Form 1120f - Franchise Return For Financial Institutions

Schedules A & D

Schedule A

Schedule D

1. Cash to Accrual Adjustments

2. Expenses to Carry Tax Exempts section 291 & 265

3. Expense to Carry Investment Subsidiary

4. Contribution Adjustments

5. Capital Loss Adjustments

6. Iowa Franchise Tax Refund Reported on Federal Return

7. Other:

8 .

9 .

10.

11.

1 2 .

TO TA L S

Enter Totals On:

LINE 4, IA 1120F, Schedule A

LINE 6, IA 1120F, Schedule D

Schedule C2 - Payments

Current Period’s Estimated Tax Payments

Amount

Date of Payment

Please note:

1. Prior Period’s Overpayment Credited to Current Period

Use whole dollars for all amounts

2. First Installment:

shown on this return and any schedules

3. Second Installment:

or attachments.

4. Third Installment:

5. Fourth Installment:

Mail your return to:

6. Additional Installment:

Franchise Tax Return Processing

7. Voucher/Extension Payments

8. Other Payments

Iowa Department of Revenue and Finance

PO Box 10413

Des Moines IA 50306-0413

9. Total Payments. Add lines 1-8.

Enter on line 18, IA 1120F

NOTE: Failure to complete the schedule below will result in an incomplete return and may delay processing.

Allocation Schedule

Information for distributing Iowa Franchise Tax to incorporated cities and counties

Incorporated City Where Branch is Located

City

County

IOWA Branch Address

Name of Iowa Incorporated City Percent

Code No. Code No. Name of County

1 .

2 .

3 .

4 .

5 .

6 .

7 .

8 .

9 .

1 0 .

1 1 .

T O TA L

NOTE: “Percentage” is each location’s percent of demand deposits net of withdrawals calculated to the nearest one-hundredth of 1 percent.

In the City Code No. column, enter code “01” for county seat cities and code “00” for rural locations in unincorporated areas.

Additional Information

Any questions?

1 Short period information: Period____/____to____/____

Iowa is in the Central Time Zone.

Reason for short period: ________________________________________________________

Call 1-800-367-3388 (Iowa only)

2 Year business was started in Iowa: _________

or 515/281-3114

3 Information from the p r i o r return:

Hours: 9 a.m. - 4 p.m., Monday-Friday

Corporation Name: _____________________________________________________________

Federal TIN: ____________________________________ Net Income: ___________________

E-mail: idrf@idrf.state.ia.us

4 Accounting method:

Cash

Accrual

Year accrual method began: _________

43-001b (08/31/01)

Name of Financial Institution: ___________________________________ TIN: ___________________

Form 1120f - Franchise Return For Financial Institutions - 2001 Page 2

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