# Bulletin No. 2022–15

> Briefs, arguments, decisions, and more.

URL: https://www.frixlaw.com/law-library/documents/agency%3Airs%3A17cc6f3456a2e39d

## Record

- **Collection:** Agency decision
- **Document type:** Agency decision

## Text

HIGHLIGHTS
OF THIS ISSUE




Bulletin No. 2022–15
April 11, 2022

These synopses are intended only as aids to the reader in
identifying the subject matter covered. They may not be
relied upon as authoritative interpretations.

ADMINISTRATIVE
Announcement 2022-7, page 946.
This Announcement is issued pursuant to § 521(b) of
Pub. L. 106-170, the Ticket to Work and Work Incentives Improvement Act of 1999, which requires the Secretary of the Treasury to report annually to the public
concerning advance pricing agreements (APAs) and the
Advance Pricing and Mutual Agreement Program (APMA
Program), formerly known as the Advance Pricing
Agreement Program (APA Program). This twenty-third
report describes the experience, structure, and activities of the APMA Program during calendar year 2021.

EMPLOYEE PLANS
REG-121508-18, page 996.
This document sets forth proposed regulations relating
to certain multiple employer plans (MEPs) described in

Finding Lists begin on page ii.

the Internal Revenue Code. The proposed regulations
provide an exception, if certain requirements are met, to
the application of the “unified plan rule” for MEPs in the
event of a failure by one or more employers participating
in the plan to take actions required of them to satisfy the
applicable requirements of the Code. These proposed
regulations would affect certain MEPs, participants in
those MEPs (and their beneficiaries), employers participating in those MEPs, and plan administrators of those
MEPs. This document also withdraws proposed regulations published in the Federal Register on July 3, 2019,
amending the application of the unified plan rule to MEPs
and provides a notice of a public hearing.

The IRS Mission
Provide America’s taxpayers top-quality service by helping
them understand and meet their tax responsibilities and enforce the law with integrity and fairness to all.

Introduction
The Internal Revenue Bulletin is the authoritative instrument
of the Commissioner of Internal Revenue for announcing official rulings and procedures of the Internal Revenue Service
and for publishing Treasury Decisions, Executive Orders, Tax
Conventions, legislation, court decisions, and other items of
general interest. It is published weekly.
It is the policy of the Service to publish in the Bulletin all substantive rulings necessary to promote a uniform application
of the tax laws, including all rulings that supersede, revoke,
modify, or amend any of those previously published in the
Bulletin. All published rulings apply retroactively unless otherwise indicated. Procedures relating solely to matters of internal management are not published; however, statements of
internal practices and procedures that affect the rights and
duties of taxpayers are published.
Revenue rulings represent the conclusions of the Service
on the application of the law to the pivotal facts stated in
the revenue ruling. In those based on positions taken in rulings to taxpayers or technical advice to Service field offices,
identifying details and information of a confidential nature are
deleted to prevent unwarranted invasions of privacy and to
comply with statutory requirements.
Rulings and procedures reported in the Bulletin do not have the
force and effect of Treasury Department Regulations, but they
may be used as precedents. Unpublished rulings will not be
relied on, used, or cited as precedents by Service personnel in
the disposition of other cases. In applying published rulings and
procedures, the effect of subsequent legislation, regulations,
court decisions, rulings, and procedures must be considered,
and Service personnel and others concerned are cautioned

against reaching the same conclusions in other cases unless
the facts and circumstances are substantially the same.
The Bulletin is divided into four parts as follows:
Part I.—1986 Code.
This part includes rulings and decisions based on provisions
of the Internal Revenue Code of 1986.
Part II.—Treaties and Tax Legislation.
This part is divided into two subparts as follows: Subpart A,
Tax Conventions and Other Related Items, and Subpart B,
Legislation and Related Committee Reports.
Part III.—Administrative, Procedural, and Miscellaneous.
To the extent practicable, pertinent cross references to these
subjects are contained in the other Parts and Subparts. Also
included in this part are Bank Secrecy Act Administrative
Rulings. Bank Secrecy Act Administrative Rulings are issued
by the Department of the Treasury’s Office of the Assistant
Secretary (Enforcement).
Part IV.—Items of General Interest.
This part includes notices of proposed rulemakings, disbarment and suspension lists, and announcements.
The last Bulletin for each month includes a cumulative index
for the matters published during the preceding months. These
monthly indexes are cumulated on a semiannual basis, and are
published in the last Bulletin of each semiannual period.

The contents of this publication are not copyrighted and may be reprinted freely. A citation of the Internal Revenue Bulletin as the source would be appropriate.

April 11, 2022 

Bulletin No. 2022–15

Part I
Announcement and Report Concerning Advance Pricing Agreements
Announcement 2022-7

March 22, 2022
This Announcement is issued pursuant to § 521(b) of Pub. L. 106-170, the Ticket to Work and Work Incentives Improvement Act of
1999, which requires the Secretary of the Treasury to report annually to the public concerning advance pricing agreements (APAs)
and the Advance Pricing and Mutual Agreement Program (APMA Program), formerly known as the Advance Pricing Agreement
Program (APA Program). The first report covered calendar years 1991 through 1999. Subsequent reports covered each calendar year
2000 through 2020 separately. This twenty-third report describes the experience, structure, and activities of the APMA Program
during calendar year 2021. It does not provide guidance regarding the application of the arm’s length standard.
Part I of this report includes information on the structure, composition, and operation of the APMA Program; Part II presents statistical data; and Part III includes general descriptions of various elements of the APAs executed in 2021, including types of transactions
covered, transfer pricing methods used, and completion time.
Nicole L. Welch
Acting Director, Advance Pricing and Mutual Agreement Program

April 11, 2022

946

Bulletin No. 2022–15

Part I. The APMA Program – Structure, Composition, and Operation
[Pub. L. 106-170 § 521(b)(2)(A)]
In February 2012, the former APA Program was moved from the Office of Chief Counsel to the Office of Transfer Pricing Operations1
within the Large Business and International Division of the IRS and combined with the U.S. Competent Authority staff responsible
for transfer pricing cases, thereby forming the APMA Program (APMA).
As of December 31, 2021, APMA’s APA cases were handled by 80 team leaders, 25 economists, 9 managers, and 3 assistant directors.2 Each assistant director oversees three managers who lead teams consisting of both team leaders and economists. APMA’s main
office is in Washington, DC, and it also has offices in northern California (San Francisco and San Jose), southern California (Los
Angeles and Laguna Niguel), Chicago, and New York.
On August 31, 2015, a new revenue procedure governing APA applications was published in 2015-35 I.R.B. on page 263. Revenue
Procedure (Rev. Proc.) 2015-41 provides guidance, information and instructions on APA requests and the administration of APAs.
Rev. Proc. 2015-41 updates and supersedes Rev. Proc. 2006-9, 2006-1 C.B. 278, as modified by Rev. Proc. 2008-31, 2008-1 C.B.
1133, which is also superseded.
Model APAs appear as appendices to this report. Appendix 1 is the model for APAs covered by Rev. Proc. 2006-9. Appendix 2 is the
current model APA for APAs covered by Rev. Proc. 2015-41. A list of primary APMA contacts is available at https://www.irs.gov/
businesses/corporations/apma-contacts.

In 2017, Transfer Pricing Operations became Treaty & Transfer Pricing Operations (“TTPO”).
In late 2020, TTPO’s Treaty Assistance and Interpretation Team (TAIT) joined APMA, bringing the total number of groups in APMA to four. The three legacy APMA groups have primary
responsibility for cases arising under the business profits and associated enterprises articles of U.S. tax treaties. TAIT endeavors to resolve competent authority issues arising under all other
articles of U.S. tax treaties including issues arising under U.S. tax treaties relating to estate and gift taxes. As such, TAIT is separate from APMA’s APA program, and the total numbers of
team leaders and managers handling APA cases do not include TAIT analysts and managers.
1
2

Bulletin No. 2022–15

947

April 11, 2022

Part II. APMA Program Statistical
Data
Part II. APMA Program Statistical Data

[Pub.[Pub.
L. 106-170
§ 521(b)(2)(C)(i-viii)]
L. 106-170
§ 521(b)(2)(C)(i-viii)]

Table 1: APA Applications Filed
3
§ 521(b)(2)(C)(i)
Table 1: APA
Applications Filed

§ 521(b)(2)(C)(i)

Unilateral
Unilateral

Filed 1991-1999
Filed 1991-19993
Filed 2000-2020
Filed 2000-2020
Filed in 2021
Filed in 2021
Total Filed 1991-2021
3

637
16

637
16

Bilateral
Bilateral

Multilateral
Multilateral

1,724 1,724
121

121

29
8

Total Filed 1991-2021

29
8

Total Total
401401
2,390
2,390
145145

2,936

2,936
Applications Filed
2012-2021

250
200
150
100
50
0

2012 2013 2014 2015 2016 2017 2018 2019 2020 2021

Bilateral APAs
Filed per Country 2021
China All Other Countries
16%
3%
Mexico
3%
United Kingdom
3%
Korea
4%
Germany
5%

Italy
7%

Japan
33%

India
16%

Canada
10%

The charts
above illustrate
numberapplications
of complete
applications
filed
per year
and received
the bilateral
The charts
above illustrate
the numberthe
of complete
filed
per year and the
bilateral
requests
in 2021 per foreign
requests
received31,
in2021,
2021APMA
per foreign
Asuser
of December
31,
2021,
APMA
had also
country.
As of December
had alsocountry.
received 29
fee filings that
were
not yet
accompanied
by substantially complete APA
applications,
addition
to the
145
complete
APAaccompanied
applications. by substantially complete APA
received
29 userinfee
filings
that
were
not yet
applications, in addition to the 145 complete APA applications.

3

The first APA Statutory Report, which compiled APA data from 1991-1999, did not report the cumulative number
of applications for those years by submission type, so the cumulative totals cannot be reported in that manner.

3
The first APA Statutory Report, which compiled APA data from 1991-1999, did not report the cumulative number of applications for those years by submission type, so the cumulative totals
cannot be reported in that manner.

3

April 11, 2022

948

Bulletin No. 2022–15

Table 2: Executed4 and Pending APAs

Table 2: Executed4 and Pending APAs
§ 521(b)(2)(C)(ii-vi)
56
§ 521(b)(2)(C)(ii-vi)

Unilateral
Unilateral 662
662
25
25
687

Total Executed 1991-2020
Total Total
Executed
1991-2020
Executed
in 2021
Total Total
Executed
in 2021 1991-2021
Executed
Total Executed 1991-2021
Total Total
Pending
as of 12/31/2021
Pending
as of 12/31/2021
Renewals Executed in 20215

687
39

39

19
26

Renewals
PendingExecuted
as of 12/31/2021
Renewals
in 20215
6

Bilateral Multilateral
Total
1,385
20
2,067 Total
Bilateral
Multilateral
1,38598
20
1
124 2,067
98
1
1,483
21
2,191 124

19
26

6

Renewals Pending as of 12/31/2021

1,483
395395
59
147 59

147

21
27
27

2,191
461 461

12

78
185

0
12
0

78
185

APAs Executed
2012-2021
150
100
50
0

2012 2013 2014 2015 2016 2017 2018 2019 2020 2021

All Other Countries
9%

Bilateral APAs
Executed by Country 2021

Switzerland
4%
Netherlands
3%
Italy
3%
China
3%
India
5%
Korea Canada
6%
7%

Japan
40%

Germany
20%

In 2021, the percentage of renewals executed increased (63 percent of all APAs executed in 2021

In 2021, the percentage of renewals executed increased (63 percent of all APAs executed in 2021 versus 59 percent in 2020). The
59 percent
in in
2020).
The charts
above
illustrate
the number
of APAs
executed
chartsversus
above illustrate
trends
the number
of APAs
executed
per yeartrends
and theincountries
involved
in the bilateral
APAs that were
executed in 2021.
4
Executed APAs refers to all APAs finalized or renewed.
5
The number of renewals executed is included in the total number of APAs executed during the year.
6
The number of renewals still pending as of year-end is also included in the total number of pending APAs.

4

Executed APAs refers to all APAs finalized or renewed.
5
The number of renewals executed is included in the total number of APAs executed during the year.
6
The number of renewals still pending as of year-end is also included in the total number of pending APAs.
4

Bulletin No. 2022–15

949

April 11, 2022

per year and the countries involved in the bilateral APAs that were executed in 2021.
Pending APAs
2012-2021
500
400
300
200
100
0

2012 2013 2014 2015 2016 2017 2018 2019 2020 2021

Pending Bilateral APAs
by Country 2021

All Other Countries
Switzerland 15%
3%
United Kingdom
4%
Mexico
5%

Japan
25%

Korea
5%
Italy
5% Germany
5%

India
22%

Canada
11%

topillustrates,
chart illustrates,
of pending
requests
increased
relative
to As of December 31,
As theAs
topthe
chart
the numberthe
of number
pending requests
increased
slightly
relative toslightly
December
31, 2020.
2021,December
almost half of
the2020.
pending
APA requests
involved
either Japan
or the
India.
31,
Asbilateral
of December
31, 2021,
almost
half of
pending bilateral APA requests
involved either Japan or India.

Table 3: APAs Revoked or Cancelled and Applications Withdrawn
§ 521(b)(2)(C)(vii)78

Table 3: APAs Revoked or Cancelled and Applications Withdrawn
§ 521(b)(2)(C)(vii)
Unilateral
Bilateral
Multilateral
Total
Unilateral Bilateral Multilateral
Total
Revoked or Cancelled in 2021
0
0
0
0
Revoked or Cancelled in 2021
0
0
0
0
Total Revoked or Cancelled 1991-20217
11
Total Revoked or Cancelled 1991-20217
11 6
Applications Withdrawn in 2021
1
4
1

Total Applications Withdrawn 1991-20218

Applications Withdrawn in 2021
Total Applications Withdrawn 1991-20218

1

4

1

6
279

279

7

The first APA Statutory Report, which compiled APA data from 1991-1999, did not report the cumulative number
of applications for those years by submission type, so the cumulative totals cannot be reported in that manner.
8
See supra note 7.

