Form 5472 Example: Filled-In Sample With Line-by-Line Annotations

To make the example concrete, we use a realistic, common fact pattern. Every value below is illustrative, but the structure matches what a typical first-year, foreign-owned single-member LLC actually files.

With these facts, only one reportable transaction exists — the capital contribution — which is the most common situation by far. The deep dive on why funding the LLC is reportable is at /capital-contribution-form-5472/.

Part I is the “who is filing” block — it describes the US LLC. You complete the identity lines exactly as they appear on the LLC’s formation documents and EIN letter.

Note the LLC writes its ownEIN here. The owner’s identifying number is a separate matter handled in Part II.

Part II describes the foreign owner — the related party on the other side of the reportable transaction. Because a non-resident individual usually has no US taxpayer identification number, this is where the reference ID number appears.

The reference ID number is a unique identifier you create when the owner has no US number. How to construct and assign it is explained in full at /form-5472-reference-id-number/.

These parts carry the actual money. Part III identifies whom the transactions were with; Parts V and VI record what those transactions were. In our example there is exactly one: the owner’s $10,000 capital contribution.

Because Maria paid herself nothing and the LLC paid her nothing, Part IV (monetary transactions for services, rent, royalties) stays empty, and the advanced parts for large multinationals do not apply. For a fuller list of what would go in each part if there were more transactions, see /form-5472-reportable-transaction/.

Form 5472 cannot go to the IRS by itself — it must ride on a return. For a disregarded entity, that return is a pro forma Form 1120: a shell you complete only at the top. In the example, the pro forma 1120 carries Silva Trading LLC’s identity and nothing else.

How the example package is filed

The completed package — one pro forma 1120 with one Form 5472 attached — is mailed to P.O. Box 149342, Austin, TX 78714-9342, or faxed to 855-887-7737. It cannot be e-filed. Keep the certified-mail receipt or fax confirmation as proof of the filing date. The complete step-by-step is in /how-to-file-form-5472/.

This example is meant to demystify Form 5472 — to show that, for a simple LLC with one capital contribution, the form is not mysterious. But understanding the form and filing it without error are different things. The penalty for a substantially incomplete or incorrect Form 5472 is the same $25,000 as for not filing at all, and the most common mistakes are subtle: a missing reference ID, an omitted mid-year loan, the wrong filing method, or a blank signature.

The cost-benefit is stark. A self-prepared form that looks right but omits one reportable transaction can be treated as not filed. For a flat $299, a specialist captures every transaction, assembles the pro forma 1120 correctly, and files it the accepted way. Use the example to learn what the form contains; let a specialist carry the penalty risk. Note that form5472.tax does not represent clients before the IRS — our service is preparing and filing the return correctly so a penalty never arises.

The first example covered a clean capital contribution. A loan is the next most common fact pattern, and it changes which line carries the money. When Maria wires $5,000 to the LLC as a loan rather than as equity, the substance is different — the LLC owes her the money back — and Form 5472 treats it as its own reportable transaction. All values here remain illustrative and are not real IRS data.

Where the loan shows up

The loan does not go in Part IV (which is reserved for monetary transactions such as service payments, rent, royalties, and interest the LLC actually pays). Instead, amounts loaned to the reporting entity by the related party are summarized in Part VIas non-monetary or other reportable amounts. Maria’s name, Brazil address, and the same reference ID (98-7654321-001) carry over from Parts II and III unchanged.

If the LLC later pays Maria interest on that loan, the interest is a separate Part IV item. The full taxonomy of which transactions land where is at /form-5472-reportable-transaction/, and the funding-versus-loan distinction is covered at /capital-contribution-form-5472/.

This example introduces Part IV, which the first two examples left blank. Part IV captures monetary transactions between the LLC and the related party — service payments, rent, royalties, commissions, and interest. When the LLC pays its owner $8,000 for services, that cash movement is exactly what Part IV exists to report. Every figure here is illustrative.

Reading Part IV in the example

Part IV has paired columns — amounts the LLC paid to the related party and amounts it received from them. Maria’s $8,000service fee is an amount the LLC paid, so it lands on the “paid” side. The total of Part IV (and Part VI) flows up to the “total value of gross payments” figure summarized on the Part I block.

Note that paying the owner for services has US tax consequences beyond Form 5472 — it can create US-source income questions and withholding considerations — so the dollar figure on Form 5472 is only part of the picture. The line-by-line walkthrough of Part IV is in /form-5472-instructions/.

Real years are rarely a single clean transaction. This example shows how one Form 5472 absorbs several related-party transactions in the same tax year — you do not file a separate form per transaction. All amounts below are illustrative.

Mapping each transaction to its part

The key skill is classification: deciding which part each transaction belongs to. A capital contribution and a distribution of capital are both summarized in the “other amounts” block (Part VI); a loan to the LLC is also a Part VI item; only a payment for services, rent, royalties, or interest would move into Part IV. Because nothing in this example is a service-type payment, Part IV stays empty even though the year was busy.

The danger in a multi-transaction year is omission: forgetting the mid-year loan or the small distribution. A Form 5472 that omits a reportable transaction can be treated as not filed, exposing the LLC to the full $25,000 penalty. The complete list of what counts is at /form-5472-reportable-transaction/.

Founders often expect the pro forma 1120 to look like a full corporate tax return. It does not. The value of comparing a blank form to the completed example is seeing how little changes — only the identifying header is filled, because a disregarded entity reports no entity-level income on the 1120 itself. Form 5472 carries the substance; the 1120 is just the cover it rides on. The EIN and figures below are illustrative.

Side-by-side, line by line

The one line people forget on the completed version is the signature — an unsigned 1120 can invalidate the whole package. The end-to-end assembly is detailed in /how-to-file-form-5472/.

Learning from a good example is only half the lesson — knowing what makes a bad example dangerous is the other half. The errors below recur constantly in self-prepared filings, and each one is individually capable of triggering the penalty.

The penalty for a substantially incomplete or incorrect Form 5472 is the same $25,000 as for not filing at all, assessed per form, per year. Because there is no statute of limitations on an unfiled or invalid form, an error can surface years later. Whether you must file at all is covered at /do-i-need-to-file/.

A short final review catches most of the errors above. Run this checklist against the completed example before the package leaves your hands. It maps directly to Maria’s $10,000 capital-contribution filing, and the same checklist scales to the multi-transaction examples.

Keep the proof of filing indefinitely — because the penalty has no statute of limitations, your certified-mail receipt or fax confirmation is the only evidence of the filing date. For a flat $299, we run this checklist for you and file the package the accepted way. The full procedure is at /how-to-file-form-5472/, and the form’s purpose is explained at /what-is-form-5472/ and /pro-forma-1120/.