities, and Other Non Passive Transactions Descripton Sales Price Cost Date Acquired Date Sold Term Code 1099 B Code Foreign Country Code Foreign Income Code TSJ SHS Imperial Dividend Income Pool /15/13 11/21/14 L C CA 2 T FOREIGN 8621 PART 1 PFIC or QEF Information 2 Name of PFIC or QEF line 1 Imperial Dividend Income Pool 3 line 2 Unknown / #CAD 4 Employer Identification Number (NOT Applicable) Address of PFIC or QEF Street address City State Zip or Postal Code 9 Foreign country Canada 10 Foreign province 14 Foreign Country Code CA 15 Foreign Income Code Passive Income 16 Reference ID Number ETTWEBINAR001 Additional Information Required 17 Class of Stock Shares at Beginning of Year Changes During Year Date of Change Shares at Year End- Override Value of Shares Held Year End /02/ /31/ /03/ /28/ /31/ /30/ /30/ /30/ /31/ /29/ /30/ /31/ /21/ /28/ Jointly Owned ** Note that the CCH tax software rounds the number of units to the nearest number which may results in an inaccurate or negative number of units at the end of the year. Adjustments may be required. PART 12 Distributions / Dispositions from Section 1291 Fund 1 of 2 1 Total distributions from the section 1291 fund during the year Total distributions made by the fund for each of the 3 years preceding the current tax year 3 Number of prior years if fewer than 3 4 Gain or loss from disposition of section 1291 fund stock 5 Excess Distribution override Holding period beginning date 11/15/ PFIC applicable date PAGE 47 OF 83

48 8 Holding period ending date 12/31/ Distribution number 1 2 of 2 1 Total distributions from the section 1291 fund during the year 2 Total distributions made by the fund for each of the 3 years preceding the current tax year 3 Number of prior years if fewer than 3 4 Gain or loss from disposition of section 1291 fund stock Excess Distribution override 6 Holding period beginning date 7 PFIC applicable date 8 Holding period ending date 9 Distribution number 2 PART 13 Section 1291 Distribution Detail Distribution Number Current Year Distribution Foreign Tax Credit Excess Distribution Alloc. to Each Day in Holding Period OR Foreign Tax Credit Alloc. to Each Year in Holding Period OR Amount Allocated to Current Tax Year and Pre PFIC years OR Tax Increase Override Foreign Tax Credit - Override Interest Override PAGE 48 OF 83

49 How to Calculate Form Line Calculations, Forms Guide & Tax Software Entry Guide - Mary Beth Lougen EA USTCP Chief Operating Officer Expat Tax Tools B.Lougen@f8621.com 1 (844) ext PAGE 49 OF 83

50 PREVIEW ONLY / DO NOT FILE CURRENT YEAR HOLDINGS Hide DetailsShow Details Block Number Allocation to Blocks Number of Securities Transaction amount Date Transaction Type Beginning of Year Additions (USD) Return of Capital Adjustments Sale # of Securities After Adjustments # of Securities Cost Base 1 11/15/13 Purchase , ( ) , /29/13 Reinvestment /02/13 Purchase /20/13 Reinvestment /02/14 Purchase /31/14 Reinvestment /03/14 Purchase /28/14 Reinvestment /31/14 Reinvestment /30/14 Reinvestment /30/14 Reinvestment /30/14 Reinvestment /31/14 Reinvestment /29/14 Reinvestment /30/14 Reinvestment /31/14 Reinvestment /28/14 Reinvestment /30/15 Reinvestment /27/15 Reinvestment /31/15 Reinvestment /30/15 Reinvestment /29/15 Reinvestment /30/15 Reinvestment /31/15 Reinvestment /31/15 Reinvestment /30/15 Reinvestment /30/15 Reinvestment /30/15 Reinvestment TOTALS ON DECEMBER 31, 2015: FMV: $ 7, Total Shares: FMV / Share: $ DEEMED DISPOSITION (DD) Block ACB FMV in Block Gain on Block ACB at Year End Unreveresed Inclusions Carryforward Line 15f 1 8, , , , , SECTION 1291 SALES Purchase Date Sale Date Days Held Securities in Block Securities Sold Securities Left Basis Sale Price Gain / Loss Line 15f 11/15/13 05/14/ , , DISTRIBUTED & REINVESTED EARNINGS $ USD Reinvestment on 01/30/15 PAGE 50 OF 83

