Form 510c - Maryland Composite Pass-Through Entity Income Tax Return - 2011 Page 2
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SCHEDULE A
Form
510C
Federal employer identification number (9 digits)
Name
Number and street
City or town
State
ZIP code
MARYLAND COMPOSITE PASS-THROUGH ENTITY INCOME TAX RETURN
PASS THROUGH ENTITY MEMBER INFORMATION FOR COMPOSITE FILERS
A
B
C
D
E
F
G
Standard
PTE
Income
Distributive or
Member name
Number of
Exemption
Deduction
Decoupling
allocable
pro rata share
Social Security Number
Exemptions
Amount
Amount
Modifications
to Maryland
of tax paid
SUBTOTAL of members from additional
Form 510 C Schedule A
TOTALS
COM/RAD 071
11-49
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