Form 8916-A Form 8916-A Supplemental Attachment to Schedule M-3

Tax Year 2007 Work Request Notification
Form 8916-A, Supplemental Attachment to Schedule M-3
Initials:

Date:

c

BE

912 810 6

SE:W:CAR:MP:T: B : R

JAM

9/28:06

4. Review Chief: Ed Mikesell

SE:W:CAR:MP:T:B: R

evm

9/28/06

5. Branch Chief: Curt Freeman

S€:W:CAR:MP:T:B

CF

9/28/06

6. Senior Technical Advisor: Bob Erickson

SE:W:CAR:MP:T

CF

9/28/06

To:

Symbols:

1.Scanned by:

SE:W:CAR:MP:T:B: C

2. Section Chief: Barbara Bradley

SE:W:CAR:MP:T:6:

3. Reviewer:

Joan McAlpine

7. *TPCC Circulations Email sent to Distribution List by:
8. Initiator (Tax ~

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Attached is a marked up draft that can be used to develop any necessary Work Requests for
the 2008 processing year. The major changes are as follows:

Based on a request from LMSB we will change the Form 8916-A to a three-part form by
making the existing Cost of Goods Sold schedule Part I, and adding Part II Interest
Income and Part III t nterest Expense.

Also, we changed the title of the form to "Supplemental Attachment to Schedule M-3"to
correspond to the change in the purpose of the form.

This Notification is for changes due to:

Legislation or other Chief Counsel guidance:

O A Program change initiated by: LMSB
We do not anticipate the need for any further changes that would require a Work Request Notification.
We may need to make further changes that would require a subsequent Work Request Notification.
If you have any questions, please contact the TLS shown below, or the reviewer on line 3 (above).

Clarence Light
SE:W:CAR:MP:T:

-7

NCFB C7-376

l;I;:skoL

9127106

IRoom:
Phone Number:

(202)283-0130

clarence.o.light@irs.gov
Fax Number:

(202)283-4545

Supplemental Attachment to

Form

8916-A

OM5 NQ 1545-XXXX

2006<

e~ Schedule M-3

kgsnmrrit of the Treasury
Internal Revenue Sew~ce

F Attach to Schedule M - 3 for Form 1065. 1120, er 1120$,
Employer identlflcation number

Name of commcn uarent

El
120-L,
or 1 120PC

I

Name of

I

subsd~am
-

-

l ~ a rIt Cost of Goods S d d

Income (Loss)

Cost of Goods Soid Items

per Income
Statement

I

Amounts artributable to cost f ow assJtnpt.ons .

2

Arno~ntsattrib~tableto sect on 263A costs:

(b)

Temporary

Dlfference

Employer identlficatim number

:

(4
Permanent
Dlference

(4

Income (Loss)
per Tax Return

.

a Stock option expense . . . . . . . . . .
b Other equity based compensation

c Meals and entertainment

d Parachute payments

. . . . . .

. . . . . . . . .

. . . . . . . . . .

.

e Compensation with section 162(m) limitat&?!.'.
f

Pension and profit sharing.

. . . . . . . . .

g Other post-retirement benefits

h Deferred compensation.

. . . . . . .

. . . . . . . . .

i Section 198 environmental remediation costs
j

Amortization

.

.

. . . . . . . . . . . . .

k Deplet~on . . . . . . . . . . . . . .
1

Depreciation

. . . . . . . . . . . . .

m Corporate owned life insurance premiums

n Other section 263A costs

. . .

. . . . . . . . .
. . . . . . . .

3

Inventory shrinkage accruals

4

Excess inventory and obsolescence reserves

5

Lower of cost or market write-downs

6

Other items with differences (attach schedule) .

7

Other items with no differences .

8

Total cost of goods sold. Add l~nes1 thorugh 7.
Enter total on Schedule M-3 (Form 1065), Part II, line
15; Schedule M-3 (Form l t 2 0 ) , Part II, line 17; or
Schedule M-3 (Form 1120S),Part !I, line 15.

. .

-

. . . . .

.

. . . . . .

For Papemork ReductionAct Notice, see page 2.

LLLL
Cat No 48657X

Form

8916-A pose

FI

Id)
Income (Loss)

lnterest income from
Hybrid Securities
SalzlPurchase

I

1

1-

Interest
Income
Total Inlcrcst
Income. Add lines 1
through 5. Enter
total on Schcdllle M3 (Form 1 120, 1 120PC, 1 120-L), Part 11,
line 13 or Schedule 1
M-3 (Form 1065,
1 120-S) Part 11, line
t

Ill-Interest

Ex~c

(bl

(a)

Intcrcst
Expcnse Per
E x ~ c n s eItem
Incomc Statement
Intcrest expcnse
froin Hybrid
Securities
--SalelPurch a s ~
Lnteresr cxDense
Intercompany
In tcrest Expcr~sc
Other lntcrcst
Expensc
Tolal lntcrcst
Expense. .4dd lines
I through 4. Enter
total on Schcdule
M-3 (Form 1 120)
Part 111, linc 8, or

Schedulc M-3
(1 120-PC, 1 120-L),
Part 111, line 36 or
Schedule M-3
(Form 1065)
Part ill, linc 27, or
Schcdule M-3
(1 1 20-S) Part 111,
) tine 26.

1

'Temporary

Di fferencc

--

(cl
Perrnan cn t
Diffcrcnce

L

(4
Expcnse per
Tax Return

L