Form Ct-1120 - Corporation Business Tax Return

Schedule F – Taxes

Column A

Column B

1. Payroll.............................................................................

2. Real property ..................................................................

3. Personal property ...........................................................

4. Sales and use .................................................................

5. Other: See instructions. .................................................

6. Connecticut corporation business tax deducted in the computation of federal taxable income ........

7. Tax on or measured by income or profits imposed by other states or political subdivisions

deducted in the computation of federal taxable income: Attach schedule. .......................................

8. Total unallowable deduction for corporation business tax purposes: Add Line 6 and Line 7,

Column B. Enter here and on Schedule D, Line 3. ............................................................................

Schedule G – Additional Required Information – Attach a schedule of corporate officers’ names, titles, and addresses. See instructions.

1. In which CT town(s) does the corporation own or lease, as lessee, real or tangible personal property, or perform services?

______________________________________________________________________________________________________________



2. (a) Did this corporation directly or indirectly transfer a controlling interest in an entity owning CT real property?

Yes



If Yes, enter: Entity name

___________________________________ Federal Employer ID Number

_________________________





(b) Was there a direct or indirect transfer of a controlling interest in your company owning CT real property?

Yes



If Yes, enter: Transferor name

_______________________________ Federal Employer ID Number

_________________________



(c) If the answer to either 2(a) or 2(b) is Yes, enter: Transferee(s) name ____________________________________________________

Date of transfer _________________________ , and attach a list of addresses for all Connecticut realty property transferred.



3. Did any corporation at any time during the year own a majority of the voting stock of this corporation?

Yes



If Yes, enter: Corporation name _________________________________ Federal Employer ID Number ___________________________

4. Last taxable year this corporation was audited by the Internal Revenue Service

____________________





Were adjustments reported to CT?

Yes

No (If No, attach explanation.)



Declaration: I declare under penalty of law that I have examined this return (including any accompanying schedules and statements) and, to the best of

my knowledge and belief, it is true, complete, and correct. I understand the penalty for willfully delivering a false return or document to the Department

of Revenue Services (DRS) is a fine of not more than $5,000, imprisonment for not more than five years, or both. The declaration of a paid preparer

other than the taxpayer is based on all information of which the preparer has any knowledge.

Corporate officer’s name (print)

Corporate officer’s signature

Date

Corporate officer’s email address (print)

Telephone number

(

)



Sign Here

Title

May DRS contact the preparer shown below about this return?

Keep a



Yes

See instructions.

copy

of this

Paid preparer’s name (print)

Date

return for

your

Paid preparer’s signature

Preparer’s SSN or PTIN

records.

Firm’s name and address

FEIN

Telephone number

(

)

Mail paper return with payment to:

Mail paper return without payment to:

Make check payable to:

Department of Revenue Services

Commissioner of Revenue Services

State of Connecticut

Attach check to return with paper clip.

PO Box 2974

PO Box 150406

Do not staple.

Hartford CT 06104-2974

Hartford CT 06115-0406

Form CT-1120 (Rev. 12/12)

Page 3 of 3

Form Ct-1120 - Corporation Business Tax Return - 2012 Page 3

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