Form R - Business Income Tax Return - 2014 (Page 3 of 3) in pdf

ALL FEDERAL SCHEDULES LISTED BELOW AND OTHER

PAGE 3 OF 3

SUPPORTING DOCUMENTS MUST BE ATTACHED TO THIS RETURN

SCHEDULE X - Reconciliation with Federal Income Tax Return

ITEMS NOT DEDUCTIBLE

ADD

ITEMS NOT TAXABLE

DEDUCT

N. Capital Gains from sale, exchange or other disposition (including

A. Capital Losses (including IRC 1221 & 1231 property) …………….

IRC 1221 & 1231 property) …………………………………………..

B. Expenses attributable to non-taxable income ………………………. $

O. Interest earned or accrued …………………………………………..

C. City & State income taxes and other taxes based on income ………. $

P. Dividends …………………………………………………………… $

D. Net Operating Loss deduction per federal return (Line 29a from

Form 1120) …………………………………………………………….

Q. Other intangible income (please explain) …………………………..

E. Payments to Partners (including former partners) ………………….. $

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R. Federal Tax Credits (if expense reduction) ………………………… $

F. Amounts distributed or set aside for REIT & RIC investors ……….

G. Amounts deducted for self-employment retirement, health and life

insurance plans ………………………………………………………..

S. Other income exempt from city tax (please explain) ……………….

H. Special Deduction (Line 29b from Form 1120) ……………………. $

_______________________________________________________

I. Rental activities by Partnership, S-Corp, LLC, Trusts ……………… $

Z. Total of Lines N through S …………………………………………. $

J. Other expenses not deductible (please explain) ……………………..

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M. Total of Lines A through J …………………………………………. $

1. INCOME PER FEDERAL RETURN ATTACHED…………………………………………………………………………………………………………………. $

2. A. ITEMS NOT DEDUCTIBLE (From Line M Schedule X above) ……………………………………………………

Add

B. ITEMS NOT TAXABLE (From Line Z Schedule X above) ………………………………………………………… Deduct

C. ENTER EXCESS OF LINE 2A OR 2B (Carry to Line 2-A Page 1) (MUST BE ALLOCATED FOR EACH LOCALITY) …………………………………..

SCHEDULE Y - Business Apportionment Formula

Use this schedule if engaged in business in more than one locality, and you do not have books and records which will disclose with reasonable accuracy what portion of the net profits is

attributed to that part of the business done within the boundaries of the city or cities involved.

A. Located Everywhere

Step 1. Original cost of real and tangible personal property ……………………………………………………………. $

Gross annual rentals multiplied by 8 ……………………………………………………………………………. $

Total Step 1 ………………………………………………………………………………………………………………………………………………….

Step 2. Gross receipts from sales made and work or services performed …………………………………………………………………………………………..

Step 3. Total wages, salaries, commissions and other compensation of all employees …………………………………………………………………………….

B. List city portion of the above 3 steps in spaces below and compute percentage of each appropriate locality (B divided by A)

CLAY TWP-

BUTLER TWP

VANDALIA

BROOKVILLE

UNION

WEST MILTON

CLAYTON

CLAYTON JEDD

JEDZ

Step 1

Step 2

Step 3

Average

Percentage*

TOTAL

INCOME**

Balance of adjusted net income …………………………………………………………………………………………………………………………………………... $

Total adjusted net income ………………………………………………………………………………………………………………………………………………… $

Are any employees leased in the year covered by this return? (Check box)

Yes

If yes, please provide Name _______________________________ Address ________________________________________ and Federal ID # of the leasing company ___________________________

All Partnerships required to file as entities must attach ALL of the federal schedules detailing the partners’ distributive shares (Federal Schedule K and K-1).

*Determine average percentage by dividing total percentages by number of percentages used.

**Multiply adjusted net income by the average for each locality and enter allocable amount by locality in this space.