Schedule F Individual - Other Income - 2006 Page 2
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2
3Schedule F Individual - Page 2
Rev. 12.06
Part II
Corporate Dividends and Partnerships Distributions
34
34
Column C
Column D
Column A
Column B
Employer Identification
Subject to
Subject to withholding
Payer's name
Not subject to withholding
Account Number
Subject to withholding
withholding(Distributions
(Deemed distributions under
Number
under Section
Section
1012(j) or 1221(d))
1012(j) or 1221(d))
00
00
00
00
(01)
00
00
00
00
(02)
00
00
00
00
(03)
00
00
00
(04)
00
00
00
00
00
(05)
00
00
00
00
Total distributed amount ......................................................................
(12)
1.
(09)
........................................................................
(06)
00
(
)
Less: Exempt amount from dividends distributed under Act No. 26 of 1978 .........................................................................
2.
(15)
Total (Transfer the total of Column D to Part 2, line 2E of the return ).....................................................................................
00
3.
00
Special tax: 10% of Column A (Enter in Part 4, line 19 of the return).................................................................................
4.
(07)
(10)
00
Special tax: 5% of Column B (Enter in Part 4, line 20 of the return) ....................................................................
5.
00
(13)
Special tax: 5% of Column C (Enter in Part 4, line 21 of the return) ...................................................................
6.
Tax withheld or paid (Submit Form 480.6B. Enter on Schedule B Individual, Part III, lines 5, 6 and 7, as applicable)
7.
..
(08)
(11)
(14)
00
00
00
NOTE: If you elected to include the distributions indicated in Columns A, B and/or C as ordinary income, do not consider lines 4, 5 and/or 6, and transfer the total of line 1, Columns A, B and/or C to Part 2, line 2D of the return.
Part III
Special Partnerships Profits
(SUBMIT SCHEDULE R - SEE INSTRUCTIONS)
40
Employer Identification Number
Profits
Payer's name
00
(01)
00
(02)
00
(03)
00
Total Profits (Transfer to Part 2, line 2B of the return)...............................
.................................................................................................................................................................................
(04)
Part IV
Profits from Corporations of Individuals
Payer's name
Profits or Losses
Employer Identification Number
00
(05)
00
(06)
00
(07)
Net profit ..................................................................................................................................................................................................................................................................................
00
Less: Losses from previous years
(Submit Schedule) .....................................................................................................................................................................................................................
(
)
00
Total Profits
00
(Transfer to Part 2, line 2F of the return. If it is less than zero, enter zero)...................................................................................................................................................................
(08)
Part V
Distributions and Transfers from Governmental Plans
Taxable Amount - Savings Account
Fill in if
Distribution
(A)
(B)
(C)
(D)
(F)
(E)
(G)
Description
you Prepaid
Date
Total
Basis
Taxable
Taxable Amount
Lump-sum
Distributions under
Transfers under
distributions
Distribution
Amount
Act 250 of 2006
$10,000
Section 1169B
($10,000 or more)
1.
Taxable as ordinary income (Transfer the amount of
00
00
00
00
(09)
(12)
(14)
Columns C and E to Part 2, line 2G of the return) ..............
00
2.
00
00
00
Taxable at 10% .......................................................
(10)
(15)
(16)
00
00
3.
Taxable at 5% .........................................................
00
(11)
(13)
4.
Tax on distributions or transfers (5% of Column D and 10% of Columns F and G. Enter in Part 4, line 25 of the return) ........................................................................................................................
00
(17)
5.
Tax withheld (Enter on Schedule B Individual, Part III, line 18) .............................................................................................................................................................................................................
00
(18)
Retention Period: Ten (10) years
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