Form Bpt-In - Alabama Business Privilege Tax Initial Privilege Tax Return - 2010
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2DUALTT-AONM-YRXY-MOHJ-EUJY
FORM
101101BN
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BPT-IN
2010
-This form has been enhanced to complete all calculations and to compute the
A
D
R
LABAMA
EPARTMENT OF
EVENUE
amount of tax due. Just key in your data prior to printing the form. If you choose
Alabama Business Privilege Tax
to use the fill-in option, PLEASE DO NOT HANDWRITE ANY OTHER DATA ON
THE FORM OTHER THAN YOUR SIGNATURE.
Initial Privilege Tax Return
Initial Privilege Tax – This form is to be completed ONLY by taxpayers who incorporated, organized,
-It has also been enhanced to print a two dimensional (2D) barcode. The PRINT
FORM button MUST be used to generate the (2D) barcode which contains data
qualified, registered or started doing business in Alabama in 2010. NOTE: Initial returns must be filed
entered on the form. The use of a 2D barcode vastly improves processing of
within 2-1/2 months of incorporation, organization or qualification. See the detailed instructions on
your return and reduces the costs associated with processing your return.
the Alabama Department of Revenue Web site ( ).
Make check payable to: Alabama Department of Revenue
(Payment must be submitted with Form BPT-V, unless payment is made electronically)
Please enter the date the entity incorporated,
Mail to: Alabama Department of Revenue, Business Privilege Tax Section
organized, qualified or registered in Alabama or started
P.O. Box 327320, Montgomery, AL 36132-7320
doing business in Alabama, whichever occurred first:
•
•
Type of taxpayer (check only one):
1a.
C Corporation
1b.
Insurance Company
•
•
•
1c.
Financial Institution Group Member
1d.
LLE Taxed as Corporation
1e.
Real Estate Investment Trust
2a. Date of Qualification,
•
•
•
•
Incorporation or Organization ____________________
1f.
Business Trust
1g.
S Corporation
1h.
Limited Liability Entity
(mm/dd/yyyy)
•
1i.
Disregarded Entity
DO NOT FILE FORM BPT-IN AS AN ANNUAL RETURN
TAXPAYER INFORMATION
3a. LEGAL NAME OF BUSINESS ENTITY
3b. FEIN
FEIN NOT REQUIRED (SEE INSTRUCTIONS)
3c. BPT ACCOUNT NUMBER (SEE INSTRUCTIONS)
•
3d. MAILING ADDRESS
3e. SECRETARY OF STATE FILE / ACCOUNT NUMBER (SEE SOS.ALABAMA.GOV)
•
Find Sec of State File #
3f. CITY
3g. STATE
3h. ZIP CODE
3i. FEDERAL BUSINESS CODE NUMBER (NAICS) (SEE )
•
____ ____
Find NAICS Code
4a. CONTACT PERSON CONCERNING THIS FORM
4b. CONTACT PERSON’S PHONE NUMBER
4c. TAXPAYER’S E-MAIL ADDRESS
(
)
5a. County of incorporation or organization for all Alabama entities . . . . . . . . . . . . . . . . . . . . . . . . .
5a
5b. State or country of incorporation or organization for all foreign entities . . . . . . . . . . . . . . . . . . .
5b
6a. Date of qualification or registration in Alabama for foreign entities . . . . . . . . . . . . . . . . . . . . . . .
6a
6b. Date of incorporation or organization for all entities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
6b
6c. Date started doing business in Alabama . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
6c
6d. Telephone number of the taxpayer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
6d
7a. Name of registered agent in Alabama . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
7a
7b. FEIN or social security number . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
7b
7c. Street address . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
7c
7d. City, state and zip code . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
7d
8a. Name of corporate president or primary member/partner . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
8a
8b. Social security number. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
8b
8c. Street address . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
8c
8d. City, state and zip code . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
8d
9a. Name of corporate secretary or secondary member/partner. . . . . . . . . . . . . . . . . . . . . . . . . . . .
9a
9b. Social security number. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
9b
9c. Street address . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
9c
9d. City, state and zip code . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
9d
10.
Kind of business done in Alabama . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
10
11.
Principal place of business in Alabama . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
11
City, state and zip code . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
12.
Kind of business done generally . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
12
13.
Mailing address of the principal place of business if outside State of Alabama . . . . . . . . . . . . .
13
City, state and zip code . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
COMPUTATION OF AMOUNT DUE
•
14.
Privilege tax due (Page 2, Part B, line 21) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Go to Page 2 of BPT-IN
14
Amount Due
•
15.
Penalty due (see instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
15
•
16.
Interest due (see instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
16
•
17.
Total privilege tax due (add lines 14, 15 and 16) (Form BPT-V must be submitted if payment is made by check) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
17
18.
Check here if paid electronically:
•
I authorize a representative of the Department of Revenue to discuss my return and attachments with my preparer.
UNDER PENALTIES OF PERJURY, I declare that I have examined this return and accompanying schedules and statements and, to the best of my knowledge and belief,
they are true, correct, and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge.
Please
Your
Sign Here
Signature
Title
Date
Date
Phone number
Preparer’s social security no.
Paid
Preparer’s
•
signature
Preparer’s
•
Firm’s name (or yours,
E.I. No.
Use Only
if self-employed)
•
ZIP Code
and address
ADOR
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Parent category: Financial