5
The first APA Statutory Report, which compiled APA data from 1991-1999, did not report the cumulative number of applications for those years by submission type, so the cumulative totals
cannot be reported in that manner.
See supra note 7.

7

8

April 11, 2022

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Bulletin No. 2022–15

Table 4: APAs Executed in 2021 by Industry
§ 521(b)(2)(C)(viii)
Table 4: APAs Executed in 2021 by Industry

§ 521(b)(2)(C)(viii)

Industry
Industry

Manufacturing
Manufacturing
Wholesale/Retail Trade
Wholesale/Retail Trade
Services
Services
Management
Management
Finance, Insurance, and Real Estate
Finance, Insurance, and Real Estate
All Other Industries

46
47
17
8
4
2

All Other Industries

46
47
17
8
4
2

APAs Executed
in 2021 by Industry
Wholesale/Retail
Trade
38%

Manufacturing
37%
All Other Industries
2%
Finance, Insurance
and Real Estate
3%

Services
14%

Management
6%

TableTable
4a: Manufacturing
APAs Executed
in Executed
20219
4a: Manufacturing
APAs
in 2021

Type of Manufacturing

Type of Manufacturing
Transportation Equipment
Transportation Equipment
Chemical
Chemical
Computer
and Electronic
Computer
and Electronic
Products Products
9
9
Miscellaneous
Miscellaneous
Machinery
Machinery
All Other
All Manufacturing
Other Manufacturing

17
10
5
4
3
7

17
10
5
4
3
7

9

Industries in the Miscellaneous Manufacturing subsector (NAICS Code 339) make a wide range of products that
cannot readily be classified in specific NAICS manufacturing subsectors.

6
9

Industries in the Miscellaneous Manufacturing subsector (NAICS Code 339) make a wide range of products that cannot readily be classified in specific NAICS manufacturing subsectors.

Bulletin No. 2022–15

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April 11, 2022

Transportation
Equipment
Transportation
37%
Equipment
37%

Type of Manufacturing APAs
in 2021 APAs
Type ofExecuted
Manufacturing
Chemical
Executed in 2021

22%
Chemical
22%

Computer and
Electronic
Products
Computer
and
11%
Electronic Products
11%
Miscellaneous
9%
Miscellaneous
9%

All Other
Manufacturing
All Other
15%
Manufacturing
15%

Machinery
6%
Machinery
6%

TableTable
4b: Wholesale/Retail
Trade APAsTrade
Executed
in 2021
4b: Wholesale/Retail
APAs
Executed in 2021

Table 4b: Wholesale/Retail
Trade APAs
Executed in 2021
Type of Wholesale/Retail
Trade
Type of Wholesale/Retail Trade
Type
of
Wholesale/Retail
Trade
Merchant Wholesalers, Durable Goods
29
Merchant Wholesalers, Durable Goods
29
Nondurable
Goods
Merchant Wholesalers, Durable
Goods
299
Merchant Wholesalers, Nondurable Goods
9
Merchant
Wholesalers,
Motor Vehicle
and PartsNondurable
Dealers Goods
94
Motor Vehicle and Parts Dealers
4
Motor
Vehicle
and Parts Dealers
All Other
Wholesalers
45
All Other Wholesalers
5
All Other Wholesalers
5

All Other
Wholesalers
All Other
11%
Wholesalers
11%
Motor Vehicle and

Type of Wholesale/Retail Trade APAs
Executed in 2021
Type of Wholesale/Retail
Trade APAs
Executed in 2021

PartsVehicle
Dealersand
Motor
8%
Parts Dealers
8%

Merchant
Wholesalers,
Durable
Merchant
GoodsDurable
Wholesalers,
62%
Goods
62%

Merchant
Wholesalers,
Merchant
Nondurable
Goods
Wholesalers,
19%
Nondurable Goods
19%

7
7
April 11, 2022

952

Bulletin No. 2022–15

Part III. General Descriptions of APAs Executed in 2021
[Pub. L. 106-170 § 521(b)(2)(D) and (E)]
Part III. General
Descriptions of APAs Executed in 2021

Part
III. General
Descriptions
of APAs Executed
[Pub.
L. 106-170
§ 521(b)(2)(D)
and (E)]in 2021
Nature of the Relationships [Pub. L. 106-170 § 521(b)(2)(D) and (E)]
§ 521(b)(2)(D)(i)
Nature of the Relationships
Nature of the Relationships
§ 521(b)(2)(D)(i)
§ 521(b)(2)(D)(i)
Relationships between Controlled Parties

Relationships between Controlled Parties
U.S. Parent & NonU.S. Parent
&
U.S. Subsidiary
25%
Non-U.S. Subsidiary
25%
Sister Companies
14%
Sister Companies
14%

Non-U.S. Parent &
U.S. Subsidiary 61%
Non-U.S. Parent &
U.S. Subsidiary
61%

As in prior years, more than half of the APAs executed in 2021 involved transactions between
non-U.S. parents and U.S. subsidiaries.
As in prior years, more than half of the APAs executed in 2021 involved transactions between
Covered
Transactions,
Risks, and Tested Parties
non-U.S.
parentsFunctions
and U.S.and
subsidiaries.
Covered Transactions, Functions and Risks, and Tested Parties
§ 521(b)(2)(D)(ii-iii)
§ 521(b)(2)(D)(ii-iii)
Covered Transactions, Functions and Risks, and Tested Parties
§ 521(b)(2)(D)(ii-iii)
Types of Covered Transactions
Use of Intangible

As in prior years, more than half of the APAs executed in 2021 involved transactions between non-U.S. parents and U.S. subsidiaries.

Property by a U.S.
Use ofEntity
Intangible
Property
by a U.S.
10%
Entity
Use of Intangible
10% by a NonProperty
UseU.S.
of Intangible
Entity
Property6%
by a NonProperty into the U.S.
U.S.
Entity
Sale of29%
Tangible
Provision of Services
6% Entity
Property into the U.S.
by a U.S.
Provision
of Services
29%
21%
by
a
U.S.
All Other Types of
Provision of Services Entity
21%
Transactions
by a Non-U.S. Entity
All Other
Provision17%
of Services
1%Types of
Transactions
by a Non-U.S. Entity
1%
17%
10
in APAs
executed
sale
the transactions
10
Most Most
of the of
transactions
covered in covered
APAs executed
in 2021
involve in
the2021
sale ofinvolve
tangible the
goods
or of
thetangible
provision goods
of services. Fifteen
or
the
provision
of
services.
Fifteen
percent
of
the
transactions
involve
the
use
of
intangible
10
percent
of
the
transactions
involve
the
use
of
intangible
property,
which
can
be
among
the
most
challenging
transactions
Most of the transactions covered in APAs executed in 2021 involve the sale of tangible goods in APMA’s
property, which can be among the most challenging transactions in APMA’s inventory.
inventory.
Sale of Tangible Types of Covered Transactions
Property from the
Sale ofU.S.
Tangible
Property
from the
16%
U.S.
Sale of Tangible 16%

or the provision of services. Fifteen percent of the transactions involve the use of intangible
be among
the most
challenging
in APMA’s
In theproperty,
majority ofwhich
APAs, can
the covered
transactions
involve
numerous transactions
business functions
and risks. inventory.
For instance, with respect to func-

tions, APAs involving manufactured products typically involve a controlled group that conducts research and development (R&D),
engages
10 in product design and engineering, manufactures the product, markets and distributes the product, and performs support
APAs often cover more than one type of transaction.
functions such as legal, finance, and human resources. Regarding risks, the controlled group may assume a variety of risks, including
10 risks, R&D risks, financial risks, credit and collection risks, product liability risks, and general business risks. In the APA evalmarket
APAs often cover more than one type of transaction.
uation process, a significant amount of time and effort is devoted
8 to understanding how the functions and risks are allocated among
the controlled group of companies that are party to the covered transactions. For methods requiring the selection of a tested party, the
8
tested party chosen generally will be the least complex of the controlled
taxpayers.

10

APAs often cover more than one type of transaction.

Bulletin No. 2022–15

953

April 11, 2022

and risks are allocated among the controlled group of companies that are party to the covered
transactions. For methods requiring the selection of a tested party, the tested party chosen
generally will be the least complex of the controlled taxpayers.
Types of Tested Parties
U.S. Distributor
45%
Non-U.S. Distributor
13%

All Other Types of
Tested Parties
1%

U.S. Service Provider
Non-U.S. Service
9%
Provider
9%

U.S. Manufacturer
23%
11

in 2021 were
distributors,
U.S.
Consistent
with
prior
years,ofa tested
majority
of11 tested
Consistent
with prior
years,
a majority
parties
in 2021parties
were U.S. distributors,
U.S.U.S.
manufacturers,
or U.S.
service providers.
manufacturers, or U.S. service providers.

Transfer Pricing Methods Used
§ 521(b)(2)(D)(iv)
Transfer Pricing Methods Used

§ 521(b)(2)(D)(iv)

In 2021, the most commonly used transfer pricing method (TPM) for both the sale of tangible property and the use of intangible
property continued to be the comparable profits method/transactional net margin method (CPM/TNMM). The CPM/TNMM was used
2021,ofthe
most
commonly
used transfer pricing method (TPM) for both the sale of tangible
for 85Inpercent
these
types
of transactions.

property and the use of intangible property continued to be the comparable profits

For covered
transactions involving
intangible
property that used
the CPM/TNMM
CPM/TNMM, thewas
operating
method/transactional
net tangible
marginand
method
(CPM/TNMM).
The
used margin
for 85(OM) is still the
most percent
common profi
t
level
indicator
(PLI)
used
to
benchmark
results.
It
was
used
65
percent
of
the
time.
Other
PLIs, such as the Berry
of these types of transactions.
Ratio and return on total cost, made up the other 35 percent. As used here, “OM” is defined as the ratio of operating profit to sales,12
and “Berry Ratio” is defined as the ratio of gross profit to operating expenses.13 Most services transactions (90 percent) also used the
For covered transactions involving tangible and intangible property that used the CPM/TNMM,
CPM/TNMM with the OM and operating profit to operating expense being the most common PLIs (used 56 percent of the time).14

the operating margin (OM) is still the most common profit level indicator (PLI) used to
benchmark
results.Comparables
It was usedSelection
65 percent
of theand
time.
Other
PLIs, such to
as Comparables
the Berry Ratio
and Party Data
Sources
of Comparables,
Criteria,
Nature
of Adjustments
or Tested
return on total cost, made up the other 35 percent. As used here, “OM” is defined as the ratio of
§ 521(b)(2)(D)(v-vii)
operating profit to sales,12 and “Berry Ratio” is defined as the ratio of gross profit to operating
13
For the
APAs executed
in 2021
that involved
the CPM/TNMM
withalso
a North
American
tested party, thewith
mostthe
widely
expenses.
Most
services
transactions
(90 percent)
used
the CPM/TNMM
OMused
anddata source

for comparables was Standard and Poor’s Compustat/Capital IQ database. Different sources were used in other cases (e.g., where the
tested11party was not a U.S. or Canadian entity or where transaction-based methods were applied). The other most commonly used
Not all the executed APAs involve a tested party.
databases
are listed in the table below.
12
See Treas. Reg. § 1.482-5(b)(4)(ii)(A).
13
See Treas. Reg. § 1.482-5(b)(4)(ii)(B).
Table 5: Sources of Comparable Data
Bureau van Dijk (BvD)

9
Prowess

Global Vantage

RoyaltySource

ktMINE

RoyaltyStat

Orbis
In making comparability adjustments, typical balance sheet adjustments, as identified in Treas. Reg. §§ 1.482-1(d)(2) and 1.482-5(c)
(2)(iv), were made in most cases, including where appropriate, adjustments for payables, receivables, and inventory. In addition,
where appropriate, adjustments for different accounting practices were made to convert from LIFO to FIFO inventory accounting,
and a small number of cases involved the accounting reclassification of expenses, e.g., from COGS to operating expenses.

Not all the executed APAs involve a tested party.
See Treas. Reg. § 1.482-5(b)(4)(ii)(A).
13
See Treas. Reg. § 1.482-5(b)(4)(ii)(B).
14
The majority of APAs that covered services transactions also included tangible/intangible transactions and are not tested under a separate PLI.
11

12

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Ranges, Goals, and Adjustment Mechanisms
§ 521(b)(2)(D)(viii-ix)
Most transactions covered in APAs target an interquartile range as described in Treas. Reg. § 1.482-1(e)(2)(iii)(C). Where the transaction involves a royalty payment for the use of intangible property, both specific royalty rates and ranges have been used. Where the
covered transaction is the sale or license of intangible property, and the payment for such transfer would be a royalty based solely on
external comparable uncontrolled transactions, a secondary or confirming method, e.g., a test of the post-royalty operating margin
or cost-plus mark-up, has sometimes also been used. The testing periods of the APAs executed in 2021 were either a single year, the
term of the APA only, or the term of the APA plus rollback years.
APAs executed in 2021 included several mechanisms for making adjustments to the tested party results when the results fall outside
the interquartile range or do not match the point required by the APA. Examples of the mechanisms used include an adjustment bringing the tested party’s results for a single year to either the closer edge of the range or the median of the range, an adjustment to bring
the results over the APA term to the closer edge of the range, or an adjustment to bring the results to a specified point or royalty rate.
Critical Assumptions
§ 521(b)(2)(D)(v)
The model APAs used by the IRS (included as Appendix 1 and Appendix 2 of this report) include standard critical assumptions that
there will be no material changes to the taxpayer’s business or to its tax or financial accounting practices during the APA term. A few
bilateral cases have also included critical assumptions tied to the taxpayer’s profitability in a certain year or over the term of the APA.
Pursuant to § 7.06(3) of Rev. Proc. 2015-41, APMA will cancel an APA in the event of a failure of a critical assumption unless the
parties agree to revise the APA.
Term Lengths of APAs Executed in 2021
§ 521(b)(2)(D)(x)
Table 6: Term Lengths of APAs Executed in 2021
Term Length (years)
1
2
3
4
5
6
7
8
9
10
12
15
Average

Number of APAs
2
1
2
6
73
19
6
5
3
4
2
1
6

As described in § 3.03(1) of Rev. Proc. 2015-41, taxpayers should request an APA term that would cover at least five prospective
years and may also request that the APA be “rolled back” to cover one or more earlier taxable years, although the appropriate
APA term is decided on a case-by-case basis. Of the APAs executed in 2021, 22 percent included rollback years. A substantial number
of those APAs with terms of greater than five years were submitted as a request for a five-year term, and the additional years were
agreed to between the taxpayer and the IRS (or, in the case of a bilateral APA, between the IRS and the foreign government upon the
taxpayer’s request) to ensure a reasonable amount of prospectivity in the APA term.

