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FORM 5472 + PRO-FORMA 1120 — FILING WORKSHEET
For foreign-owned single-member US LLCs (disregarded entities)
Free resource from WyomingLLC.xyz · Not tax advice — confirm with the IRS
instructions or a tax professional. Sources linked on the page.
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HOW TO USE
Fill this worksheet first to gather every value the IRS forms ask for, then
transcribe onto the official forms:
  - Form 5472:  https://www.irs.gov/forms-pubs/about-form-5472
  - Form 1120:  https://www.irs.gov/forms-pubs/about-form-1120
A foreign-owned single-member LLC files a PRO-FORMA 1120 with Form 5472
ATTACHED, sent together by mail or fax (these returns are not e-filed).

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SECTION A — YOUR LLC (the "reporting corporation")
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[ ] Legal LLC name ............:
[ ] EIN .......................:
[ ] US mailing address ........:
[ ] State of formation ........: Wyoming
[ ] Date formed ...............:
[ ] Principal business activity:
[ ] Business activity code ....: (see 1120 instructions)
[ ] Tax year ..................: Calendar year  /  Other: __________
[ ] Total value of LLC assets (end of year, USD):

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SECTION B — THE FOREIGN OWNER (the "25% foreign shareholder")
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[ ] Full legal name ...........:
[ ] Country of citizenship ....:
[ ] Country of residence ......:
[ ] Foreign address ...........:
[ ] US TIN/ITIN if any ........: (often none — leave blank if not issued)
[ ] Foreign tax ID if any .....:
[ ] Ownership percentage ......: 100%

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SECTION C — REPORTABLE TRANSACTIONS (LLC <-> foreign owner / related parties)
List every money movement between you and your LLC during the tax year.
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[ ] Capital contributions you put INTO the LLC (USD) ...:
[ ] Distributions you took OUT of the LLC (USD) ........:
[ ] Loans from you to the LLC (USD) ...................:
[ ] Loans from the LLC to you (USD) ...................:
[ ] Amounts paid by the LLC to you / related parties ..:
[ ] Amounts paid to the LLC by you / related parties ..:
[ ] Other reportable transactions .....................:

REPORTABLE-TRANSACTION LEDGER (fill one row per movement)
  Date        | Direction (in/out) | Type (contribution/distribution/loan/payment) | Amount USD | Note
  ----------- | ------------------ | --------------------------------------------- | ---------- | ----
  __________  | _________________  | ____________________________________________  | _________  | ____
  __________  | _________________  | ____________________________________________  | _________  | ____
  __________  | _________________  | ____________________________________________  | _________  | ____

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SECTION D — PRE-FILING CHECKLIST
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[ ] EIN obtained (required before filing)
[ ] Tax year confirmed (calendar year for most)
[ ] All reportable transactions listed above
[ ] Pro-forma 1120: top section filled (name, EIN, address); write
    "Foreign-owned U.S. DE" across the top per IRS instructions
[ ] Form 5472 completed and ATTACHED to the 1120
[ ] Mailed or faxed to the IRS address/fax in the current 5472 instructions
[ ] Copy kept for your records
[ ] Deadline met (see the deadlines checklist file)

PENALTY REMINDER: Failure to file a correct Form 5472 on time is a
$25,000 penalty PER FORM, PER YEAR. Do not skip it.
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