8
Form 1120-L (2015)
Page
Schedule M
Other Information (see instructions)
1
Yes
No
Yes
No
Check method of accounting:
8
At any time during the year, did one foreign person
own, directly or indirectly, at least 25% of (a)
a
Accrual
b
Other (specify)
the total voting power of all classes of stock of
2
Check if the corporation is a:
the corporation entitled to vote or (b) the total value of
a
Legal reserve company—if checked
all classes of stock of the corporation?
.
.
.
.
If “Yes,” enter: a Percentage owned
Kind of company:
▶
and b Owner’s country
(1)
Stock
(2)
Mutual
▶
Principal business:
(1)
Life Insurance
The corporation may have to file
Form 5472,
c
(2)
Health and accident insurance
Information Return of a 25% Foreign-Owned U.S.
b
Fraternal or assessment association
Corporation or a Foreign Corporation Engaged in a
c
Burial or other insurance company
U.S. Trade or Business. Enter number of Forms 5472
attached
▶
3
Enter the percentage that the total of the
9
Has the corporation elected to use its own payout
corporation’s
life
insurance
reserves
(section
pattern for discounting unpaid losses and unpaid loss
816(b)) plus unearned premiums and unpaid losses
adjustment expenses? .
.
.
.
.
.
.
.
.
(whether or not ascertained) on noncancelable life,
health
or
accident
policies
not
included
in
10
Does the corporation discount any of the loss
life insurance reserves bears to the corporation’s
reserves shown on its annual statement? .
.
.
.
total reserves (section 816(c))
%.
11a
Enter the total unpaid losses shown on the
Attach a statement showing the computation.
corporation’s annual statement:
$
(1) For the current year:
4
Does the corporation have any variable annuity
contracts outstanding?
.
.
.
.
.
.
.
.
(2) For the previous year:
$
b
Enter the total unpaid loss adjustment expenses
5
At the end of the tax year, did the corporation own,
shown on the corporation’s annual statement:
directly or indirectly, 50% or more of the voting
(1) For the current year:
$
stock of a domestic corporation? (For rules of
attribution, see section 267(c).) .
.
.
.
.
.
(2) For the previous year:
$
If “Yes,” attach a statement showing (a) name and
If the corporation has an operations loss deduction
12
employer identification number (EIN), (b) percentage
(OLD) for the tax year and is electing under section
owned, and (c) taxable income or (loss) before NOL
810(b)(3) to forego the carryback period, check
and special deductions of such corporation for the
here
.
.
.
.
.
.
.
.
.
.
.
.
▶
tax year ending with or within your tax year.
If the corporation is filing a consolidated return, the
statement required by Regulations section 1.1502-21
6
Is the corporation a subsidiary in an affiliated group
(b)(3) must be attached or the election will not be
or a parent-subsidiary controlled group? .
.
.
valid.
If “Yes,” enter name and EIN of the parent
corporation.
▶
13
Enter the available OLD carryover from prior tax years.
7
At
the
end
of
the
tax
year,
did
any
(Do not reduce it by any deduction on page 1,
individual, partnership, corporation, estate, or trust
$
line 21b.)
▶
own, directly or indirectly, 50% or more of
Enter the corporation’s state of domicile
14a
▶
the corporation’s voting stock? (For rules of
attribution, see section 267(c).) If “Yes,” complete a
b
Was the annual statement used to prepare the tax
and b below
.
.
.
.
.
.
.
.
.
.
.
return filed with the state of domicile? .
.
.
.
.
a
Attach a statement showing name and identifying
If “No,” complete c below.
number. (Do not include any information already
c
Enter the state where the annual statement used to
entered in 6 above.)
prepare the tax return was filed
▶
b
Enter percentage owned
▶
15
Is the corporation required to file Schedule UTP (Form
1120),
Uncertain
Tax
Position
Statement
(see
instructions)? .
.
.
.
.
.
.
.
.
.
.
.
If "Yes," complete and attach Schedule UTP.
1120-L
Form
(2015)