PART IV - FILING OF CERTAIN FOREIGN FORMS |
DISCLOSURE STATEMENT RELATED TO FORMS 5713: FORM 5713 HAS BEEN FILED BY THE FOLLOWING MEMBERS OF THE CONTROLLED GROUP: MAYO CLINIC (EIN: 41-6011702) MAYO FOUNDATION FOR MEDICAL EDUCATION AND RESEARCH (EIN: 41-1506440) DISCLOSURE STATEMENT RELATED TO FORMS 5471: UNDER THE CONSTRUCTIVE OWNERSHIP RULES OF IRC SECTIONS 958(A) AND (B), THE TAXPAYER IS REQUIRED TO FILE FORMS 5471, INFORMATION RETURN OF U.S. PERSONS WITH RESPECT TO CERTAIN FOREIGN CORPORATIONS, AS A CATEGORY 1C, 4, AND 5C FILER WITH RESPECT TO THE SPECIFIED FOREIGN CORPORATIONS (SFCS) AND CONTROLLED FOREIGN CORPORATIONS (CFCS) LISTED BELOW. THESE FILING REQUIREMENTS ARE OR WILL BE SATISFIED THROUGH THE FILING OF FORMS 5471 FOR THESE SFCS AND CFCS BY OTHER U.S. TAXPAYERS IDENTIFIED BELOW WHO HAVE THE SAME FILING REQUIREMENT. ADDITIONAL SFCS AND CFCS REQUIRING THE FILING OF FORMS 5471 MAY BE IDENTIFIED BY THE OTHER U.S. TAXPAYERS IDENTIFIED BELOW AFTER THE TAXPAYER'S FILING DATE. THE OTHER U.S. TAXPAYERS IDENTIFIED BELOW WILL SATISFY THE FILING REQUIREMENTS OF FORMS 5471 FOR ANY ADDITIONAL SFCS AND CFCS NOT IDENTIFIED BELOW. TAXPAYER NAME: MAYO CLINIC ADDRESS: 200 FIRST STREET SW, ROCHESTER, MN 55905 ID NUMBER OF U.S. TAX RETURN WITH WHICH FORM 5471 WAS FILED: 41-6011702 IRS SERVICE CENTER WHERE U.S. TAX RETURN WAS OR WILL BE FILED: OGDEN, UT TAXPAYER NAME: MAYO FOUNDATION FOR MEDICAL EDUCATION AND RESEARCH ADDRESS: 200 FIRST STREET SW, ROCHESTER, MN 55905 ID NUMBER OF U.S. TAX RETURN WITH WHICH FORM 5471 WAS FILED: 41-1506440 IRS SERVICE CENTER WHERE U.S. TAX RETURN WAS OR WILL BE FILED: OGDEN, UT SPECIFIED FOREIGN CORPORATIONS AND CONTROLLED FOREIGN CORPORATIONS REQUIRING THE FILING OF FORM 5471: ATRIAN MEDICAL LTD UNIT 204, BUSINESS INNOVATION CENTRE, NATIONAL UNIVERSITY OF IRELAND GALWAY, H91 TK33, IRELAND BAIN CAPITAL CREDIT CLO 2017-2, LTD C/O MAPLESFS, LTD, PO BOX 1903, BOUNDARY HALL, CRICKET SQUARE GRAND CAYMAN, KY1-1102, CAYMAN ISLANDS REF#: BAINCAPITALCREDITCLO20172LTD EBA MED SA AVENUE DE SECHERON 15, CH-1202 GENEVA, SWITZERLAND REF#: EBAMEDSA ENERGY CAPITAL PARTNERS MEZZANINE OPPORTUNITIES FUND OFFSHORE FEEDER AIV, LP 40 BEECHWOOD ROAD SUMMIT, NJ 07901 EIN: 98-1278544 MAYO CLINIC (UK) LTD 3 MORE LONDON RIVERSIDE LONDON, SE1 2AQ, UNITED KINGDOM REF#: MCMCUKL MAYO INSURANCE COMPANY LTD PO BOX 1051 GRAND