51 2014: : : /15/13 01/30/ /29/13 01/30/ /02/13 01/30/ /20/13 01/30/ /02/14 01/30/ /31/14 01/30/ /03/14 01/30/ /28/14 01/30/ /31/14 01/30/ /30/14 01/30/ /30/14 01/30/ /30/14 01/30/ /31/14 01/30/ /29/14 01/30/ /30/14 01/30/ /31/14 01/30/ /28/14 01/30/ $ USD Reinvestment on 02/27/ : : : /15/13 02/27/ /29/13 02/27/ /02/13 02/27/ /20/13 02/27/ /02/14 02/27/ /31/14 02/27/ /03/14 02/27/ /28/14 02/27/ /31/14 02/27/ /30/14 02/27/ /30/14 02/27/ /30/14 02/27/ /31/14 02/27/ /29/14 02/27/ /30/14 02/27/ /31/14 02/27/ /28/14 02/27/ /30/15 02/27/ $ USD Reinvestment on 03/31/ : : : /15/13 03/31/ /29/13 03/31/ /02/13 03/31/ /20/13 03/31/ /02/14 03/31/ /31/14 03/31/ /03/14 03/31/ /28/14 03/31/ /31/14 03/31/ /30/14 03/31/ /30/14 03/31/ /30/14 03/31/ /31/14 03/31/ /29/14 03/31/ /30/14 03/31/ /31/14 03/31/ /28/14 03/31/ /30/15 03/31/ /27/15 03/31/ $ USD Reinvestment on 04/30/ : : : /15/13 04/30/ /29/13 04/30/ /02/13 04/30/ /20/13 04/30/ /02/14 04/30/ /31/14 04/30/ /03/14 04/30/ /28/14 04/30/ /31/14 04/30/ /30/14 04/30/ /30/14 04/30/ /30/14 04/30/ PAGE 51 OF 83

52 07/31/14 04/30/ /29/14 04/30/ /30/14 04/30/ /31/14 04/30/ /28/14 04/30/ /30/15 04/30/ /27/15 04/30/ /31/15 04/30/ $ USD Reinvestment on 05/29/ : : : /15/13 05/29/ /29/13 05/29/ /02/13 05/29/ /20/13 05/29/ /02/14 05/29/ /31/14 05/29/ /03/14 05/29/ /28/14 05/29/ /31/14 05/29/ /30/14 05/29/ /30/14 05/29/ /30/14 05/29/ /31/14 05/29/ /29/14 05/29/ /30/14 05/29/ /31/14 05/29/ /28/14 05/29/ /30/15 05/29/ /27/15 05/29/ /31/15 05/29/ /30/15 05/29/ $ USD Reinvestment on 06/30/ : : : /15/13 06/30/ /29/13 06/30/ /02/13 06/30/ /20/13 06/30/ /02/14 06/30/ /31/14 06/30/ /03/14 06/30/ /28/14 06/30/ /31/14 06/30/ /30/14 06/30/ /30/14 06/30/ /30/14 06/30/ /31/14 06/30/ /29/14 06/30/ /30/14 06/30/ /31/14 06/30/ /28/14 06/30/ /30/15 06/30/ /27/15 06/30/ /31/15 06/30/ /30/15 06/30/ /29/15 06/30/ $ USD Reinvestment on 07/31/ : : : /15/13 07/31/ /29/13 07/31/ /02/13 07/31/ /20/13 07/31/ /02/14 07/31/ /31/14 07/31/ /03/14 07/31/ /28/14 07/31/ /31/14 07/31/ /30/14 07/31/ /30/14 07/31/ /30/14 07/31/ /31/14 07/31/ /29/14 07/31/ /30/14 07/31/ /31/14 07/31/ /28/14 07/31/ /30/15 07/31/ PAGE 52 OF 83

