2022 Virginia Schedule of Related Entity  
Schedule 500AB Add Backs and Exceptions *VA0IAB122888*

Name as shown on Virginia return   _________________________________________________   FEIN   _______________________
Number of related entities   _______________

Part I – Taxpayer’s Payments Made to Related Entities
Jurisdiction (State or Country) Amount Paid to Related Entity For
Royalties or  
Where  Of Commercial Other Intangible  
Name of Related Entity FEIN Organized Domicile Interest Expenses
1. 1a .00 1b .00
2. 2a .00 2b .00
3. 3a .00 3b .00
4. Total Interest / Intangible Expense Payments. 4a .00 4b .00
Deduct Intangible Expense Payments Qualifying for Exceptions. See Part II, below.
5. Exception 1 5 .00
6. Exception 2 6 .00
7. Exception 3 7 .00
8. Total Exception Amount – Add Lines 5, 6, & 7. Enter here and on Form 500, Question A. 8 .00
9. Net Addition – Royalties or Other Intangibles – Line 4b minus Line 8. 9 .00
10. Net Addition of Interest and Royalties – Enter the total of Lines 4a plus Line 9 here and on Schedule 500ADJ, Section A, Line 3. 10 .00

Part II – Exceptions Applicable to Royalties
Exception 1 (Subject to tax): For each related entity for which the taxpayer claims an exception, identify all states and foreign countries 
in which the related entity paid a tax measured by net income or capital and enclose a copy of the tax returns filed (schedules and 
supplemental forms may be omitted). Show the portion of the tax paid by the related entity on its separate return that is attributed to the 
royalties and other expenses related to intangible property. If the related entity filed a consolidated or combined return in the other state 
or foreign country with the taxpayer, then the recipient’s income and taxpayer’s deduction offset each other and no tax is deemed paid. If 
more space is needed, enclose a separate sheet.
Tax Paid on the Royalties & Other 
List Each Jurisdiction Royalties & Other Intangible Income on Total Qualifying 
in Which Tax Paid Type of Tax Paid Intangible Income Which Tax Paid Royalties
Name of Related Entity
.00 .00
.00 .00
Gross Revenues of Related Entity
.00 .00
.00 .00 .00
Name of Related Entity
.00 .00
.00 .00
Gross Revenues of Related Entity
.00 .00
.00 .00 .00
Name of Related Entity
.00 .00
Rev. 07/22 .00 .00
Gross Revenues of Related Entity
.00 .00
.00 .00 .00
2601022-W Name of Related Entity
.00 .00
.00 .00
Gross Revenues of Related Entity
.00 .00
.00 .00 .00
Va. Dept. of Taxation Total Royalties Qualifying for Exception 1 (Also enter the amount in Part I, Line 5). .00
Enclose Schedule 500AB with Your Virginia Corporation Return, Form 500.

2022 Virginia                      Schedule of Related Entity  
Schedule 500AB                     Add Backs and Exceptions                            *VA0IAB222888*
Page 2

Name as shown on Virginia return  ____________________________________ FEIN  _____________________________________

Exception 2 (One-Third Revenue): For each related entity for which the taxpayer claims an exception, identify the three unrelated parties 
paying the highest amount of royalties to the related entity. Enter the amount of royalties that the taxpayer paid to the related entity that 
were made at rates and terms comparable to the agreements made with the unrelated parties. If the total royalties and other expenses 
related to intangible property paid to unrelated parties do not equal or exceed one-third of the gross revenues of the related entity, the 
payments to that related entity do not qualify for the exception. If more space is needed, enclose a separate sheet.
                                                                                       Royalties Paid by            Total Qualifying 
                                           Three Unrelated Parties Paying Royalties    Unrelated Party              Royalties
Name of Related Entity           1                                                     .00
                                 2                                                     .00
Gross Revenues of Related Entity 3                                                     .00
                                 4  All Other Unrelated Parties Paying Royalties       .00                                      .00
Name of Related Entity           1                                                     .00
                                 2                                                     .00
Gross Revenues of Related Entity 3                                                     .00
                                 4  All Other Unrelated Parties Paying Royalties       .00                                      .00
Name of Related Entity           1                                                     .00
                                 2                                                     .00
Gross Revenues of Related Entity 3                                                     .00
                                 4  All Other Unrelated Parties Paying Royalties       .00                                      .00
Name of Related Entity           1                                                     .00
                                 2                                                     .00
Gross Revenues of Related Entity 3                                                     .00
                                 4  All Other Unrelated Parties Paying Royalties       .00                                      .00
Total Royalties Qualifying for Exception 2 (Also enter the amount in Part I, Line 6 ).                                          .00
Exception 3 (Conduit):  For each related entity for which the taxpayer claims an exception, identify the unrelated party to whom the 
related entity paid a royalty for the same intangible property licensed to the taxpayer, and describe the purpose of the licensing transactions 
between the parties in order to demonstrate that the licensing transaction did not have as its principal purpose the avoidance of tax. Enter 
the amount of royalties that the related entity paid to the unrelated party. If more space is needed, enclose a separate sheet. 
                                                                                                                    Total Qualifying 
                                                                                                                    Royalties
Name of Related Entity                     Name of Unrelated Entity

Purpose of Transaction
                                                                                                                                .00
Name of Related Entity                     Name of Unrelated Entity

Purpose of Transaction
                                                                                                                                .00
Name of Related Entity                     Name of Unrelated Entity

Purpose of Transaction
                                                                                                                                .00
Name of Related Entity                     Name of Unrelated Entity

Purpose of Transaction
                                                                                                                                .00
Total Royalties Qualifying for Exception 3 (Also enter the amount in Part I, Line 7.)                                           .00
                      Enclose Schedule 500AB with Your Virginia Corporation Return, Form 500.