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Amount of Time Taken to Complete New and Renewal APAs
§ 521(b)(2)(E)
Amount of Time Taken to Complete New and Renewal APAs

§ 521(b)(2)(E)

Table 7: Months to Complete New and Renewal APAs Executed in 2021

Table 7: Months to Complete New and Renewal APAs Executed in 2021
Unilateral

Bilateral

Unilateral & Bilateral

Unilateral
Bilateral
Unilateral & Bilateral
Average
Median
Average
Median
Average
Median
Average Median Average Median Average
Median
New
24.5
23.5
52.3
49.2
48.5
45.2
New
24.5
23.5
52.3
49.2
48.5
45.2
Renewal
24.3
26.1
37.1
35.1
34.0
30.9
Renewal
24.3
26.1
37.1
35.1
34.0 35.1
30.9
New & Renewal
24.4
26.1
43.0
36.6
39.2
New & Renewal
24.4
26.1
43.0
36.6
39.2
35.1

Months to Complete New and Renewal APAs Executed in 2021
Months to Complete

60.0

New

50.0
40.0

Renewal

30.0

New &
Renewal

20.0
10.0
0.0

Average

Median

Unilateral

Average

Median

Bilateral
Type of APA

Average

Median

Unilateral &
Bilateral

Although the median time required to complete an APA increased in 2021 to 35.1 months

Although the median time required to complete an APA increased in 2021 to 35.1 months (versus 32.7 months in 2020), it remains
(versus 32.7 months in 2020), it remains lower than the median completion times in 2019 (38.8
lower than the median completion times in 2019 (38.8 months) and in 2018 (40.2 months).

months) and in 2018 (40.2 months).

Efforts to Ensure Compliance with APAs
§ 521(b)(2)(F)
Efforts to Ensure Compliance with APAs

§ 521(b)(2)(F)

As described in § 7.02(1) of Rev. Proc. 2015-41, taxpayers are required to file annual reports to demonstrate compliance with the
terms and conditions of their APAs. The filing and review of these annual reports are critical parts of the APA process. Through annual
As described in § 7.02(1) of Rev. Proc. 2015-41, taxpayers are required to file annual reports to
report review, the APMA Program monitors taxpayer compliance with APAs on a contemporaneous basis. Annual report review also
demonstrate
compliance
theorterms
andassociated
conditions
APAs.
filing
andAPA
review
of
provides
current information
on thewith
success
problems
withofthetheir
various
TPMsThe
adopted
in the
process.

these annual reports are critical parts of the APA process. Through annual report review, the
APMA Program monitors taxpayer compliance with APAs on a contemporaneous basis. Annual
report review also provides current information on the success or problems associated with the
various TPMs adopted in the APA process.

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Nature of Documentation Required in Annual Report
§ 521(b)(2)(D)(xi)
APAs require taxpayers to file timely and complete annual reports describing their operations and demonstrating compliance with
the APA’s terms and conditions. Not every annual report will include each of the items listed in the following table; they are required
where the facts demonstrate a need for such documentation.

1.

2.
3.
4.
5.

6.

7.

Statement regarding all material differences between Taxpayer’s business operations during APA year and description of
Taxpayer’s business operations contained in Taxpayer’s APA request. If there are no material differences, a statement to
that effect.
Statement concerning all material changes in Taxpayer’s accounting methods and classifications, and methods of estimation, from those described or used in Taxpayer’s request for the APA. If there has been no material change in accounting
methods and classifications or methods of estimation, a statement to that effect.
Any change to the Taxpayer notice information.
Description of any failure to meet critical assumptions. If there has been none, a statement to that effect.
Statement identifying whether any material information submitted while the APA request was pending is discovered to be
false, incorrect, or incomplete.
The amount, reason for, and financial analysis of any compensating adjustment, for the APA year, including but not limited to the amounts paid or received by each affected entity; the character (such as capital or ordinary expense) and country
source of the funds transferred, and the specific line item(s) of any affected U.S. tax return; and any change to any entity
classification for federal income tax purposes of any member of Taxpayer’s group that is relevant to the APA.
The amounts, description, reason for, and financial analysis of any book-tax difference relevant to the TPM for the APA
year, as reflected on Schedule M-1 or Schedule M-3 of the U.S. return for the APA year.

8.

Statement regarding whether Taxpayer contemplates requesting, or has requested, to renew, modify, or cancel the APA.

9.

Financial statements and any necessary account detail to show compliance with the TPM, with a copy of the opinion from
an independent certified public accountant or other documentation required by paragraph 5(f) of the APA.

10.

Financial analysis demonstrating Taxpayer’s compliance with TPM.

11.

Organizational chart.

12.

A copy of the APA and any amendment.

13.

A penalty of perjury statement.

Approaches for Sharing of Currency or Other Risks
§ 521(b)(2)(D)(xii)
In appropriate cases, APAs may provide specific approaches for dealing with risks, including currency risk, such as adjustment mechanisms and/or critical assumptions.

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APPENDIX 1– Model APA (based on Rev. Proc. 2006-9)

ADVANCE PRICING AGREEMENT
between
[Insert Taxpayer’s Name]
and
THE INTERNAL REVENUE SERVICE
PARTIES
The Parties to this Advance Pricing Agreement (APA) are the Internal Revenue Service (IRS) and [Insert Taxpayer’s Name], EIN
________.
RECITALS
[Insert Taxpayer Name] is the common parent of an affiliated group filing consolidated U.S. tax returns (collectively referred to as
“Taxpayer”) and is entering into this APA on behalf of itself and other members of its consolidated group.
Taxpayer’s principal place of business is [City, State]. [Insert general description of taxpayer and other relevant parties].
This APA contains the Parties’ agreement on the best method for determining arm’s-length prices of the Covered Transactions
under I.R.C. section 482, the Treasury Regulations thereunder, and any applicable tax treaties.
{If renewal, add} [Taxpayer and IRS previously entered into an APA covering taxable years ending _____ to ______, executed on
________.]
AGREEMENT
The Parties agree as follows:
1.

Covered Transactions. This APA applies to the Covered Transactions, as defined in Appendix A.

2.

Transfer Pricing Method. Appendix A sets forth the Transfer Pricing Method (TPM) for the Covered Transactions.

3.

Term. This APA applies to the APA Term, as defined in Appendix A.

4.

Operation.

5.

a.

Revenue Procedure 2006-9 governs the interpretation, legal effect, and administration of this APA.

b.

Nonfactual oral and written representations, within the meaning of sections 10.04 and 10.05 of Revenue Procedure 2006-9
(including any proposals to use particular TPMs), made in conjunction with the APA Request constitute statements made in
compromise negotiations within the meaning of Rule 408 of the Federal Rules of Evidence.

Compliance.
a.

Taxpayer must report its taxable income in an amount that is consistent with Appendix A and all other requirements of this
APA on its timely filed U.S. Return. However, if Taxpayer’s timely filed U.S. Return for any taxable year covered by this
APA (APA Year) is filed prior to, or no later than 60 days after, the effective date of this APA, then Taxpayer must report its
taxable income for that APA Year in an amount that is consistent with Appendix A and all other requirements of this APA
either on the original U.S. Return or on an amended U.S. Return filed no later than 120 days after the effective date of this
APA, or through such other means as may be specified herein.

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b.

{Use or edit the following when U.S. Group or Foreign Group contains more than one member.} [This APA addresses the
arm’s-length nature of prices charged or received in the aggregate between Taxpayer and Foreign Participants with respect
to the Covered Transactions. Except as explicitly provided, this APA does not address and does not bind the IRS with respect
to prices charged or received, or the relative amounts of income or loss realized, by particular legal entities that are members
of U.S. Group or that are members of Foreign Group.]

c.

For each APA Year, if Taxpayer complies with the terms and conditions of this APA, then the IRS will not make or propose
any allocation or adjustment under I.R.C. section 482 to the amounts charged in the aggregate between Taxpayer and Foreign Participant[s] with respect to the Covered Transactions.

d.

If Taxpayer does not comply with the terms and conditions of this APA, then the IRS may:
i.

enforce the terms and conditions of this APA and make or propose allocations or adjustments under I.R.C. section 482
consistent with this APA;

ii. cancel or revoke this APA under section 11.06 of Revenue Procedure 2006-9; or
iii. revise this APA, if the Parties agree.
e.

Taxpayer must timely file an Annual Report (an original and four copies) for each APA Year in accordance with Appendix C
and section 11.01 of Revenue Procedure 2006-9. Taxpayer must file the Annual Report for all APA Years through the APA
Year ending [insert year] by [insert date]. Taxpayer must file the Annual Report for each subsequent APA Year by [insert
month and day] immediately following the close of that APA Year. (If any date falls on a weekend or holiday, the Annual
Report shall be due on the next date that is not a weekend or holiday.) The IRS may request additional information reasonably necessary to clarify or complete the Annual Report. Taxpayer will provide such requested information within 30 days.
Additional time may be allowed for good cause.

f.

The IRS will determine whether Taxpayer has complied with this APA based on Taxpayer’s U.S. Returns, the Financial
Statements, and other APA Records, for the APA Term and any other year necessary to verify compliance. For Taxpayer
to comply with this APA, {use the following or an alternative} an independent certified public accountant must render an
opinion that Taxpayer’s Financial Statements present fairly, in all material respects, Taxpayer’s financial position under U.S.
GAAP.

g.

In accordance with section 11.04 of Revenue Procedure 2006-9, Taxpayer will (1) maintain the APA Records, and (2) make
them available to the IRS in connection with an examination under section 11.03. Compliance with this subparagraph constitutes compliance with the record-maintenance provisions of I.R.C. sections 6038A and 6038C for the Covered Transactions
for any taxable year during the APA Term.

h.

The True Taxable Income within the meaning of Treasury Regulations sections 1.482-1(a)(1) and (i)(9) of a member of an
affiliated group filing a U.S. consolidated return will be determined under the I.R.C. section 1502 Treasury Regulations.

i.

{Optional for US Parent Signatories} To the extent that Taxpayer’s compliance with this APA depends on certain acts of
Foreign Group members, Taxpayer will ensure that each Foreign Group member will perform such acts.

6.

Critical Assumptions. This APA’s critical assumptions, within the meaning of Revenue Procedure 2006-9, section 4.05, appear in
Appendix B. If any critical assumption has not been met, then Revenue Procedure 2006-9, section 11.06, governs.

7.

Disclosure. This APA, and any background information related to this APA or the APA Request, are: (1) considered “return information” under I.R.C. section 6103(b)(2)(C); and (2) not subject to public inspection as a “written determination” under I.R.C.
section 6110(b)(1). Section 521(b) of Pub. L. 106-170 provides that the Secretary of the Treasury must prepare a report for public
disclosure that includes certain specifically designated information concerning all APAs, including this APA, in a form that does
not reveal taxpayers’ identities, trade secrets, and proprietary or confidential business or financial information.

8.

Disputes. If a dispute arises concerning the interpretation of this APA, the Parties will seek a resolution by the Director of the
Advance Pricing and Mutual Agreement Program, to the extent reasonably practicable, before seeking alternative remedies.

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9.

Materiality. In this APA the terms “material” and “materially” will be interpreted consistently with the definition of “material
facts” in Revenue Procedure 2006-9, section 11.06(4).

10. Section Captions. This APA’s section captions, which appear in italics, are for convenience and reference only. The captions do
not affect in any way the interpretation or application of this APA.
11. Terms and Definitions. Unless otherwise specified, terms in the plural include the singular and vice versa. Appendix D contains
definitions for capitalized terms not elsewhere defined in this APA.
12. Entire Agreement and Severability. This APA is the complete statement of the Parties’ agreement. The Parties will sever, delete,
or reform any invalid or unenforceable provision in this APA to approximate the Parties’ intent as nearly as possible.
13. Successor in Interest. This APA binds, and inures to the benefit of, any successor in interest to Taxpayer.
14. Notice. Any notices required by this APA or Revenue Procedure 2006-9 must be in writing. Taxpayer will send notices to the IRS
at the address and in the manner set forth in Revenue Procedure 2006-9, section 4.11. The IRS will send notices to:
Taxpayer Corporation
Attn: Jane Doe, Sr. Vice President (Taxes)
1000 Any Road
Any City, USA 10000
(phone: _________)
15. Effective Date and Counterparts. This APA is effective starting on the date, or later date of the dates, upon which all Parties
execute this APA. The Parties may execute this APA in counterparts, with each counterpart constituting an original.
WITNESS,
The Parties have executed this APA on the dates below.
[Taxpayer Name in all caps]
By: ___________________________
Jane Doe
Sr. Vice President (Taxes)

Date: ___________________, 201___

IRS
By: ___________________________
Nicole L. Welch
Acting Director, Advance Pricing and Mutual
Agreement Program

April 11, 2022

Date: ___________________, 201___

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APPENDIX A
COVERED TRANSACTIONS AND TRANSFER PRICING METHOD (TPM)

1.

