Form Tc-20l - Utah Application For Refund From A Corporation Loss Carryback - 2010 Page 2

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TC-20L — continued
Page 2
1st Prior Taxable Year
/
/
21. Enter the 1st prior taxable year-end (enter as mm/dd/yyyy) .......................................
21 _____
_____
__ _ __ _ _
22. Utah taxable income from 1st prior taxable year (enter only if gain)...........................
22 _____________ _ _ __ . 00
23. Loss carryback amount (enter the lesser of line 20 or line 22) ...................................
23 _____________ _ __ _ . 00
24. Adjusted taxable income (subtract line 23 from line 22 – not less than zero) .............
24 _____________ _ _ __ . 00
25. Tax (multiply line 24 by 5% (.05), or minimum tax if greater) ......................................
25 _____________ _ _ __ . 00
26. Tax previously paid for 1st prior taxable year..............................................................
26 _____________ _ __ _ . 00
27. Refund for 1st prior taxable year (subtract line 25 from line 26) .............................
27 _____________ _ _ __ . 00
28. Loss remaining (subtract line 23 from line 20) ............................................................
28 _____________ _ __ _ . 00
Carryforward
29. Enter loss exceeding $1,000,000 from line 3, if any ...................................................
29 _____________ _ __ _ . 00
30. Total loss to carryforward (add lines 28 and 29) .........................................................
30 _____________ _ __ _ . 00
Under penalties of perjury, I declare to the best of my knowledge and belief,
this return and accompanying schedules are true, correct and complete.
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Date
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