Form K-120s - Kansas Small Business Corporation

KANSAS

K-120S

155004

SMALL BUSINESS CORPORATION

(Rev. 8/04)

DO NOT STAPLE

For the taxable year beginning _________________ , 2004; ending ________________ , _______

Name

B. Business Activity Code (NAICS)

Employer’s Identification Numbers (EIN)

(Enter both if applicable)

___ ___ ___ ___ ___ ___

EIN this entity:

Number and Street of Principal Office

C. Date Business Began in KS (mm/dd/yyyy)

___ ___ / ___ ___/___ ___ ___ ___

___ ___ ___ ___ ___ ___ ___ ___ ___

City

State

Zip Code

D. Date Business Discontinued in KS (mm/dd/yyyy)

EIN Federal Consolidated Parent:

___ ___ / ___ ___/___ ___ ___ ___

___ ___ ___ ___ ___ ___ ___ ___ ___

Enter your original federal due date

E. State and Month/Year of Incorporation (mm/yyyy)

A. Method Used to Determine Income of Corporation in Kansas

if other than the 15th day of the 3rd

___ ___ , ___ ___ / ___ ___ ___ ___

month after the end of the tax year.

Activity wholly within Kansas or single entity apportionment method (Part I)

___ ___

F. State of Commercial Domicile

___ ___/___ ___/

___ ___ ___ ___

Combined income method

G. Type of Federal Return Filed

If any taxpayer information has

Common carrier mileage (Enclose mileage apportionment schedule)

Separate

changed since the last return was

Consolidated

filed, please check this box.

Alternative or separate accounting (Enclose letter of authorization & schedule)

H. Check the box if you have submitted a Kansas

Form K-120EL?

Qualified elective two-factor (Part I) Year qualified: __ __ __ __

IF THIS IS AN AMENDED RETURN, MARK THIS BOX

1. Federal ordinary income from federal Schedule K . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

2. Total other income (loss) and deductions from federal Schedule K . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

3. Total (Add lines 1 & 2). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

4. Total state and municipal interest (Schedule required) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

5. Taxes on or measured by income or fees or payments in lieu of income taxes (Schedule required) . .

6. Other additions to federal income (Schedule required) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

7. Total additions to federal income (Add lines 4, 5 & 6) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

8. Interest on U.S. government obligations (Schedule required). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

9. IRC Section 78 and 80% of foreign dividends (Schedule required) . . . . . . . . . . . . . . . . . . . . . . . . . . . .

10. Other subtractions from federal income (Schedule required) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

11. Total subtractions from federal income (Add lines 8, 9 & 10) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

12. Net income before apportionment (Add line 3 to line 7 and subtract line 11) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Residents - Use line 12 to compute the shareholder's portion of Kansas income for column 7, page 2, Part II.

Nonresidents - Use line 12 to compute the shareholder's portion of Kansas income for column 7, page 2, Part II, and the

Schedule of Nonresident Withholding (Form KW-7S). If the corporate income is not totally in Kansas, complete Part l and

lines 13 through 18, page 1.

Part II, page 2 must be completed for all shareholders.

13. Nonbusiness income - Total company (Schedule required) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

14. Apportionable business income (Subtract line 13 from line 12) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

15. Average percent to Kansas (Part I, lines 1a, 1b, 1c & 3) . . . . . .

A __ __ __

__ __ __ __

B __ __ __

__ __ __ __

C __ __ __

__ __ __ __

___ ___ ___

___ ___ ___ ___

16. Amount to Kansas (Multiply line 14 by line 15). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

17. Nonbusiness income - Kansas (Schedule required). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

18. Total Kansas income (Add lines 16 & 17). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

19. Estimated tax paid and amount credited forward (Separate schedule) . . . . . . . . . . . . . . . . . . . . . . . . .

20. Other tax payments (Separate schedule) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

21. Refund (Add lines 19 & 20) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

I authorize the Director of Taxation or the Director's designee to discuss my return and enclosures with my preparer.

I declare under the penalties of perjury that to the best of my knowledge this is a true, correct, and complete return.

Enclose a copy of your federal

sign

return, pages 1 through 4 Schedules

Signature of Officer

Title

Date

M-1