Covered Transactions.
[Define the Covered Transactions.]

2.

APA Term.
This APA applies to Taxpayer’s taxable years ending __________ through ________ (APA Term).

3.

TPM.
{Note: If appropriate, adapt language from the following examples.}
[The Tested Party is __________.]
• CUP Method

The TPM is the comparable uncontrolled price (CUP) method. The Arm’s Length Range of the price charged for
_________ is between _______ and ___________ per unit.

• CUT Method

The TPM is the CUT Method. The Arm’s Length Range of the royalty charged for the license of ______is between
____% and ___ % of [Taxpayer’s, Foreign Participants’, or other specified party’s] Net Sales Revenue. [Insert definition of net sales revenue or other royalty base.]

• Resale Price Method (RPM)

The TPM is the resale price method (RPM). The Tested Party’s Gross Margin for any APA Year is defined as follows: the Tested Party’s gross profit divided by its sales revenue (as those terms are defined in Treasury Regulations
sections 1.482-5(d)(1) and (2)) for that APA Year. The Arm’s Length Range is between ____% and ___ %, and the
Median of the Arm’s Length Range is ___%.

• Cost Plus Method

The TPM is the cost plus method. The Tested Party’s Cost Plus Markup is defined as follows for any APA Year: the
Tested Party’s ratio of gross profit to production costs (as those terms are defined in Treasury Regulations sections
1.482-3(d)(1) and (2)) for that APA Year. The Arm’s Length Range is between ___% and ___%, and the Median of
the Arm’s Length Range is ___%.

• CPM with Berry Ratio PLI

The TPM is the comparable profits method (CPM). The profit level indicator is a Berry Ratio. The Tested Party’s
Berry Ratio is defined as follows for any APA Year: the Tested Party’s gross profit divided by its operating expenses
(as those terms are defined in Treasury Regulations sections 1.482-5(d)(2) and (3)) for that APA Year. The Arm’s
Length Range is between ____ and ___, and the Median of the Arm’s Length Range is ___.

• CPM using an Operating Margin PLI

The TPM is the comparable profits method (CPM). The profit level indicator is an operating margin. The Tested Party’s Operating Margin is defined as follows for any APA Year: the Tested Party’s operating profit divided by its sales
revenue (as those terms are defined in Treasury Regulations section 1.482-5(d)(1) and (4)) for that APA Year. The
Arm’s Length Range is between ____% and ___ %, and the Median of the Arm’s Length Range is ___%.

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• CPM using a Three-year Rolling Average Operating Margin PLI

The TPM is the comparable profits method (CPM). The profit level indicator is an operating margin. The Tested
Party’s Three-Year Rolling Average operating margin is defined as follows for any APA Year: the sum of the Tested
Party’s operating profit (within the meaning of Treasury Regulation section 1.482-5(d)(4) for that APA Year and the
two preceding years, divided by the sum of its sales revenue (within the meaning of Treasury Regulation section
1.482-5(d)(1)) for that APA Year and the two preceding years. The Arm’s Length Range is between ____% and
____%, and the Median of the Arm’s Length Range is ___%.

• Residual Profit Split Method

The TPM is the residual profit split method. [Insert description of routine profit level determinations and residual
profit-split mechanism].
[Insert additional provisions as needed.]
4.

Application of TPM.
For any APA Year, if the results of Taxpayer’s actual transactions produce a [price per unit, royalty rate for the Covered
Transactions] [or] [Gross Margin, Cost Plus Markup, Berry Ratio, Operating Margin, Three-Year Rolling Average Operating
Margin for the Tested Party] within the Arm’s Length Range, then the amounts reported on Taxpayer’s U.S. Return must
clearly reflect such results.
For any APA year, if the results of Taxpayer’s actual transactions produce a [price per unit, royalty rate] [or] [Gross Margin,
Cost Plus Markup, Berry Ratio, Operating Margin, Three-Year Rolling Average Operating Margin for the Tested Party]
outside the Arm’s Length Range, then amounts reported on Taxpayer’s U.S. Return must clearly reflect an adjustment that
brings the [price per unit, royalty rate] [or] [Tested Party’s Gross Margin, Cost Plus Markup, Berry Ratio, Operating Margin,
Three-Year Rolling Average Operating Margin] to the Median.
For purposes of this Appendix A, the “results of Taxpayer’s actual transactions” means the results reflected in Taxpayer’s
and Tested Party’s books and records as computed under U.S. GAAP [insert another relevant accounting standard if applicable], with the following adjustments:
(a) [The fair value of stock-based compensation as disclosed in the Tested Party’s audited financial statements shall be
treated as an operating expense]; and
(b) To the extent that the results in any prior APA Year are relevant (for example, to compute a multi-year average), such
results shall be adjusted to reflect the amount of any adjustment made for that prior APA Year under this Appendix A.

5.

APA Revenue Procedure Treatment
If Taxpayer makes an adjustment under paragraph 4 of this Appendix A (a “primary adjustment”), Taxpayer and its related
foreign entity may elect APA Revenue Procedure Treatment in accordance with section 11.02(3) of Revenue Procedure
2006-9 and avoid the possible adverse tax consequences of a secondary adjustment that would otherwise follow the primary
adjustment.
[Insert additional provisions as needed.]

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APPENDIX B
CRITICAL ASSUMPTIONS

This APA’s critical assumptions are:
1. The business activities, functions performed, risks assumed, assets employed, and financial and tax accounting methods and
classifications [and methods of estimation] of Taxpayer in relation to the Covered Transactions will remain materially the same as
described or used in Taxpayer’s APA Request. A mere change in business results will not be a material change.
[Insert additional provisions as needed.]

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APPENDIX C
APA RECORDS AND ANNUAL REPORT

APA RECORDS
The APA Records will consist of all documents listed below for inclusion in the Annual Report, as well as all documents, notes, work
papers, records, or other writings that support the information provided in such documents.

ANNUAL REPORT
The Annual Report (and each of the four copies required by paragraph 5(e) of this APA) will include:
1.

Two copies of a properly completed APA Annual Report Summary in the form of Appendix E to this APA, one copy of the form
bound with, and one copy provided separately from, the rest of the Annual Report.

2.

A table of contents, organized as follows:

3.

Statements that fully identify, describe, analyze, and explain:
a.

All material differences between the U.S. Group’s business operations (including functions, risks assumed, markets, contractual terms, economic conditions, property, services, and assets employed) during the APA Year from the business operations described in the APA Request. If there have been no material differences, the Annual Report will include a statement
to that effect.

b.

All material differences between the U.S. Group’s accounting methods and classifications, and methods of estimation used
during the APA Year, from those described or used in the APA Request. If any change was made to conform to changes in
U.S. GAAP (or other relevant accounting standards) Taxpayer will specifically identify the change. If there has been no
material change in accounting methods and classifications or methods of estimation, the Annual Report will include a statement to that effect.

c.

Any change to the Taxpayer notice information in paragraph 14 of this APA.

d.

Any failure to meet any critical assumption. If there has been no failure, the Annual Report will include a statement to that
effect.

e.

Whether or not material information submitted while the APA Request was pending is discovered to be false, incorrect, or
incomplete.

f.

Any change to any entity classification for federal income tax purposes (including any change that causes an entity to be
disregarded for federal income tax purposes) of any Worldwide Group member that is a party to the Covered Transactions
or is otherwise relevant to the TPM.

g.

The amount, reason for, and financial analysis of (1) any primary adjustments made under Appendix A for the APA Year; and
(2) any (a) secondary adjustments that follow such primary adjustments or (b) accounts receivable that Taxpayer establishes,
in lieu of secondary adjustments, by electing APA Revenue Procedure Treatment pursuant to paragraph 5 of Appendix A and
Revenue Procedure 2006-9, section 11.02(3), for the APA Year, including but not limited to:
i.

the amounts due or owed, and paid or received by each affected entity;

ii. the character (such as capital, ordinary, income, expense) and country source of the funds transferred, and the specific
affected line item(s) of any affected U.S. Return;

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iii. the date(s) and means by which the payments are or will be made; and
iv. whether or not APA Revenue Procedure Treatment was elected pursuant to paragraph 5 of Appendix A and Revenue
Procedure 2006-9, section 11.02(3).
h.

The amounts, description, reason for, and financial analysis of any book-tax difference relevant to the TPM for the APA Year,
as reflected on Schedule M-1 or Schedule M-3 of the U.S. Return for the APA Year.
i.

Whether Taxpayer contemplates requesting, or has requested, to renew, modify, or cancel the APA.

4.

The Financial Statements, and any necessary account detail to show compliance with the TPM, including consolidating financial
statements, segmented financial data, records from the general ledger, or similar information if the assets, liabilities, income, or
expenses relevant to showing compliance with the TPM are a subset of the assets, liabilities, income, or expenses presented in
the Financial Statements.

5.

{Use the following or the alternative prescribed by paragraph 5(f) of this APA:} A copy of the independent certified public
accountant’s opinion required by paragraph 5(f) of this APA.

6.

A financial analysis that reflects Taxpayer’s TPM calculations for the APA Year. The calculations must reconcile with and reference the information required under item 4 above in sufficient account detail to allow the IRS to determine whether Taxpayer has
complied with the TPM.

7.

An organizational chart for the Worldwide Group, revised annually to reflect all ownership or structural changes of entities that
are parties to the Covered Transactions or are otherwise relevant to the TPM.

8.

A copy of the APA and any amendment.

9.

A penalty of perjury statement, executed in accordance with Revenue Procedure 2006-9, section 11.01(6) and (7).

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APPENDIX D
DEFINITIONS

The following definitions control for all purposes of this APA. The definitions appear alphabetically below:
Term
Annual Report
APA

Definition
A report within the meaning of Revenue Procedure 2006-9, section 11.01.
This Advance Pricing Agreement, which is an “advance pricing agreement” within the meaning of
Revenue Procedure 2006-9, section 2.04.
APA Records
The records specified in Appendix C.
APA Request
Taxpayer’s request for this APA dated _________, including any amendments or supplemental or
additional information thereto.
APA Year
This term is defined in paragraph 5(a) of this APA.
Covered Transaction(s)
This term is defined in Appendix A.
Financial Statements
Financial statements prepared in accordance with U.S. GAAP and stated in U.S. dollars.
Foreign Group
Worldwide Group members that are not U.S. persons.
Foreign Participants
[name the foreign entities involved in Covered Transactions].
I.R.C.
The Internal Revenue Code of 1986, 26 U.S.C., as amended.
Pub. L. 106-170
The Ticket to Work and Work Incentives Improvement Act of 1999.
Revenue Procedure 2006-9 Rev. Proc. 2006-9, 2006-1 C.B. 278.
Transfer Pricing Method
A transfer pricing method within the meaning of Treasury Regulation section 1.482-1(b) and Reve(TPM)
nue Procedure 2006-9, section 2.04.
U.S. GAAP
U.S. generally-accepted accounting principles.
U.S. Group
Worldwide Group members that are U.S. persons.
U.S. Return
For each taxable year, the “returns with respect to income taxes under subtitle A” that Taxpayer
must “make” in accordance with I.R.C. section 6012. {Or substitute for partnership: For each taxable year, the “return” that Taxpayer must “make” in accordance with I.R.C. section 6031.}
Worldwide Group
Taxpayer and all organizations, trades, businesses, entities, or branches (whether or not incorporated, organized in the United States, or affiliated) owned or controlled directly or indirectly by the
same interests.

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APPENDIX E
APA ANNUAL REPORT SUMMARY FORM

The APA Annual Report Summary on the next page is a required APA Record. The APA Team Leader supplies some of the information requested on the form. Taxpayer is to supply the remaining information requested by the form and submit the form as part of
its Annual Report.

