PART II: COMPUTATION OF BUSINESS TRANSACTED
(Gross receipts — see notes on page 4)
Line
Line
(c)
(d)
The information below
reference to
reference to
Gross amount
Gross amount
is given as of
IRS Form
IRS Form
of business
of business
____________________ , _______
1120
1120S
transacted
transacted at or
everywhere
from Illinois
Month & Day
Year
Gross receipts, less returns
1c
1c
$ _______________ $ _______________
Dividends
4
4b (Sch. K)
$ _______________ $ _______________
Interests
5
4a (Sch. K)
$ _______________ $ _______________
Gross rents
6
3A (Sch. K)
and Line 2
(form 8825)
$ _______________ $ _______________
Gross royalties
7
4c (Sch. K)
$ _______________ $ _______________
Capital gains —
Sch. D
Sch. D
gross sales price
[Line 1
[Line 1
col. (d)]
col. (d)]
$ _______________ $ _______________
Sales of business
Form 4797
Form 4797
property — gross
[Line 2
[Line 2
sales price
col (d) and
col. (d) and
Line 20]
Line 20]
$ _______________ $ _______________
Other income
10
5
$ _______________ $ _______________
Non-taxable receipts:
Tax-exempt interest
Sch. M-1
Sch. M-1
or dividends
Line 7
Line 5a
$ _______________ $ _______________
Other
$ _______________ $ _______________
TOTAL GROSS RECEIPTS
$ _______________ $ _______________
(Gross Amount of Business Transacted)
IMPORTANT—These interrogatories must be accompanied by a photocopy of the appropriate pages of the IRS Form 1120
or 1120S containing the line references for all lines completed above. If the corporation is included in a consolidated return,
the appropriate schedules also must be provided.
The undersigned corporation has caused this statement to be signed by a duly authorized officer who affirms, under penal-
ties of perjury, that the facts stated herein are true and correct. All signatures must be in BLACK INK.
Dated _______________________________ , _____
________________________________________________
Month & Day
Year
Exact Name of Corporation
______________________________________
Any Authorized Officer’s Signature
______________________________________
Name and Title (type or print)
Page 2