CAYMAN, KY1-1102, CAYMAND ISLANDS REF#: MCMICL MC ALLIANCE LTD C/O SERVICES CAYMAN LIMITED, PO BOX 10008 WILLOW HOUSE, CRICKET SQUARE, GRAND CAYMAN CJ KY EIN: 98-1527769 SIT ALPHA II BOND FUND, LTD C/O APPLEBY TRUST (CAYMAN) LTD, CLIFTON HOUSE 75 FORT STREET, PO BOX 1350 GRAND CAYMAN, CAYMAN ISLANDS EIN: 98-0648163 WUXI DIAGNOSTICS LAB (SHIJIAZHUANG) CO, LTD RM 1245, BUILDING 5, 319 CHANGJIANG AVE, GAOXIN DISTRICT, SHIJIAZHUANG, CHINA REF#: WUXISHIJIAZHUANG WUXI DIAGNOSTICS LAB (WUXI) CO, LTD ROOM 306, NO 88 MEILIANG ROAD, BINHU DISTRICT, WUXI CITY, JIANGSU PROVINCE, CHINA REF#: WUXIDIAGNOSTICSLAB WUXI DIAGNOSTICS MEDICAL TESTING INSTITUTE (SHANGHAI) CO, LTD SECTION A 1ST FLOOR BUILDING 104, NO 1-30 LANE 88 MIN BEI ROAD MINHANG DISTRICT, SHANGHAI, CHINA REF#: WUXIDIAGNOSTICSSHANGHAI DISCLOSURE STATEMENT RELATED TO FORMS 8865: UNDER THE CONSTRUCTIVE OWNERSHIP RULES OF IRC SECTIONS 958(A) AND (B), THE TAXPAYER IS REQUIRED TO FILE FORMS 8865, INFORMATION RETURN OF U.S. PERSONS WITH RESPECT TO CERTAIN FOREIGN PARTNERSHIPS (CFPS), AS A CATEGORY 2 AND 3 FILER. THESE FILING REQUIREMENTS ARE OR WILL BE SATISFIED THROUGH THE FILING OF FORMS 8865 FOR THESE PARTNERSHIPS BY OTHER U.S. TAXPAYERS IDENTIFIED BELOW WHO HAVE THE SAME FILING REQUIREMENT. ADDITIONAL CFPS REQUIRING THE FILING OF FORMS 8865 MAY BE IDENTIFIED BY THE OTHER U.S. TAXPAYERS IDENTIFIED BELOW AFTER THE TAXPAYER'S FILING DATE. THE OTHER U.S. TAXPAYERS IDENTIFIED BELOW WILL SATISFY THE FILING REQUIREMENTS OF FORMS 8865 FOR ANY ADDITIONAL CFPS NOT IDENTIFIED BELOW. TAXPAYER NAME: MAYO CLINIC ADDRESS: 200 FIRST STREET SW, ROCHESTER, MN 55905 ID NUMBER OF U.S. TAX RETURN WITH FORMS 8865 WAS FILED: 41-6011702 IRS SERVICE CENTER WHERE U.S. TAX RETURN WAS OR WILL BE FILED: OGDEN, UT APPIAN NATURAL RESOURCES FUND (HG AIV) L.P. 47 ESPLANADE ST. HELIER, JERSEY JE1 0BD APPIAN NATURAL RESOURCES FUND (NV) L.P. 47 ESPLANADE ST. HELIER, JERSEY JE1 0BD ABINGWORTH BIOVENTURES VII LP 38 JERMYN ST. LONDON, UNITED KINGDOM, W1Y 6DN ANRH COOPERATIEF U.A. ZUIDPLEIN 126, WTC, TOWER H, 15TH FL. AMSTERDAM, THE NETHERLANDS, 1077 XV ARVO, LLC C/O WALKERS CORP. LTD, CAYMAN CORPORATE CENTRE, 27 HOSPITAL ROAD GEORGE TOWN, CAYMAN ISLANDS, KY1-9008 BAIN CAPITAL ASIA FUND II, L.P. 200 CLARENDON ST., FL 41 BOSTON, MA UNITED STATES, 02116-5016 BAIN CAPITAL ASIA FUND III, L.P. 200 CLARENDON