Form Nj 1040-Sc - Payment On Behalf Of Nonconsenting Shareholders - 2015
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1New Jersey Gross Income Tax
NJ
Payment on Behalf of
1040-SC
(09-15)
Nonconsenting Shareholders
FOR OFFICIAL USE ONLY
Tax Year Beginning _________________________ and Ending _________________________
New Jersey S Corporation Information
Shareholder Information
Federal Identification Number
NJ Corporation Number
Social Security Number
________________ / ___________ / ________________
Last Name
First name
Taxpayer Name
Address
Street Address
City
State
Zip Code
City
State
Zip Code
Amount of Payment from Schedule K, Part VII, Column (F) or
$
,
.
Schedule K Liquidated, Part VII, Column (H) of the CBT-100S
THIS FORM MAY BE REPRODUCED
New Jersey Gross Income Tax
NJ
Payment on Behalf of
1040-SC
(09-15)
Nonconsenting Shareholders
FOR OFFICIAL USE ONLY
Tax Year Beginning _________________________ and Ending _________________________
New Jersey S Corporation Information
Shareholder Information
Federal Identification Number
NJ Corporation Number
Social Security Number
________________ / ___________ / ________________
Taxpayer Name
Last Name
First Name
Address
Street Address
City
State
Zip Code
City
State
Zip Code
Amount of Payment from Schedule K, Part VII, Column (F) or
$
,
.
Schedule K Liquidated, Part VII, Column (H) of the CBT-100S
THIS FORM MAY BE REPRODUCED
New Jersey Gross Income Tax
NJ
Payment on Behalf of
1040-SC
Nonconsenting Shareholders
(09-15)
FOR OFFICIAL USE ONLY
Tax Year Beginning _________________________ and Ending _________________________
New Jersey S Corporation Information
Shareholder Information
Federal Identification Number
NJ Corporation Number
Social Security Number
________________ / ___________ / ________________
Last Name
First Name
Taxpayer Name
Address
Street Address
City
State
Zip Code
City
State
Zip Code
Amount of Payment from Schedule K, Part VII, Column (F) or
$
,
.
Schedule K Liquidated, Part VII, Column (H) of the CBT-100S
THIS FORM MAY BE REPRODUCED
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