4
Schedule M-3 (Form 1120-F) 2012
Page
Name of corporation
Employer identification number
Reconciliation of Net Income (Loss) per Income Statement of Non-Consolidated Foreign
Part III
Corporations With Taxable Income per Return (see instructions) (continued from page 3)
(d)
(e)
(a)
(b)
(c)
Other Permanent
Expense/Deduction Items
Expense per
Temporary
Permanent
Differences
Deduction per
Income Statement
Differences
Differences
for Allocations to
Tax Return
Non-ECI and ECI
13
Pension and profit-sharing
.
.
.
.
14
Other post-retirement benefits .
.
.
15
Deferred compensation .
.
.
.
.
16
Charitable contributions .
.
.
.
.
17
Domestic production activities deduction
18
Current
year
acquisition
or
reorganization
investment
banking
fees, legal and accounting fees .
.
.
19
Current year acquisition/reorganization
other costs .
.
.
.
.
.
.
.
.
20
Amortization/impairment of goodwill
.
21
Amortization
of
acquisition,
reorganization, and start-up costs .
.
22
Other
amortization
or
impairment
write-offs
.
.
.
.
.
.
.
.
.
23
Depreciation
.
.
.
.
.
.
.
.
24
Bad debt expense
.
.
.
.
.
.
25
Purchase versus lease (for purchasers
and/or lessees)
.
.
.
.
.
.
.
26a
Interest expense per books .
.
.
.
b
Interest expense under Regulations
section 1.882-5 (from Schedule I (Form
1120-F), line 23)
.
.
.
.
.
.
.
c
Regulations section 1.882-5 allocation
amount
subject
to
deferral
or
disallowance (from Schedule I (Form
(
)
1120-F), line 24d) .
.
.
.
.
.
.
d
U.S. source substitute interest payments
e
Interest equivalents (e.g., guarantee
fees) not included on line 26d
.
.
.
27
Dividend equivalents .
.
.
.
.
.
28
Fee and commission expense
.
.
.
29
Rental expense
.
.
.
.
.
.
.
30
Royalty expense .
.
.
.
.
.
.
31
Expenses
allocable
to
effectively
connected income under Regulations
section 1.861-8 from home office or
other books that do not give rise to U.S.
booked liabilities (from Schedule
H
(Form 1120-F), line 20)
.
.
.
.
.
32
Other expense/deduction items with
differences (attach statement)
.
.
.
33
Total
expense/deduction
items.
Combine lines 1 through 32. Enter here
and on Part II, line 26 .
.
.
.
.
.
Schedule M-3 (Form 1120-F) 2012