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APA Annual Report

Department of the Treasury—Internal Revenue Service

SUMMARY

Large Business and International Division

Team Leader _______________________

Treaty and Transfer Pricing Operations

Economist _______________________________

Advance Pricing and Mutual Agreement Program

APA Information

APA No. _______________

Intl Examiner
_____________________________

Taxpayer Name: ___________________________________________________
Taxpayer EIN:_________________ NAICS:___________________
APA Term: Taxable years ending ________ to ____________
Original APA [ ] Renewal APA [ ]
Annual Report due dates:
_________________, 201__ for all APA Years through APA Year ending in 200__; for each APA Year
thereafter, on _________________ [month and day] immediately following the close of the APA Year
Principal foreign country(ies) involved in covered transaction(s): _______________________________________
Type of APA: [ ] unilateral [ ] bilateral with ________________
Tested party is [ ] US [ ] foreign [ ] both
Approximate dollar volume of covered transactions (on an annual basis) involving tangible goods and services:
[ ] N/A [ ] <$50 million [ ] $50-100 million [ ] $100-250 million [ ] $250-500 million [ ] >$500 million
APA tests on (check all that apply):
[ ] annual basis [ ] multi-year basis [ ] term basis
APA provides (check all that apply) a:
[ ] range [ ] point [ ] floor only [ ] ceiling only [ ] other_____________
APA provides for adjustment (check all that apply) to:
[ ] nearest edge [ ] median [ ] other point

APA Annual Report
Information

APA date executed: ______________, 201__
This APA Annual Report Summary is for APA Year(s) ending in 200__ and was filed on _____________, 201__

(to be completed

Check here [ ] if Annual Report was filed after original due date but in accordance with extension.

by the Taxpayer)

Has this APA been amended or changed? [ ] yes [ ] no

Effective Date: ______________________

Has Taxpayer complied with all APA terms and conditions? [ ] yes [ ] no
Were all the critical assumptions met? [ ] yes [ ] no
Has a Primary Compensating Adjustment been made in any APA Year covered by this Annual Report?
[ ] yes [ ] no If yes, which year(s): 200___
Have any necessary Secondary Compensating Adjustments been made? [ ] yes [ ] no
Did Taxpayer elect APA Revenue Procedure treatment? [ ] yes [ ] no
Any change to the entity classification of a party to the APA? [ ] yes [ ] no
Taxpayer notice information contained in the APA remains unchanged? [ ] yes [ ] no
Taxpayer’s current US principal place of business: (City, State) _____________________________________
APA Annual Report

Financial analysis reflecting TPM calculations

[ ] yes [ ] no

Checklist of

Financial statements showing compliance with TPM(s)

[ ] yes [ ] no

Key Contents

Schedule M-1 or M-3 book-tax differences

[ ] yes [ ] no

(to be completed

Current organizational chart of relevant portion of world-wide group

[ ] yes [ ] no

by the Taxpayer)

Attach copy of APA

[ ] yes [ ] no

Other APA records and documents included:

Contact Information

April 11, 2022

Authorized Representative

Phone Number

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Affiliation and Address

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APPENDIX 2– Model APA (based on Rev. Proc. 2015-41)
TEMPLATE FOR ADVANCE PRICING AGREEMENT
UNDER REVENUE PROCEDURE 2015-41
_______________
The Advance Pricing and Mutual Agreement Program (“APMA”) of the Internal Revenue Service (“IRS”) is providing this
template for use in drafting advance pricing agreements (“APAs”) issued under IRS Revenue Procedure 2015-41, 2015-35 I.R.B.
263 (“Rev. Proc. 2015-41”). This template is designed to systematize how taxpayers propose terms for their APAs and standardize
language used in executed APAs. It will improve efficiency in the APA process and enhance consistency in the administration of the
APA program.
Rev. Proc. 2015-41 requires that taxpayers include as part of a complete APA request a draft APA and a “redline” comparison of the
proposed draft APA against the current model APA. See section 2.03, exhibit 15, of the Appendix to Rev. Proc. 2015-41. This template
serves as the model APA. A taxpayer is required to produce the “redline” comparison by following the instructions below to edit this
template with tracked changes. The draft APA and “redline” comparison are then to be included in Word format in the complete APA
request. (Before editing the template with tracked changes, a taxpayer should remove this introduction and the instructions below
from the Microsoft Word file.)
The assigned APMA team will review the APA’s terms proposed in the draft APA. If the APMA team accepts the proposed terms
in light of its review of the taxpayer’s complete APA request and other information obtained during the APA process, then the text of
the draft APA, edited as needed to fill in any information not available at the time of the APA Request, will be adopted as the text of
a finally executed APA. If the APMA team does not accept the proposed terms, it will discuss modifications to the draft APA with the
taxpayer during the APA process. For bilateral and multilateral APAs, the terms of the executed APA will of necessity be consistent
with the terms of the underlying mutual agreement between the United States and one or more treaty partners.
GENERAL INSTRUCTIONS
The template is designed to minimize editing by using an options-based format for selecting from terms presented in certain sections of the model APA. The options presented are those which APMA considers standard and which it has accepted in final APAs.
These options are not binding on APMA, however. APMA reserves the right to modify the option selections, the specific option language used, or any other terms before executing an APA with the taxpayer.
Options are indicated by square brackets (“[]”). An “x” should be inserted between the brackets to indicate the selected option
(“[x]”). Options that are not selected should not be deleted, but instead should be left in the text of the draft APA. The options to which
APMA and the taxpayer ultimately agree for the final APA will be indicated by the presence or absence of an “x”. The term associated
with the “x” will be given operative effect in the executed APA.
Certain options are flagged with an asterisk after the square brackets (“[]*”). To facilitate the APMA team’s subsequent review of
the draft APA, the asterisks should not be deleted. Taxpayers that select flagged options are required to specifically provide justification for the selection in the APA request. See section 1.02, Part 5, of the Appendix to Rev. Proc. 2015-41.
The template contains placeholder phrases consisting of a hashtag followed by one or more words in block capital letters
(e.g., “#COUNTRY”). Generally, the taxpayer should replace a placeholder phrase with appropriate text, subject to the following
conventions:
•

If a placeholder phrase occurs within an option that the taxpayer has rejected, the taxpayer should change the hashtag to a
caret (e.g., change “#COUNTRY” to “^COUNTRY”) but otherwise leave the phrase intact.15 The caret indicates that the
Taxpayer has rejected this option. For example, for a bilateral APA with Japan, the lines on the first page just below the title
would read:

15
As a result, almost all occurrences of the hashtag in the template will be replaced with a caret or other text in the taxpayer’s draft APA. The few remaining occurrences of the hashtag will
mark a placeholder phrase that cannot yet be replaced with appropriate text (see, for example, the placeholder phrase in paragraph 6(e) for a date that cannot be determined until the APA nears
execution). Searching the draft APA for the hashtag will locate all placeholder phrases that still need replacement.

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[x] Bilateral with Japan

[] Multilateral with ^COUNTRIES

[] Unilateral

•

The placeholder phrase “#CURRENCY” should be replaced, for example, with “U.S. dollars,” “Euros,” or “Japanese yen.”

•

The placeholder phrase “#DATE” should be replaced with a date in the format of “December 31, 2020.”

The APA Term will be expressed as dates certain, e.g., “January 1, 2017 to December 31, 2022, inclusive”, rather than as particular
tax years.
Taxpayers may need to draft custom text for situations or options not included in the template. For example, a taxpayer may propose additional critical assumptions to address specific regulatory contingencies or conditions the taxpayer is expected to face during
the term of the APA. As another example, the provision titled “Limitation on Assistance” at the end of the Recitals might be modified
based on an understanding reached in the prefiling stage of the APA process. In some cases, a particular critical assumption might facilitate reaching an agreement on an APA. Taxpayers that include custom text are required to specifically provide justification for the
inclusion in the APA request, just as selecting an option with an asterisk requires justification. Any custom text must also be evident
in the “redline” comparison of the proposed draft APA.
INSTRUCTIONS ON TABLES
The template contains certain tables that the taxpayer should edit. Entries in the tables will not contain hashtags, but taxpayers
nevertheless should fill in the information and add additional rows to the tables if needed. Taxpayers also should fill in the “APA
Information” in the table in Appendix D, to the extent available or proposed.
INSTRUCTIONS ON APPENDIX A
Appendix A of this template contains the description of the APA’s covered issue(s) and covered method(s). Taxpayers should note
the following points in completing Appendix A:
•

The template includes just one covered issue with one corresponding covered method. If there is more than one covered
Issue proposed for the APA, the taxpayer should add additional covered issues in Appendix A, section 3, with tracked
changes.

•

If there is more than one covered method, the taxpayer should first replicate the template’s entire text for Covered Method
1 in Appendix A, section 4, without tracked changes, to provide template text for each additional covered method, and then
edit the text for each covered method with tracked changes.

•

Normally, each covered issue will have its own corresponding covered method. However, in some cases, a covered method
may apply at once to more than one covered issue. For example, covered issues may be proposed to be aggregated and tested
by a single covered method. In such cases, the heading for that covered method could read, for example, “Covered Method
for Covered Issues 1-3”.

•

Any interaction between different covered methods should be adequately explained in the text, and in an appropriate manner. For example, an explanation might be provided in an introduction at the start of section 4 of Appendix A, preceding the
description of the respective covered methods.

Appendix A uses the term “Tested Party.” When applied in the context of methods that consider, or test, data from only one party
to a transaction, this term is similar in concept to the term “tested party” as discussed in the OECD Guidelines at paragraphs 3.18
and 3.19, and as defined in the U.S. Treasury Regulations section 1.482-5(b)(2). However, some methods consider, or test, data from
both parties to a transaction, where there is no singular “tested” party. Even in applying such methods, however, it is typically the
case that one particular party’s results are formally tested for compliance with the method. For purposes of this template, in such
circumstances, the party whose results are formally tested in applying any particular method is the “Tested Party”, even if that party
is not strictly a “tested party” as discussed in the OECD Guidelines paragraphs 3.18 and 3.19, or as defined in the U.S. Treasury
Regulations section 1.482-5(b)(2).

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ADVANCE PRICING AGREEMENT
between
#SIGNATORY
and
THE INTERNAL REVENUE SERVICE
[] Bilateral with #COUNTRY
[] Multilateral with #COUNTRIES
[] Unilateral
Term: #DATE to #DATE, inclusive
[] This APA is commonly referred to as #APA NAME.
PARTIES
The Parties to this APA are the Internal Revenue Service (“IRS”) and #NAME OF EACH NON-IRS SIGNATORY, WITH EIN.
[]

#SIGNATORY will be referred to as “U.S. Taxpayer.”

[]

#SIGNATORY is the common parent of an affiliated group filing consolidated U.S. tax returns and is entering into this APA
on behalf of both itself and the following members of its consolidated group: #MEMBERS OF GROUP. All members of this
consolidated group will be referred to collectively as “U.S. Taxpayer.”
RECITALS

[]

This APA is a renewal of one or more prior APAs, which are listed below in reverse chronological order:
Party(ies)

Execution Date

Term

Key:
•

Party(ies): The signatory(ies) to the prior APA, other than the IRS, with each signatory’s taxpayer identification number;

•

Execution Date: The date, or the later of the dates, on which the prior APA was executed;

•

Term: The term of the prior APA.

[]

This is a bilateral APA within the meaning of Rev. Proc. 2015-41 and implements the terms of a mutual agreement reached
between the United States and #COUNTRY.

[]

This is a multilateral APA within the meaning of Rev. Proc. 2015-41 and implements the terms of a mutual agreement reached
among the United States, #COUNTRIES.

[]

This APA is a unilateral APA within the meaning of Rev. Proc. 2015-41 and is not based on any mutual agreement.
The Parties to this APA are defined in the ”Parties” section above. Regarding the Party(ies) to this APA other than the IRS:

[]

No such Party has an immediate parent or owner that is not a U.S. entity.

[]

One or more such Parties has an immediate parent or owner that is not a U.S. entity, as follows:

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Party

Parent’s or Owner’s
Identifying Information

Parent’s or Owner’s
Contact Information

Key:
•

Party: Name of the Party having an immediate parent or owner that is not a U.S. entity;

•

Parent’s or Owner’s Identifying Information: Name of the immediate parent or owner of such Party, and the taxpayer
identification number of that parent or owner for income tax purposes in its country of residence;

•

Parent’s or Owner’s Contact Information: The immediate parent’s or owner’s address and phone number.

The term “Worldwide Group” is defined below in paragraph 12 of this APA. The ultimate parent entity or owner of Worldwide
Group is:
#ENTITY NAME, ADDRESS, AND PHONE
U.S. Taxpayer’s principal place of business is #CITY, #STATE. #BRIEF DESCRIPTION OF U.S. TAXPAYER AND NON-U.S.
TAXPAYER (DEFINED IN SECTION 1 OF APPENDIX A), AND SPECIFICALLY OF EACH COVERED ENTITY (DEFINED
IN SECTION 1 OF APPENDIX A).
This APA contains the Parties’ agreement on the Covered Method(s) for resolving the Covered Issue(s) under Code section 482 and
any other Code sections that are identified in Appendix A to this APA, the U.S. Treasury Regulations thereunder, and (if applicable):
[]

The income tax convention(s) between the United States and #COUNTRY(IES).

This APA shall not limit the authority of the IRS to (1) verify compliance with this APA as to the Covered Issue(s), or (2) audit
issues other than Covered Issue(s), including issues that arise under Code section 482 and any other Code sections identified in Appendix A to this APA, and the U.S. Treasury Regulations thereunder.
LIMITATION ON ASSISTANCE
The Covered Issue(s) may relate to one or more countries which (i) have an income tax convention with the United States, but
(ii) are not a party to a mutual agreement whose terms are implemented by this APA. U.S. Taxpayer acknowledges that the IRS may
decline to provide competent authority assistance concerning taxation by such country(ies) that relates to the Covered Issue(s). See
section 2.02(4)(d) of Rev. Proc. 2015-41.

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AGREEMENT
The Parties agree as follows:
1.

Covered Entities. This APA’s Covered Entities are defined in Appendix A.

2.

Covered Issue(s). This APA applies to the Covered Issue(s), as defined in Appendix A.

3.

Covered Method(s). Appendix A sets forth the Covered Method(s) for the Covered Issue(s).

4.

Term. This APA applies to the APA Term, as defined in Appendix A.

5.

Operation.

6.

a.

Rev. Proc. 2015-41 governs the interpretation, legal effect, and administration of this APA.

b.

The APMA program provides a voluntary process whereby the IRS and taxpayers may resolve transfer pricing issues and
issues for which transfer pricing principles may be relevant in a principled and cooperative manner on a prospective basis.
As such, the APA process (as defined in Rev. Proc. 2015-41) is an alternative to dispute resolution that benefits both taxpayers and the IRS and that is intended to promote and encourage open communication. Accordingly, the IRS and U.S. Taxpayer
agree that neither party will attempt to use nonfactual oral or written representations, within the meaning of sections 6.04 and
6.05 of IRS Revenue Procedure 2015-41 (including any proposals to use particular Covered Method(s)), made in conjunction with the APA Request in any judicial or administrative proceeding. The IRS and U.S. Taxpayer also agree that factual
representations made in conjunction with the APA Request may be used in judicial and administrative proceedings.

Compliance.
a.

U.S. Taxpayer must report its taxable income in an amount that is consistent with Appendix A and all other requirements of
this APA. U.S. Taxpayer must so report its taxable income in the following manner:
i.