ST., FL 41 BOSTON, MA UNITED STATES, 02116-5016 BAIN CAPITAL EUROPE FUND IV, L.P. 200 CLARENDON ST., FL 41 BOSTON, MA UNITED STATES, 02116-5016 BAIN CAPITAL EUROPE FUND V, SCSP 200 CLARENDON ST., FL 41 BOSTON, MA UNITED STATES, 02116-5016 BAIN CAPITAL FUND XII, L.P. 200 CLARENDON ST., FL 41 BOSTON, MA UNITED STATES, 02116-5016 BAIN CAPITAL SPECIAL SITUATIONS ASIA, L.P. 200 CLARENDON ST., FL 41 BOSTON, MA UNITED STATES, 02116-5016 BLACK RIVER FOOD FUND 2 LP 33 S. 6TH ST., SUITE 4100 MINNEAPOLIS, MN, UNITED STATES, 55402 BLACKSTONE REAL ESTATE PARTNERS (OFFSHORE) VIII-NQ L.P. C/O THE BLACKSTONE GROUP, 345 PARK AVE. NEW YORK, NY, UNITED STATES, 10154 BLACKSTONE REAL ESTATE PARTNERS EUROPE V L.P. C/O THE BLACKSTONE GROUP, 345 PARK AVE. NEW YORK, NY, UNITED STATES, 10154 BLACKSTONE REAL ESTATE PARTNERS EUROPE V-NQ L.P. C/O THE BLACKSTONE GROUP, 345 PARK AVE. NEW YORK, NY, UNITED STATES, 10154 BVCF III, L.P. 190 ELGIN AVE. GEORGE TOWN, GRAND CAYMAN, CAYMAN ISLANDS, KY1-9005 BVCF IV, L.P. C/O WALKERS CORP. LTD, 27 HOSPITAL RD GEORGE TOWN, GRAND CAYMAN, CAYMAN ISLANDS, KY1-9008 BVCF REALIZATION FUND, L.P., C/O WALKERS CORP. LTD, 27 HOSPITAL RD GEORGE TOWN, GRAND CAYMAN, CAYMAN ISLANDS, KY1-9008 CANAAN X L.P 285 RIVERSIDE AVE., STE 250 WESTPORT, CT UNITED STATES, 06880 CANAAN XI L.P 285 RIVERSIDE AVE., STE 250 WESTPORT, CT UNITED STATES, 06880 CREDIT SOLUTIONS INDIA HOLDCO PTE LTD 77 ROBINSON RD #13-00 SINGAPORE, SINGAPORE, SN 068896 CVC CAPITAL PARTNERS VI (A) L.P. 27 ESPLANADE ST. HELIER, JERSEY, JE1 1SG CVC CAPITAL PARTNERS VII (A) L.P. 27 ESPLANADE ST. HELIER, JERSEY, JE1 1SG EAGLE HOLDINGS LIMITED FIRST FLOOR, JUBILEE BUILDINGS, VICTORIA STREET DOUGLAS, ISLE OF MAN, IM1 2SH EQT CAMERA SIDE CAR (NO.2) SCSP 26A BLVD ROYAL LUXEMBOURG, LUXEMBOURG, L-2449 EQT VIII (NO.2) SCSP 26A BLVD ROYAL LUXEMBOURG, LUXEMBOURG, L-2449 EVOLUTION FUND I, L.P. C/O MSVC GP LTD, STE 905-6, 9/F ICBC TOWER, 3 GARDEN RD HONG KONG, HONG KONG GREAT HILL EQUITY PARTNERS VI-A, LP C/O CO SERVICES CAYMAN LTD, P.O. BOX 10008, WILLOW HOUSE, CRICKET SQUARE GRAND CAYMAN, CAYMAN ISLANDS, KY1-1001 GREENSTONE RESOURCES II L.P. PO BOX 656, E. WING, TRAFALGAR COURT, LES BANQUES ST PETER PORT, GUERNSEY, GY1 3PP IDG CHINA CAPITAL FUND III LP UNIT 5505, 55/F, THE CENTER, 99 QUEEN'S RD CENTRAL HONG KONG, HONG KONG IDG CHINA VENTURE CAPITAL FUND V L.P. UNIT 5505, 