53 02/27/15 07/31/ /31/15 07/31/ /30/15 07/31/ /29/15 07/31/ /30/15 07/31/ $ USD Reinvestment on 08/31/ : : : /15/13 08/31/ /29/13 08/31/ /02/13 08/31/ /20/13 08/31/ /02/14 08/31/ /31/14 08/31/ /03/14 08/31/ /28/14 08/31/ /31/14 08/31/ /30/14 08/31/ /30/14 08/31/ /30/14 08/31/ /31/14 08/31/ /29/14 08/31/ /30/14 08/31/ /31/14 08/31/ /28/14 08/31/ /30/15 08/31/ /27/15 08/31/ /31/15 08/31/ /30/15 08/31/ /29/15 08/31/ /30/15 08/31/ /31/15 08/31/ $ USD Reinvestment on 09/30/ : : : /15/13 09/30/ /29/13 09/30/ /02/13 09/30/ /20/13 09/30/ /02/14 09/30/ /31/14 09/30/ /03/14 09/30/ /28/14 09/30/ /31/14 09/30/ /30/14 09/30/ /30/14 09/30/ /30/14 09/30/ /31/14 09/30/ /29/14 09/30/ /30/14 09/30/ /31/14 09/30/ /28/14 09/30/ /30/15 09/30/ /27/15 09/30/ /31/15 09/30/ /30/15 09/30/ /29/15 09/30/ /30/15 09/30/ /31/15 09/30/ /31/15 09/30/ $ USD Reinvestment on 10/30/ : : : /15/13 10/30/ /29/13 10/30/ /02/13 10/30/ /20/13 10/30/ /02/14 10/30/ /31/14 10/30/ /03/14 10/30/ /28/14 10/30/ /31/14 10/30/ /30/14 10/30/ /30/14 10/30/ /30/14 10/30/ /31/14 10/30/ /29/14 10/30/ /30/14 10/30/ PAGE 53 OF 83

54 10/31/14 10/30/ /28/14 10/30/ /30/15 10/30/ /27/15 10/30/ /31/15 10/30/ /30/15 10/30/ /29/15 10/30/ /30/15 10/30/ /31/15 10/30/ /31/15 10/30/ /30/15 10/30/ $ USD Reinvestment on 11/30/ : : : /15/13 11/30/ /29/13 11/30/ /02/13 11/30/ /20/13 11/30/ /02/14 11/30/ /31/14 11/30/ /03/14 11/30/ /28/14 11/30/ /31/14 11/30/ /30/14 11/30/ /30/14 11/30/ /30/14 11/30/ /31/14 11/30/ /29/14 11/30/ /30/14 11/30/ /31/14 11/30/ /28/14 11/30/ /30/15 11/30/ /27/15 11/30/ /31/15 11/30/ /30/15 11/30/ /29/15 11/30/ /30/15 11/30/ /31/15 11/30/ /31/15 11/30/ /30/15 11/30/ /30/15 11/30/ $ USD Distribution on 12/31/ : : : /15/13 12/31/ ** /29/13 12/31/ ** /02/13 12/31/ ** /20/13 12/31/ ** /02/14 12/31/ ** PAGE 54 OF 83

55 01/31/14 12/31/ ** /03/14 12/31/ ** /28/14 12/31/ ** /31/14 12/31/ ** /30/14 12/31/ ** /30/14 12/31/ ** /30/14 12/31/ ** /31/14 12/31/ ** /29/14 12/31/ ** /30/14 12/31/ ** /31/14 12/31/ ** /28/14 12/31/ ** /30/15 12/31/ /27/15 12/31/ /31/15 12/31/ /30/15 12/31/ PAGE 55 OF 83

56 05/29/15 12/31/ /30/15 12/31/ /31/15 12/31/ /31/15 12/31/ /30/15 12/31/ /30/15 12/31/ /30/15 12/31/ EXCESS DISTRIBUTION SUMMARY Line 15a Line 15b Line 15c Line 15d Line 15e Line 15f Line 16b Line 16c Line 16d Line 16e Line 16f , CARRYOVER CALCULATION ADJUSTED DISTRIBUTIONS PER UNIT (LINE 15B) 2015 Distributions Per Unit Adjustment Calculating in Original Currency Distribution Units Adjustment Adjusted Distribution Adjusted Distribution Per Share , , , , Total Adjusted Annual Distributions Per Unit: PAGE 56 OF 83

57 PREVIEW ONLY / DO NOT FILE 672. (450.) STATEMENT LINE X 1291TAX. 37. X 1291INT. 1. STATEMENT LINE 21 Form 8621, Line 16b ETTWEBINAR001 / Excess allocated to current year or pre PFIC periods 90. TOTAL 90. Form 8621, Line 15a ETTWEBINAR PAGE 57 OF 83

58 3,418. 3,868. (450.) X PAGE 58 OF 83

59 X SHS Imperial Dividend Income Pool 11/15/13 05/14/15 3,418. 3,868. (450.) 3,418. 3,868. (450.) PAGE 59 OF 83