For any APA Tax Year for which U.S. Taxpayer timely files its original U.S. return prior to, or no later than 60 days after, the
U.S. Effective Date, U.S. Taxpayer must so report its taxable income for that APA Tax Year in one of the following ways:
A. on such original U.S. return;
B. on an amended U.S. return submitted no later than 120 days after the U.S. Effective Date;
C. through a means proposed by U.S. Taxpayer and accepted by the applicable IRS practice area no later than 120 days
after the U.S. Effective Date (or by such other deadline as is agreed between U.S. Taxpayer and the applicable IRS
practice area); or
D. if applicable:
[]* no later than 120 days after the U.S. Effective Date through the following means: #DESCRIPTION OF
MEANS.

ii. For all other APA Tax Years, U.S. Taxpayer must so report its taxable income on its timely filed original U.S. return.
iii. The provisions of paragraphs 6(a)(i) and 6(a)(ii) are modified by this paragraph 6(a)(iii). If a Covered Method includes
a term test (including the case of an annual test with a supplemental term test) or a subterm test, as described in section
4 of Appendix A, then the APA Covered Year as of which the term test or subterm test applies would change in the event
of an Early Termination. Specifically, while in the absence of an Early Termination a term test would apply as of the last
APA Covered Year, in the event of an Early Termination the term test would apply as of an earlier APA Covered Year.
Similarly, while in the absence of an Early Termination a subterm test would apply as of the last APA Covered Year in
the subterm, in the event of an Early Termination the subterm test might apply as of an earlier APA Covered Year. In
these situations, the Early Termination might not be established in time for U.S. Taxpayer to know to apply the term test
or subterm test as of the earlier APA Covered Year in reporting taxable income as required under paragraphs 6(a)(i) and

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6(a)(ii) for the APA Tax Year corresponding to that earlier APA Covered Year. In such cases, U.S. Taxpayer may need to
correct its reporting for that APA Tax Year. Specifically, U.S. Taxpayer will need to correct its income reporting for that
APA Tax Year if the application of the term test or subterm test in that earlier APA Covered Year changes the existence
or amount of an APA Primary Adjustment for the Covered Method for that APA Tax Year. In such cases:
A) The resulting incorrectness in the prior reporting for that APA Tax Year is excused; and
B) U.S. Taxpayer must correct such prior reporting through a means listed in paragraph 6(a)(i) within 120 days of the
Early Termination being established.
b.

For each Covered Issue, if any, that involves determination of pricing and/or income allocation16 under Code section
482 (or Code section 367(d)) as modified by any applicable income tax convention, this APA addresses the pricing and/
or income allocation between U.S. Taxpayer and Non-U.S. Taxpayer in the aggregate. Except as explicitly provided,
this APA does not address and does not bind the IRS with respect to pricing or income allocation (1) among particular
legal entities that are members of U.S. Taxpayer, or (2) among particular legal entities that are members of Non-U.S.
Taxpayer. In addition, this APA does not address pricing or income allocation between an entity that is not a Covered
Entity, and any entity.

c.

For each APA Tax Year, if U.S. Taxpayer complies with the terms and conditions of this APA, then, provided that this
APA remains effective for that APA Tax Year for a particular Covered Issue, the IRS will not make or propose any allocation or adjustment that is inconsistent with the application under this APA of the applicable Covered Method to that
Covered Issue.

d.

If U.S. Taxpayer does not comply with the terms and conditions of this APA, then the IRS may:
i.

enforce the terms and conditions of this APA and make or propose allocations or adjustments based on the application of the Covered Method(s) to the Covered Issue(s) as provided in this APA;

ii. cancel or revoke this APA under section 7.06 of Rev. Proc. 2015-41; or
iii. revise this APA, if the Parties agree.
e.

U.S. Taxpayer must timely file an Annual Report for each APA Tax Year in accordance with this paragraph 6(e), Appendix
C to this APA, and section 7.02 of Rev. Proc. 2015-41. Annual Reports for multiple APA Tax Years may be combined,
provided that all required information for each APA Tax Year is clearly presented. For each Annual Report, U.S. Taxpayer
must submit an original printed version containing a signed original “penalties of perjury” declaration, one printed copy
of the contents of the original printed version, and an electronic copy of the contents of the original printed version. Any
exhibits in the printed version must be tabbed, and the electronic copy is subject to the same requirements, as to medium
and format, that are specified for APA requests in section 2 of the Appendix to Rev. Proc. 2015-41. Upon request, U.S. Taxpayer must provide additional copies of the printed version, at addresses specified by the IRS. U.S. Taxpayer must file the
Annual Report for each APA Tax Year by the later of (i) #DATE CERTAIN, NORMALLY APPROXIMATELY 90 DAYS
AFTER THE U.S. EFFECTIVE DATE, and (ii) the fifteenth day of the twelfth month following the close of the APA
Tax Year. The IRS may by notice request additional information reasonably necessary to clarify or complete the Annual
Report. (See paragraph 16, and section 3(c) of Appendix C, regarding notices.) U.S. Taxpayer will provide such requested
information within 30 days from the date of the notice unless a later date is specified in the notice. Additional time may be
allowed for good cause in the discretion of the Director of the Advance Pricing and Mutual Agreement Program.

f.

The IRS will determine whether U.S. Taxpayer has complied with this APA based on U.S. Taxpayer’s U.S. returns, the
Financial Statements and additional statements required under this paragraph 6(f), and other APA Records, for all APA
Tax Years and any other tax year necessary to verify compliance. The Financial Statements and additional statements
required for a particular tax year are:
[]

16

For every U.S. Covered Entity, the Financial Statements together with the additional statements specified in
paragraph 6(f)(i); and for every Non-U.S. Covered Entity, the Financial Statements together with the additional statements specified in paragraph 6(f)(ii).

As used in this APA, “income allocation” includes allocation of loss.

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[]* For every U.S. Covered Entity, the Financial Statements together with the additional statements specified in
paragraph 6(f)(i).
[]* For every Non-U.S. Covered Entity, the Financial Statements together with the additional statements specified
in paragraph 6(f)(ii).
i.

For each U.S. Covered Entity, the additional statements consist of the following statement(s):
[]

An audit opinion for that U.S. Covered Entity’s Financial Statements, as defined in paragraph 6(f)(iii).

[]* One or more of the following, as indicated:
[]

An accountant’s report for that U.S. Covered Entity’s Financial Statements, as defined in paragraph 6(f)(iii).

[]

A self-certification for that U.S. Covered Entity’s Financial Statements, as defined in paragraph 6(f)(iii).

[]

A self-certification for that U.S. Covered Entity’s Financial Statements, together with a tying certification for
that entity’s Financial Statements, as defined in paragraph 6(f)(iii).

[]

#OTHER MEANS OF VERIFYING THE RELIABILITY OF THE U.S. COVERED ENTITY’S FINANCIAL STATEMENTS.

ii. For each Non-U.S. Covered Entity, the additional statements consist of the following statement(s):
[]

An audit opinion for that Non-U.S. Covered Entity’s Financial Statements, as defined in paragraph 6(f)(iii).

[]* One or more of the following, as indicated:
[]

An accountant’s report for that Non-U.S. Covered Entity’s Financial Statements, as defined in paragraph 6(f)
(iii).

[]

A self-certification for that Non-U.S. Covered Entity’s Financial Statements, as defined in paragraph 6(f)(iii).

[]

A self-certification for that Non-U.S. Covered Entity’s Financial Statements, together with a tying certification
for that Covered Entity’s Financial Statements, as defined in paragraph 6(f)(iii).

[]

#OTHER MEANS OF VERIFYING THE RELIABILITY OF THE NON-U.S. COVERED ENTITY’S
FINANCIAL STATEMENTS.

iii. With reference to the Financial Statements for a particular Covered Entity for a particular tax year, certain terms
used in paragraphs 6(f)(i) and 6(f)(ii) are defined as follows:
A. An audit opinion is an opinion of an independent certified public or chartered accountant who audited the
Financial Statements.
B. An accountant’s report is a report of an independent certified public or chartered accountant who is associated
with the Financial Statements.
C. A self-certification is an attestation, as defined in paragraph 6(f)(iii)(E), that the Financial Statements have
been prepared according to the Applicable Accounting Standard.
D. A tying certification consists of the following:
(1) An attestation, as defined in paragraph 6(f)(iii)(E), that the Financial Statements can be reconciled to the
consolidated Financial Statements for that entity’s direct or indirect parent according to workpapers provided with the attestation;

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(2) The workpapers referred to in paragraph 6(f)(iii)(D)(1), which must demonstrate the consolidation of the
Covered Entity’s Financial Statements into the Financial Statements of the parent referred to in paragraph
6(f)(iii)(D)(1);
(3) The Financial Statements of the parent referred to in paragraph 6(f)(iii)(D)(1); and
(4) An audit opinion (as defined in paragraph 6(f)(iii)(A)) for the Financial Statements of the parent referred
to in paragraph 6(f)(iii)(D)(1).
E. An attestation is an affirmation by an officer of the Covered Entity in the following form:
I, [Officer’s Name and Title], of [Name of Covered Entity] affirm under penalties of perjury that the facts
stated below are true. I either have adequate first-hand knowledge to make this affirmation or have gained
adequate knowledge to make this affirmation through diligent consultation(s) with one or more individuals who have first-hand knowledge.
[Facts attested to.]
[Signature]
g.

In accordance with section 7.04 of Rev. Proc. 2015-41, U.S. Taxpayer will (1) maintain the APA Records, and (2) make
them available to the IRS in connection with an examination under section 7.03 of Rev. Proc. 2015-41. Compliance with
this subparagraph constitutes compliance with the record-maintenance provisions of Code sections 6038A and 6038C
for the Covered Issue(s) for any APA Covered Year.

h.

The “true taxable income” within the meaning of U.S. Treasury Regulations sections 1.482-1(a)(1) and (i)(9) of a member of an affiliated group filing a U.S. consolidated return will be determined under the U.S. Treasury Regulations under
Code section 1502.

i.

To the extent that U.S. Taxpayer’s compliance with this APA depends on certain acts of other members of Worldwide
Group, U.S. Taxpayer will ensure that such other members will perform such acts.

7.

Critical Assumptions. The Critical Assumptions, which are this APA’s critical assumptions as defined in Rev. Proc. 2015-41,
appear in Appendix B. If any Critical Assumption has not been met, then Rev. Proc. 2015-41, section 7.06, governs, as modified
by Appendix B to this APA.

8.

Disclosure. This APA, and any background information related to this APA or the APA Request, are: (1) considered “return
information” under Code section 6103(b)(2)(C); and (2) not subject to public inspection as a “written determination” under Code
section 6110(b)(1). Section 521(b) of Pub. L. 106-170 provides that the Secretary of the Treasury must prepare a report for public
disclosure that includes certain specifically designated information concerning all APAs, including this APA, in a form that does
not reveal taxpayers’ identities, trade secrets, and proprietary or confidential business or financial information.

9.

Disputes. If a dispute arises concerning the interpretation or application of this APA, the Parties will seek a resolution by the
Director, Treaty and Transfer Pricing Operations, to the extent reasonably practicable, before seeking alternative remedies.

10. Materiality. In this APA the terms “material” and “materially” will be interpreted in a manner consistent with the description of
“material facts” in Rev. Proc. 2015-41, section 7.06(4).
11. Paragraph Captions. This APA’s paragraph captions, which appear in italic type, are for convenience and reference only. The
captions do not affect in any way the interpretation or application of this APA.
12. Terms and Definitions.
a.

Unless otherwise specified, terms in the plural include the singular and vice versa.

b.

Appendix A contains definitions for certain terms used in this APA’s body and appendices.

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c.

Certain terms used in this APA’s body and appendices are defined as follows:

Term
Annual Report
Advance Pricing
Agreement, or “APA”
APA Records
APA Request

Critical Assumptions
Financial Statements
Non-U.S. Group
Parties
Pub. L. 106-170
U.S. Effective Date
U.S. Group
Worldwide Group

Definition
A report within the meaning of Rev. Proc. 2015-41, section 7.02.
An “advance pricing agreement” within the meaning of Rev. Proc. 2015-41, section 2.02. Unless context
indicates otherwise, “this APA” or “the APA” denotes the particular APA that is executed below.
(Defined in Appendix C.)
U.S. Taxpayer’s request for this APA, which was dated #DATE, including any amendments or supplemental or additional information thereto (including but not limited to any responses to due diligence
questions).
(Defined in paragraph 7.)
Balance sheet, income statement, statement of cash flow, and explanatory notes, prepared in accordance
with the Applicable Accounting Standard as defined in section 7 of Appendix A.
In any APA Tax Year, Worldwide Group members that are not U.S. persons.
(Defined in the Recitals near the start of this APA.)
The Ticket to Work and Work Incentives Improvement Act of 1999.
(Defined in paragraph 17 and in section 7 of Appendix A. Those definitions are intended to have the
same meaning. In case of conflict, the definition in paragraph 17 controls.)
In any APA Tax Year, Worldwide Group members that are U.S. persons.
In any APA Tax Year, U.S. Taxpayer and all organizations, trades, businesses, entities, or branches
(whether or not incorporated, organized in the United States, or affiliated) owned or controlled directly
or indirectly by the same interests.

13. Deadline References. If a deadline under this APA falls on a Saturday, Sunday, or a legal holiday in the District of Columbia, the
deadline is extended to the next succeeding day that is not a Saturday, Sunday, or legal holiday in the District of Columbia.
14. Entire Agreement and Severability. This APA is the complete statement of the Parties’ agreement. The Parties will sever, delete,
or reform any invalid or unenforceable provision in this APA to approximate the Parties’ intent as nearly as possible.
15. Successor in Interest. This APA binds, and inures to the benefit of, any successor in interest to U.S. Taxpayer.
16. Notice. Any notices required by this APA or Rev. Proc. 2015-41 must be in writing. U.S. Taxpayer will send notices to the IRS
at:
Commissioner, Large Business and International Division
Internal Revenue Service
1111 Constitution Avenue, NW
SE:LB:TTPO:APMA:NCA534-01
Washington, DC 20224
(Attention: APMA)
The IRS will send notices to:
#NAME AND ADDRESS
(phone: #PHONE)
The IRS also will send notices to, if applicable:
[] #REPRESENTATIVE’S NAME AND ADDRESS
(phone: #PHONE)
provided that a valid IRS Form 2848 “Power of Attorney and Declaration of Representative” for that person was included in the
most recent Annual Report (or, if no Annual Report has been filed, was included in the APA Request).

