Form Pte-C - Nonresident Composite Payment Return - 2006 Page 3

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*06128302PTK1*
SCHEDULE
A
D
R
LABAMA
EPARTMENT OF
EVENUE
Entity’s FEIN
PTE-CK1
0
Reset Schedule
9/06
For the year January 1 - December 31, 200___ or other tax year beginning ___________________, 200___ ending ___________________, 200___
(D) Owner’s/ Shareholder’s
(G) Non-Corporate
(H) Corporate
(A) Non-Resident Owner’s/Shareholder’s Name,
(B) Social Security
(C) Entity
(E) Guaranteed
(F) Total Income
Share of Nonseparately
Owner’s/Shareholder’s
Owner’s Share of
Stated Income +
Share of Tax Due
Street Address, City, State, and ZIP
Number/FEIN
Type
Payments
(Col. D + E)
Tax Due (Col. F X 6.5%)
Portfolio Income
(Col. F X 5%)
1
2
3
4
5
6
7
8
9
10
11
12
13 Add lines 1 through 12, enter here and on page 2, line 13, columns (D) through (H) . . . . . . . . . . . . . . . .
Additional page _________

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