55/F, THE CENTER, 99 QUEEN'S RD CENTRAL HONG KONG, HONG KONG INCE CAPITAL PARTNERS, L.P. CAYMAN CORP. CENTRE, 27 HOSPITAL RD GEORGE TOWN, GRAND CAYMAN, CAYMAN ISLANDS, CJ KY1-9008 KEROGEN DIGITAL SOLUTIONS, L.P. C/O INTERTRUST CORP. SERVICES (CAYMAN) LTD, 190 ELGIN AVE. GEORGE TOWN, GRAND CAYMAN, CAYMAN ISLANDS, KY1-9005 KEROGEN FUND II INVESTMENTS HOLDING LIMITED C/O INTERTRUST CORP. SERVICES (CAYMAN) LTD, 190 ELGIN AVE. GEORGE TOWN, GRAND CAYMAN, CAYMAN ISLANDS, KY1-9005 KILDARE EUROPEAN PARTNERS II, LP CLARENDON HOUSE, 2 CHURCH ST. HAMILTON, BERMUDA, HM 11 KKR ASIAN FUND III L.P. C/O KOHLBERG KRAVIS ROBERTS & CO., 9 W. 57TH ST. NEW YORK, NY UNITED STATES, 10019 MARIETTE HOLDINGS LIMITED 13-14 ESPLANADE ST. HELIER, JERSEY, JE1 1BD MORNINGSIDE CHINA TMT FUND IV, L.P. C/O MORNINGSIDE CHINA TMT GP IV, L.P., STE 905-6, 9/F ICBC TOWER, THREE GARDEN RD HONG KONG MORNINGSIDE CHINA TMT SPECIAL OPPORTUNITY FUND II, L.P. C/O MORNINGSIDE CHINA TMT GP IV, L.P., STE 905-6, 9/F ICBC TOWER, THREE GARDEN RD HONG KONG OAKTREE OPPORTUNITIES FUND IX AIF CAYMAN, L.P. 333 S. GRAND AVE., 28TH FL. LOS ANGELES, CA UNITED STATES, 90071 OAKTREE OPPORTUNITIES FUND IX, L.P. 333 S. GRAND AVE., 28TH FL. LOS ANGELES, CA UNITED STATES, 90071 OAKTREE OPPORTUNITIES FUND X AIF CAYMAN, L.P. 333 S. GRAND AVE., 28TH FL. LOS ANGELES, CA UNITED STATES, 90071 OAKTREE PRINCIPAL FUND V RESTRUCTURING AIV (CAYMAN), L.P. 333 S. GRAND AVE., 28TH FL. LOS ANGELES, CA UNITED STATES, 90071 OAKTREE PRINCIPAL FUND V, L.P. 333 S. GRAND AVE., 28TH FL. LOS ANGELES, CA UNITED STATES, 90071 PLUTUS ENERGY INVESTMENTS HOLDING LIMITED 28 ESPLANADE ST HELIER, JERSEY, JE1 8S |
PART IV - FILING OF CERTAIN FOREIGN FORMS |
PMI CANADA HOLDINGS LP 1055 W. GEORGIA ST. VANCOUVER, CANADA, BC V6E 4N7 PMI HOLDING COMPANY LP UGLAND HOUSE, P.O. BOX 309 GRAND CAYMAN, CAYMAN ISLANDS, KY1-1104 PMI INTERMEDIATE HOLDING COMPANY LP UGLAND HOUSE, P.O. BOX 309 GRAND CAYMAN, CAYMAN ISLANDS, KY1-1104 PROVIDENCE EQUITY PARTNERS VII LP 50 KENNEDY PLAZA, 18TH FL. PROVIDENCE, RI UNITED STATES, 02903 SAIF PARTNERS INDIA V LIMITED IFS COURT, BANK ST., TWENTYEIGHT, CYBERCITY EBENE, REPUBLIC OF MAURITIUS, 72201 SAIF PARTNERS INDIA VI LIMITED IFS COURT, BANK ST., TWENTYEIGHT, CYBERCITY EBENE, REPUBLIC OF MAURITIUS, 72201 SEQUOIA CAPITAL CHINA GROWTH FUND IV, L.P. 2800 SAND HILL RD, STE 101 MENLO PARK, CA