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17. U.S. Effective Date and Counterparts. This APA is effective starting on the date, or later date of the dates, upon which all Parties
execute this APA (“U.S. Effective Date”). The Parties may execute this APA in counterparts, with each counterpart constituting
an original.
WITNESS,
The Parties have executed this APA on the dates below.
#SIGNATORY NAME IN BOLD FACE BLOCK CAPITAL LETTERS
By:

__________________________Date: _________________, 20____
#NAME
#TITLE

INTERNAL REVENUE SERVICE
By:

__________________________Date: _________________, 20____
Nicole L. Welch
Acting Director, Advance Pricing and Mutual Agreement Program

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APPENDIX A
COVERED ENTITIES, TERM, COVERED ISSUE(S), COVERED METHOD(S), INCOME REPORTING,
CONFORMING ADJUSTMENTS AND REPATRITION OF FUNDS,
CERTAIN SUBSEQUENT ADJUSTMENTS,
AND DEFINITIONS
Section 1 of this Appendix lists the Covered Entities. Section 2 defines the APA Term, APA Tax Years, and APA Covered Years.
Section 3 describes the Covered Issue(s). Section 4 describes the Covered Method applicable to each Covered Issue.
Section 5 describes the application of the Covered Method(s) to income reporting and the possible need for an APA Primary Adjustment under one or more Covered Methods. Section 6 addresses conforming adjustments and repatriation of funds following APA
Primary Adjustments.
Section 7 provides definitions that apply both to this Appendix and to the APA as a whole. The definitions table is based on a standard, inclusive model, and thus may include terms not used in this APA.
1.

Covered Entities
The U.S. Covered Entity(ies) are:
#LIST OF EACH U.S. ENTITY INVOLVED IN ONE OR MORE COVERED ISSUE(S), AND ALSO (LISTED FIRST)
ANY CONSOLIDATED RETURN PARENT FOR ANY SUCH ENTITY. FOR EACH ENTITY, NAME, ADDRESS,
PHONE, AND EIN.

The term “U.S. Taxpayer” includes collectively all U.S. Covered Entities and any other entities that are in a consolidated return
group with a U.S. Covered Entity.
The Non-U.S. Covered Entity(ies) are:
# LIST OF EACH NON-U.S. ENTITY INVOLVED IN ONE OR MORE COVERED ISSUE(S), AND ALSO (LISTED
FIRST) ANY COMMON TAX REPORTING PARENT FOR ANY SUCH ENTITY. FOR EACH ENTITY, NAME, ADDRESS, AND PHONE.
The term “Non-U.S. Taxpayer” includes collectively all Non-U.S. Covered Entities and any other entities that are in a common tax
reporting group with a Non-U.S. Covered Entity.
The term “Covered Entities” includes both the U.S. Covered Entities and the Non-U.S. Covered Entities.
2.

APA Term, APA Tax Years, and APA Covered Years
The APA applies to the period from #DATE to #DATE, inclusive (the “APA Term”).
[]

The APA Term does not include a Rollback.

[]

The APA Term includes a Rollback, which covers from #DATE to #DATE, inclusive (the “Rollback Period”).

A tax year of U.S. Taxpayer that is wholly or partly contained in the APA Term is called an “APA Tax Year.” For a particular APA
Tax Year, the portion of such APA Tax Year that is contained in the APA Term is called an “APA Covered Year.” Such APA Tax Year
and APA Covered Year are said to “correspond” to each other or to be “corresponding.”
3.

Covered Issue(s)
The Covered Issue(s) are as described below.
Covered Issue 1:
#DESCRIPTION OF COVERED ISSUE.

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4.

Covered Method(s)

Each Covered Method applies to one or more Covered Issues. A Covered Method and the Covered Issue(s) to which the Covered
Method applies are said to “correspond,” or to be “corresponding”.
The Covered Methods are summarized in the following table and are described in detail below. In case of conflict with this table,
the detailed descriptions of the Covered Methods below, and the descriptions in section 3 above of the Covered Issues, control.
Covered Method
Number

Applies to Covered
Issues Number(s)

Summary Description of
Corresponding Covered
Issues

Type of Method;
Results Tested

Point or
Range

Testing Frequency
and Periods

1
This Appendix A uses the term “Tested Party.” When applied in the context of methods that consider, or test, data from only one
party to a transaction, this term is similar in concept to the term “tested party” as discussed in the OECD Guidelines paragraphs 3.18
and 3.19, and as defined in the U.S. Treasury Regulations section 1.482-5(b)(2). However, some methods consider, or test, data from
both parties to a transaction, where there is no singular “tested” party. Even in applying such methods, however, it is typically the
case that one particular party’s results are formally tested for compliance with the method. For purposes of this template, in such
circumstances, the party whose results are formally tested in applying any particular method is the “Tested Party”, even if that party
is not strictly a “tested party” as discussed in the OECD Guidelines paragraphs 3.18 and 3.19, or as defined in the U.S. Treasury
Regulations section 1.482-5(b)(2).
Covered Method for Covered Issue 1:
a.

Tested Party

The Tested Party is #TESTED PARTY.
b. Financial Results Tested (Type of Method)
[]

[]

[]

The Covered Method is an implementation of the comparable uncontrolled price method under the OECD Guidelines and
of the comparable uncontrolled price method under the U.S. Treasury Regulations. The Tested Party’s financial results to be
tested are:
[]

per unit price paid, defined as the total amount paid for #DESCRIPTION OF GOODS divided by the number of
#DESCRIPTION OF A UNIT OF GOODS purchased.

[]

per unit price received, defined as the total amount received for #DESCRIPTION OF GOODS divided by the number
of #DESCRIPTION OF A UNIT OF GOODS sold.

The Covered Method is an implementation of the comparable uncontrolled price method under the OECD Guidelines and of
the comparable uncontrolled services price method under the U.S. Treasury Regulations. The Tested Party’s financial results
to be tested are:
[]

per unit price paid, defined as the total amount paid for #DESCRIPTION OF SERVICES divided by the number of
#DESCRIPTION OF A UNIT OF SERVICES received.

[]

per unit price received, defined as the total amount received for #DESCRIPTION OF SERVICES divided by the number
of #DESCRIPTION OF A UNIT OF SERVICES provided.

The Covered Method is an implementation of the comparable uncontrolled price method under the OECD Guidelines and
of the comparable uncontrolled transaction method under the U.S. Treasury Regulations. The Tested Party’s financial results
to be tested are the royalty paid for the license of #DESCRIPTION OF LICENSED INTANGIBLE PROPERTY divided by
the Tested Party’s:
[]

sales revenue from sales of #DESCRIPTION OF GOODS/SERVICES.

[]

#OTHER ROYALTY BASE.

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[]

The Covered Method is an implementation of the comparable uncontrolled price method under the OECD Guidelines and
of the acquisition price method under the U.S. Treasury Regulations. The Tested Party’s financial results to be tested are
described in subsection (c) below.

[]

The Covered Method is an implementation of the comparable uncontrolled price method under the OECD Guidelines and
of the market capitalization method under the U.S. Treasury Regulations. The Tested Party’s financial results to be tested are
described in subsection (c) below.

[]

The Covered Method is an implementation of the resale price method under the OECD Guidelines and of the resale price
method under the U.S. Treasury Regulations. The Tested Party’s financial results to be tested are the gross profit margin from
the sale of #DESCRIPTION OF GOODS.

[]

The Covered Method is an implementation of the resale price method under the OECD Guidelines and of the gross services
margin method under the U.S. Treasury Regulations. The Tested Party’s financial results to be tested are the gross services
margin from the provision of #DESCRIPTION OF SERVICES.

[]

The Covered Method is an implementation of the cost plus method under the OECD Guidelines and of the cost plus method
under the U.S. Treasury Regulations. The Tested Party’s financial results to be tested are the gross profit markup.

[]

The Covered Method is an implementation of the cost plus method under the OECD Guidelines and of the cost of services
plus method under the U.S. Treasury Regulations. The Tested Party’s financial results to be tested are the gross services
profit markup from the provision of #DESCRIPTION OF SERVICES.

[]

The Covered Method is based on the principles of the low value-adding intra-group services approach under the OECD
Guidelines and of the services cost method under the U.S. Treasury Regulations. The Tested Party’s financial results to be
tested are the markup on total costs for providing #DESCRIPTION OF SERVICES.

[]

The Covered Method is an implementation of the transactional net margin method under the OECD Guidelines and of the
comparable profits method under the U.S. Treasury Regulations. The Tested Party’s financial results to be tested, as reflected
in its net profit indicator (per OECD Guidelines) or profit level indicator (per U.S. Treasury Regulations), are its:
[]

operating margin.

[]

markup on total costs.

[]

Berry ratio.

[]

return on operating assets.

[]

return on invested capital.

[]* #OTHER NET PROFIT INDICATOR OR PROFIT LEVEL INDICATOR, WITH DEFINITION.
[]

The Covered Method is an implementation of the profit split (residual analysis) method under the OECD Guidelines and
of the residual profit split method under the U.S. Treasury Regulations. The Tested Party’s financial results to be tested are
described in subsection (c) below.

[]

The Covered Method is an implementation of the profit split (contribution analysis) method under the OECD Guidelines and
of the comparable profit split method under the U.S. Treasury Regulations. The Tested Party’s financial results to be tested
are described in subsection (c) below.

[]

The Covered Method is an implementation of an income based valuation technique as referenced in paragraph 6.153 of the
OECD Guidelines and of the income method under the U.S. Treasury Regulations. The Tested Party’s financial results to be
tested are described in subsection (c) below.

[]

The Covered Method is an implementation of (i) a sharing of the cost of current contributions in proportion to overall
expected benefits, within a cost contribution arrangement under the OECD Guidelines, and (ii) a sharing of intangible

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development costs in proportion to reasonably anticipated benefits, within a cost sharing arrangement under the U.S. Treasury Regulations. The Tested Party’s financial results to be tested are described in subsection (c) below.
[] The Covered Method is a method that is not specified under the OECD Guidelines and not specified under the U.S. Treasury
Regulations. The Tested Party’s financial results to be tested are described in subsection (c) below.
Such financial results are determined according to the Applicable Accounting Standard, with the proviso that in determining such
results, accounting principles and conventions that are generally accepted in the trade or industry must be used.
Such financial results are tested against a point or range as described below. The test is carried out with a frequency, and for certain time periods, as described below. If and when these financial results do not satisfy the test, they must be adjusted as described in
section 5 of this Appendix A.
c. Testing of Financial Results Against a Point or Range
The Tested Party’s financial results are tested as follows:
[]

The financial results must equal #X.

[]

The financial results must be within an Arm’s Length Range.
[]

[]

[]

[]

[]

The Arm’s Length Range is from #X to #Y inclusive.
[]

This Arm’s Length Range has an associated Median value of #Z.

[]

This Arm’s Length Range has no associated Median value.

Two Arm’s Length Ranges apply. The first is from #W to #X inclusive and applies to the annual test described in subsection (d) below. The second is from #Y to #Z inclusive and applies to the term test described in subsection (d) below.
[]

The first Arm’s Length Range has an associated Median value of #P, and the second Arm’s Length Range has an
associated Median value of #Q.

[]

These Arm’s Length Ranges have no associated Median value.

Two Arm’s Length Ranges apply. The first is from #W to #X inclusive and applies to the subterm test described in
subsection (d) below. The second is from #Y to #Z inclusive and applies to the annual test described in subsection (d)
below.
[]

The first Arm’s Length Range has an associated Median value of #P, and the second Arm’s Length Range has an
associated Median value of #Q.

[]

These Arm’s Length Ranges have no associated Median value.

Two Arm’s Length Ranges apply. The first is from #W to #X inclusive and applies to the test for the first subterm
described in subsection (d) below. The second is from #Y to #Z inclusive and applies to the test for the second subterm
described in subsection (d) below.
[]

The first Arm’s Length Range has an associated Median value of #P, and the second Arm’s Length Range has an
associated Median value of #Q.

[]

These Arm’s Length Ranges have no associated Median value.

#OTHER DESCRIPTION, FOR EXAMPLE THE EVALUATION AND TESTING MECHANICS FOR A PROFIT SPLIT,
AN INCOME METHOD, AN UNSPECIFIED METHOD, OR A SHARING OF COSTS UNDER A COST CONTRIBUTION ARRANGMENT/COST SHARING ARRANGEMENT.

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d. Testing Frequency and Testing Periods
The Tested Party’s financial results are tested as of certain APA Covered Years, and for certain time periods, as follows:
[]

The results are tested annually, meaning that they are tested as of each APA Covered Year, for a period consisting of that APA
Covered Year.
[]

There is no additional term test.

[]

There is an additional term test. For this test, the results are tested as of the Last Effective APA Covered Year, for the
period consisting of the Last Effective APA Covered Year and all prior APA Covered Years.

