STATE OF CONNECTICUT
DEPARTMENT OF REVENUE SERVICES
(Rev. 12/98)
ENTER INCOME YEAR
BEGINNING ____________________, 1998 AND
ENDING ___________________, 19 ____
CT TAX REGISTRATION NUMBER
Total Assets
L
Corporation Name
A
B
Gross Receipts
E
DATE RECEIVED (For Dept. Use Only)
Number and Street
L
Federal Business Activity Code
H
FEDERAL EMPLOYER ID NUMBER
City or Town
State
ZIP Code
E
R
Audited By
E
F
O
CHANGE OF:
Mailing Address
Closing Month
RETURN STATUS:
Initial Return
Final Return
Short Period Return
IF THIS IS A SHORT PERIOD, PLEASE CHECK CORRESPONDING BOX:
Merger
Acquisition
Change of Filing Status
IF THIS IS A FINAL RETURN, HAS THE CORPORATION:
DISSOLVED
WITHDRAWN
MERGED / REORGANIZED (Enter survivor’s CT tax registration number)_________________________
FEDERAL RETURN WAS FILED ON:
1120
1120A
1120H
CONSOLIDATED BASIS
1120PC (See Instructions)
OTHER
State of incorporation ______ Date of organization _____________ Date qualified in CT ____________ Date business commenced in CT________________
IS THIS PART OF A COMBINED RETURN INCLUDING TWO OR MORE CORPORATIONS?
Yes (Complete Form CT-1120CR)
No
WAS THIS COMPANY INCLUDED IN A CONNECTICUT COMBINED BUSINESS TAX RETURN FOR ANY PRIOR YEAR?
Yes (If revoking election to file combined for current year, attach Form CT-1120CC)
No (If first year filing combined, attach Form CT-1120CC)
– ATTACH A COMPLETE COPY OF FORM 1120 INCLUDING ALL SCHEDULES AS FILED WITH THE INTERNAL REVENUE SERVICE –
1. Federal taxable income (loss) before net operating loss and special deductions .........................................
1
2. Interest income wholly exempt from federal tax ..............................................................................................
2
3. Unallowable deduction for corporation tax (Schedule F, Line 8) ....................................................................
3
4. TOTAL (Add Lines 1, 2 and 3) .......................................................................................................................
4
5. Dividend deduction (Form CT-1120/CT-1120S ATT, Schedule I, Line 4) .........................................................
5
6. Capital loss carryover (if not deducted in computing federal capital gain) .....................................................
6
7. TOTAL (Add Line 5 and Line 6) ......................................................................................................................
7
8. NET INCOME (Subtract Line 7 from Line 4) ....................................................................................................
8
1. Net Income (Line 8) (If 100% Connecticut, enter also on Schedule A, Line 3) ...............................................
1
.
2. Apportionment fraction (Carry to six places. See instructions.) ....................................................................
2
0
3. Connecticut net income (Multiply Line 1 by Line 2) ..........................................................................................
3
4. Operating loss carryover (Form CT-1120/CT-1120S ATT, Schedule H, Line 6) .............................................
4
5. Income subject to tax (Subtract Line 4 from Line 3) ........................................................................................
5
6. TAX: Multiply Line 5 by 9.50% (.0950) .............................................................................................................
6
1. Minimum tax base (Schedule D, Column C, Line 6) (Banks, Form CT-1120/CT-1120S ATT,
Schedule J, Column D, Line 5) (If 100% Connecticut, enter also on Line 3) ...................................................
1
.
2. Apportionment fraction (Carry to six places. See instructions.) ....................................................................
2
0
3. Multiply Line 1 by Line 2 ....................................................................................................................................
3
4. Number of months covered by this return .......................................................................................................
4
5. Multiply Line 3 by Line 4, divide the result by 12 ..............................................................................................
5
6. TAX: (3 and 1/10 mills per dollar) Multiply Line 5 by .0031. (Maximum tax for Sch. B is $1,000,000)
*Banks: Multiply Line 3 by 4% (.04) ..................................................................................................................
6
1. Tax (Larger of Schedule A, Line 6, or Schedule B, Line 6 or $250) ...............................................................
1
2. Tax Credits (Form CT-1120K, Part III, Column B, Line 13) ................................................................................
2
3. Balance of tax payable (Subtract Line 2 from Line 1. If zero or less, enter -0-) ............................................
3
1 2 3 4 5 6
1 2 3 4 5 6
(a) Paid with application for extension, Form CT-1120 EXT ...........
4a
1 2 3 4 5 6
4. TAX
1 2 3 4 5 6
1 2 3 4 5 6
1 2 3 4 5 6
(b) Paid with estimates (Forms CT-1120 ESA, ESB, ESC & ESD) ..
4b
1 2 3 4 5 6
1 2 3 4 5 6
PAYMENTS
(c) Overpayment from prior year ......................................................
4 c
4
5. Balance of tax due (overpaid) (Subtract Line 4 from Line 3) ..........................................................................
5
6. Add Penalty
(6a) ___________
Interest
(6b) _________ CT-1120 Interest
(6c) ___________
6
7. Amount to be credited to 1999 estimated tax
(7a) ______________
refunded
(7b) __________
7
8. Balance due with this return (Add Line 5 and Line 6) ................................................................................
8
Make check payable to: Commissioner of Revenue Services (Attach check to return with paper clip. Do not staple.)
Mail to: Department of Revenue Services, PO Box 2974, Hartford CT 06104-2974
Check if you do not want a booklet sent to you next year. Checking this box does not relieve you of your responsibility to file.