UNITED STATES, 94025 SEQUOIA CAPITAL CHINA GROWTH FUND V, L.P. 2800 SAND HILL RD, STE 101 MENLO PARK, CA UNITED STATES, 94025 SEQUOIA CAPITAL CHINA GROWTH FUND VI, L.P. 2800 SAND HILL RD, STE 101 MENLO PARK, CA UNITED STATES, 94025 SEQUOIA CAPITAL CHINA VENTURE FUND VII, L.P. 2800 SAND HILL RD, STE 101 MENLO PARK, CA UNITED STATES, 94025 SEQUOIA CAPITAL GLOBAL GROWTH FUND III ENDURANCE PARTNERS, L.P. 2800 SAND HILL RD, STE 101 MENLO PARK, CA UNITED STATES, 94025 SEQUOIA CAPITAL INDIA IV, LTD 2800 SAND HILL RD, STE 101 MENLO PARK, CA UNITED STATES, 94025 SEQUOIA CAPITAL INDIA V, LTD 2800 SAND HILL RD, STE 101 MENLO PARK, CA UNITED STATES, 94025 SEQUOIA CAPITAL INDIA VI, LTD 2800 SAND HILL RD, STE 101 MENLO PARK, CA UNITED STATES, 94025 SEQUOIA CAPITAL US GROWTH FUND VII, L.P. 2800 SAND HILL RD, STE 101 MENLO PARK, CA UNITED STATES, 94025 SEQUOIA CAPITAL US GROWTH FUND VIII, L.P. 2800 SAND HILL RD, STE 101 MENLO PARK, CA UNITED STATES, 94025 SEQUOIA CAPITAL US VENTURE FUND XV, L.P. 2800 SAND HILL RD, STE 101 MENLO PARK, CA UNITED STATES, 94025 SEQUOIA CAPITAL US VENTURE FUND XVI, L.P. 2800 SAND HILL RD, STE 101 MENLO PARK, CA UNITED STATES, 94025 SHORELINE CHINA VALUE III, L.P. FOLIO CHAMBERS, P.O. BOX 800, RD TOWN TORTOLA, BRITISH VIRGIN ISLANDS SHUBH HOLDINGS PTE LTD 77 ROBINSON RD #13-00 SINGAPORE, SINGAPORE, SN 068896 TCV IX (A), L.P. 250 MIDDLEFIELD RD MENLO PARK, CA UNITED STATES, 94025 TCV X, L.P. 250 MIDDLEFIELD RD MENLO PARK, CA UNITED STATES, 94025 THE SOCIAL+CAPITAL PARTNERSHIP III, L.P. 317 UNIVERSITY AVE., #200 PALO ALTO, CA UNITED STATES, 94301 THE VARDE FUND XIII (B) (FEEDER), L.P. C/O WALKERS CORP. LTD, 27 HOSPITAL RD GEORGE TOWN, CAYMAN ISLANDS, KY1-9008 THE VARDE FUND XIII, L.P. C/O WALKERS CORP. LTD, 27 HOSPITAL RD GEORGE TOWN, CAYMAN ISLANDS, KY1-9008 TPC CANADA HOLDINGS LIMITED PARTNERSHIP 1055 W. GEORGIA ST. VANCOUVER, CANADA, BC V6E 4N7 TPC HOLDING COMPANY LP UGLAND HOUSE, P.O. BOX 309 GRAND CAYMAN, CAYMAN ISLANDS, KY1-1104 TPC INTERMEDIATE HOLDING COMPANY LP UGLAND HOUSE, P.O. BOX 309 GRAND CAYMAN, CAYMAN ISLANDS, KY1-1104 VARDE HOLDINGS PTE LTD 77 ROBINSON RD #13-00 SINGAPORE, SINGAPORE, SN 068896 WIND POINT PARTNERS IX-A, LP 676 N. MICHIGAN AVE., STE 3700 CHICAGO, IL UNITED STATES, 60611 WIND POINT PARTNERS VIII-A GLOBAL LP UGLAND HOUSE, P.O. BOX 309 GRAND CAYMAN, CAYMAN ISLANDS, KY1-1104 |