The application of the annual test and the application of the additional term test are coordinated as described in section 5 of
this Appendix A.
[]* The results are tested on a term basis, meaning that they are tested only once, as of the Last Effective APA Covered Year, for
a period consisting of the Last Effective APA Covered Year and all prior APA Covered Years.
[]* The results are tested on the basis of two subterms. For this purpose, the APA Term is divided into two subterms. The first
subterm consists of all APA Covered Years ending on or before #DATE, and the second subterm consists of all other APA
Covered Years. For each subterm, the results are tested as of the Last Effective APA Subterm Covered Year, for a period
consisting of the Last Effective APA Subterm Covered Year and all prior APA Covered Years in the subterm.
[]* The results are tested on a subterm basis for all APA Covered Years ending on or before #DATE (the “subterm”), and are
tested annually for each other APA Covered Year, as follows:
The results are tested as of the Last Effective APA Subterm Covered Year, for a period consisting of the Last Effective APA Subterm Covered Year and all prior APA Covered Years in the subterm.
The results are tested as of each APA Covered Year that is not in the subterm, for a period consisting of that APA Covered Year.
[]* The results are tested on a cumulative basis, meaning that (except as provided in the following sentence) they are not tested
as of the first APA Covered Year but they are tested as of each other particular APA Covered Year for a period consisting of
such particular APA Covered Year and all prior APA Covered Years. However, if the Last Effective APA Covered Year is
the first APA Covered Year, then the results are tested as of the first APA Covered Year, for a period consisting of such APA
Covered Year.
[]* The results are tested on a three-year rolling average basis, meaning that the results are tested as of each APA Covered Year,
for a period consisting of the APA Tax Year corresponding to the APA Covered Year (but excluding any portion of that APA
Tax Year that is after the APA Term), and the Tested Party’s two preceding tax years.
e. Other Provisions
The Tested Party’s financial results, to be tested as described above, are for:
[]

The Tested Party as a whole.

[]

Only a segment of the Tested Party’s activity. #DETAILED DESCRIPTION OF THE SEGMENT AND OF THE ALLOCATION AND APPORTIONMENT METHODS USED, INCLUDING ANY APPLICABLE FORMULAS AND DEFINITIONS OF QUANTITIES USED IN THOSE FORMULAS. THIS DESCRIPTION SHOULD BE DETAILED ENOUGH
TO ENABLE A STRAIGHTFORWARD VERIFICATION OF COMPLIANCE BY THE IRS EXAMINATION TEAM.

When the Tested Party’s financial results are tested as of a given APA Covered Year, those results shall reflect, to the extent relevant, any APA Primary Adjustment for this Covered Method made under section 5 of this Appendix A for the APA Tax Year corresponding to any prior APA Covered Year.

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For this Covered Method, if applicable:
[]* For APA Covered Years ending on or before #DATE, it is agreed that this Covered Method, yields financial results as shown
below, and that any APA Primary Adjustments under section 5 of this Appendix A are as shown below. #TEXT AND/OR
TABLES SHOWING THE FINANCIAL RESULTS, THE TESTING OF THOSE FINANCIAL RESULTS UNDER THE
COVERED METHOD, AND ANY RESULTING APA PRIMARY ADJUSTMENTS.
For this Covered Method, if applicable:

5.

[]

This Covered Method addresses the pricing for a transfer of intangible property (which does not constitute a platform contribution transaction as defined in U.S. Treasury Regulations section 1.482-7(b)(1)(ii)) within the meaning of U.S. Treasury
Regulations section 1.482-4. That pricing will not be subject to periodic adjustments by the IRS, during or after the APA
Term, under U.S. Treasury Regulations section 1.482-4(f)(2) or (6).

[]

This Covered Method addresses the pricing for a platform contribution transaction (“PCT”). That PCT will not be treated
as a Trigger PCT within the meaning of U.S. Treasury Regulations section 1.482-7(i)(6)(i) for purposes of making periodic
adjustments, during or after the APA Term, under U.S. Treasury Regulations section 1.482-7(i)(6).

Application of Covered Method(s) to Income Reporting
For each APA Tax Year, and for each Covered Method and corresponding Covered Issue(s), the amounts reported by U.S.
Taxpayer and Non-U.S. Taxpayer for income tax purposes under the laws of the United States and #COUNTRY(IES) must
clearly reflect the Tested Party’s actual transactions, allocations, and/or recordkeeping, as applicable, that relate to such Covered
Issue(s), adjusted as necessary to conform with section 4 of this Appendix A. Accordingly, for each particular APA Tax Year and
corresponding APA Covered Year, and for each such Covered Method:
i.

If the Tested Party’s financial results are tested as of such APA Covered Year and do not conform with section 4 of this
Appendix A, then the tax reporting for such APA Tax Year must clearly reflect an adjustment that brings such results into
conformance (an “APA Primary Adjustment”). If section 4 of this Appendix A specifies conformance to an Arm’s Length
Range, then the adjustment shall be to:
[]

the Median.

[]* the near edge of the Arm’s Length Range.
[]* the Median for Covered Issues #SPECIFY WHICH ONES, and the near edge of the Arm’s Length Range for Covered
Issues #SPECIFY WHICH ONES.
ii. If an adjustment is not required under paragraph (i) above, then the tax reporting must clearly reflect the Tested Party’s
financial results, with no adjustment. In this case there is no APA Primary Adjustment.
iii. If both an annual test and an additional term test apply under such Covered Method, and such APA Covered Year is the Last
Effective APA Covered Year, so that as of such APA Covered Year the Tested Party’s financial results are tested under both
the annual test and the term test, then paragraphs (i) and (ii) above are modified by this paragraph (iii), which coordinates
the application of both tests. As explained in more detail below, the annual test is applied first, followed by the term test.
Specifically, the need for and amount of any APA Primary Adjustment for such APA Covered Year will be determined as
follows:
A. First apply paragraphs (i) and (ii) above under the assumption that only the annual test applies. Any required adjustment
will be referred to as the “annual adjustment” rather than an “APA Primary Adjustment.” If there is no required adjustment, the annual adjustment is considered to be zero.
B. Next, apply paragraphs (i) and (ii) above to the Tested Party’s financial results as adjusted by any nonzero annual adjustment, under the assumption that only the term test applies to those results. Any required adjustment under this application of paragraphs (i) and (ii) will be referred to as the “term adjustment” rather than an “APA Primary Adjustment.” If
there is no such required adjustment, the term adjustment is considered to be zero.

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C. Add the annual adjustment and term adjustment, taking account of the magnitude and (if nonzero) direction of each. If
this sum is zero, there is no APA Primary Adjustment for such APA Covered Year. If this sum is nonzero, this sum gives
the magnitude and direction of the APA Primary Adjustment for such APA Covered Year. Any APA Primary Adjustment,
or the lack of an APA Primary Adjustment, must be clearly reflected in the tax reporting for such APA Tax Year (see
paragraphs (i) and (ii) above).
iv. If this APA is unilateral and such APA Covered Year is within the Rollback Period, then:
[]

Paragraphs (i)-(iii) above notwithstanding, an APA Primary Adjustment will not be made if that APA Primary Adjustment would decrease the income of U.S. Taxpayer for such APA Tax Year.

[]* Paragraphs (i)-(iii) above apply without modification.
If indicated, the above provisions on APA Primary Adjustments are modified as follows:
[]* Any APA Primary Adjustment that would be made under the above provisions for an APA Tax Year ending before #DATE
will instead be made for the APA Tax Year ending #THE SAME DATE (the “Telescoping Year”). For each particular Covered Method, all APA Primary Adjustments that are made for the Telescoping Year (including any APA Primary Adjustments
that are moved to the Telescoping Year as just described, as well as any APA Primary Adjustment originally made for the
Telescoping Year) are netted.
[]

The foregoing provision applies without modification.

[]

The foregoing provision applies with the following modification. An APA Primary Adjustment that is thus moved from
a particular APA Tax Year (the “Original Year”) to the Telescoping Year shall be increased in amount to reflect the time
value of money. That increase will consist of multiplication by a factor that is an annual rate raised to a power. The
annual rate is 1.#XY. The power is the quotient of (i) the average of the number of months by which the end of the Telescoping Year is later than the end of the Original Year, and the number of months by which the start of the Telescoping
Year is later than the start of the Original Year (with any fractions of months rounded to whole months), (ii) divided by
twelve.

For U.S. tax purposes, the generally applicable Code rules will apply with respect to APA Primary Adjustments, except as otherwise provided in Rev. Proc. 2015-41 or in this APA.
6.

Conforming Adjustments and Repatriation of Funds
The provisions in this section 6 apply to “Repatriable Issues,” which are Covered Issues that concern transactions between associated enterprises that fall under Article 9 of the OECD Model Tax Convention. Such transactions correspond to transactions that
under U.S. law are subject to application of Code section 482, as modified by any applicable treaty provision.
If the application of a Covered Method to a Repatriable Issue requires an APA Primary Adjustment under section 5 of this Appendix A for a given APA Tax Year, then for U.S. tax purposes there generally must be a corresponding conforming adjustment as
specified in U.S. Treasury Regulations section 1.482-1(g)(3) as amplified by Rev. Proc. 99-32 or any successor revenue procedure. However, for this purpose, all APA Primary Adjustments for such APA Tax Year arising from the application of a Covered
Method to a Repatriable Issue are first netted to yield a net APA Primary Adjustment for such APA Tax Year. Only if the net APA
Primary Adjustment is nonzero is a conforming adjustment required.
For each APA Tax Year with a nonzero net APA Primary Adjustment, for U.S. tax purposes the conforming adjustment will be
accomplished in the following steps:
i.

The conforming adjustment will be accomplished between #U.S. ENTITY and #NON-U.S. ENTITY, which will be referred
to here as “U.S. Entity” and “Non-U.S. Entity”, respectively. An intercompany payable will be established between U.S.
Entity and Non-U.S. Entity in the amount and direction of the net APA Primary Adjustment, as of the last day of such APA
Tax Year. This payable will be denominated in #CURRENCY. The payable will be treated as indebtedness for all U.S. federal tax purposes; provided, however, that the payable will not be treated as indebtedness for purposes of Code section 956
if the payable is satisfied within 90 days of the close of the APA Tax Year with respect to which it is established.

ii. []

The intercompany payable will bear interest at an arm’s length rate.

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[]

Such arm’s length rate is not specified in this APA and will be determined under applicable legal principles.

[]

Such arm’s length rate is determined as follows. #DESCRIPTION OF ARM’S LENGTH RATE (FOR EXAMPLE,
FOR A U.S. DOLLAR PAYABLE, A CERTAIN APPLICABLE FEDERAL RATE UNDER U.S. TREASURY REGULATIONS SECTION 1.482-2(a)(2)(iii)(C)).

[]

This APA is bilateral or multilateral. As agreed between the United States and #COUNTRY(IES), the intercompany
payable will not bear interest.

iii. The intercompany payable must be satisfied, in a manner permitted under Rev. Proc. 99-32 or any successor revenue procedure, within 90 days of the later of (1) the date for timely filing (with extensions) of the U.S. return for such APA Tax Year,
and (2) the APA’s U.S. Effective Date. If any amount of the intercompany payable is not otherwise so satisfied within that
90-day period, such amount, on the last day of such period, will be deemed (1) to be paid between U.S. Entity and Non-U.S.
Entity in satisfaction of the payable, and (2) to be paid (directly or indirectly, as specified below) between U.S. Entity and
Non-U.S. Entity in the opposite direction (that is, from the deemed recipient of the intercompany payable to the deemed
payor of the intercompany payable). These two deemed payments on the same day will cancel and thus yield no net cash
flow between these two entities. The second of these deemed payments will be referred to as the “reverse payment.” The
reverse payment will be deemed to be as follows:
A. If the net APA Primary Adjustment increases U.S. income:
[]

The reverse payment will be deemed to be a contribution to capital from U.S. Entity to Non-U.S. Entity, either directly,
or indirectly through the corporate chain, as the case may be.

[]

The reverse payment will be deemed to be a distribution from U.S. Entity to Non-U.S. Entity, either directly, or indirectly through the corporate chain, as the case may be.

[]

The reverse payment will be deemed to be a distribution from U.S. Entity to #COMMON PARENT, either directly, or
indirectly through the corporate chain, as the case may be, followed by a contribution by #COMMON PARENT to nonU.S. Entity, either directly or indirectly through the corporate chain, as the case may be.

B. If the net APA Primary Adjustment decreases U.S. income:
[]

The reverse payment will be deemed to be a contribution to capital from non-U.S. Entity to U.S. Entity, either directly,
or indirectly through the corporate chain, as the case may be.

[]

The reverse payment will be deemed to be a distribution from non-U.S. Entity to U.S. Entity, either directly, or indirectly through the corporate chain, as the case may be.

[]

The reverse payment will be deemed to be a distribution from non-U.S. Entity to #COMMON PARENT, either directly,
or indirectly through the corporate chain, as the case may be, followed by a contribution by #COMMON PARENT to
U.S. Entity, either directly, or indirectly through the corporate chain, as the case may be.

This situation is generally described in paragraph 4.66 of the OECD Guidelines, and in U.S. Treasury Regulations section 1.4821(g) and Rev. Proc. 99-32.
In this APA, if applicable:
[]* For the APA Tax Year(s) ending on or before #DATE, it is agreed that the net APA Primary Adjustment(s), if any, from the
application of the Covered Methods are as follows: #FOR EACH SUCH APA TAX YEAR, DESCRIPTION OF WHETHER
THERE IS A NET APA PRIMARY ADJUSTMENT, AND IF SO THE AMOUNT AND DIRECTION. IF THERE IS MORE
THAN ONE COVERED METHOD FOR A REPATRIABLE ISSUE, ALSO PROVIDE A TABLE SHOWING THE DERIVATION, FOR EACH SUCH APA TAX YEAR, OF THE NET APA PRIMARY ADJUSTMENT FROM THE APA PRIMARY ADJUSTMENT (OR LACK OF ONE) FOR EACH SUCH COVERED METHOD. #FOR ANY SUCH NET APA
PRIMARY ADJUSTMENTS, DESCRIPTION OF THE MEANS BY WHICH THE C

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Source: Frix Law Library, https://www.frixlaw.com/law-library/documents/agency%3Airs%3A17cc6f3456a2e39d. Public record. Not legal advice.
