010841200
FORM CRB page 1 of 2
MAINE FRANCHISE TAX
Combined Report For Unitary Members
Federal EIN: ______________________
COMBINED
The Combined Report must be accompanied by a legible copy of the
REPORT
parents Federal Consolidated Tax Return pages 1, 2, 3 and 4 (or equivalent).
This report must be attached to your Form 1120B-ME.
Column 1
Column 2
Column 3
Column 4
Column 5(A)
Column 5(B)
Nexus
per
Books
Adjustments and eliminations for columns 5(B) through 8
(Attach schedule showing origin of any amount on this line)
TOTALS