Form 851 (1992) - Affiliations Schedule
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4851
Affiliations Schedule
Form
OMB No. 1545-0025
(Rev. January 1992)
File with each consolidated income tax return
Expires 11-30-94
Department of the Treasury
Tax year ending
, 19
Internal Revenue Service
Common parent corporation
Employer identification number
Number, street, and room or suite no. (If a P.O. box, see instructions.)
City or town, state, and ZIP code
Prepayment Credits
Part I
Prepayment Credits
Employer
Portion of
Portion of estimated
identification
No.
Name and address of corporation
Form 7004
tax credits
number
tax deposits
and deposits
Common parent corporation
1
Subsidiary corporations:
2
3
4
5
6
7
8
9
10
Totals (Must equal amounts shown on the consolidated tax return)
Voting Stock Information, Principal Business Activity, Etc. (See instructions.)
Part II
Did the subsidiary
Stock holdings at beginning of year
make any nondividend
PBA
distributions?
No.
Principal business activity (PBA)
Code
(See instructions.)
Owned by
Number
Percent of
No.
Percent of
corporation
of
voting
value
Yes
No
shares
power
no.
1
Common parent corporation
Subsidiary corporations:
2
%
%
3
%
%
4
%
%
5
%
%
6
%
%
7
%
%
8
%
%
9
%
%
10
%
%
851
For Paperwork Reduction Act Notice, see instructions.
Cat. No. 16880G
Form
(Rev. 1-92)
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