Form A-10 - Business & Occupation Activities Return

Form A-10 - Business & Occupation Activities Return - 2010 Page 4

7. Service & Other Activities (May - Dec income only)

6. Service & Other Activities (Jan - April income only)

I.D.

Amount

I.D.

Amount

Bad Debts

[0401]

Bad Debts

[50401]

Cash & Trade Discounts

[0402]

[50402]

Interstate & Foreign Sales

[0404]

(Apportionment)

[50404]

Advances Reimburse-

[0407]

ments; Rtns & Allowances

[50407]

Gambling; Prize; Cash

[0410]

[50410]

Pay-Outs

Qualified Initiation Fees;

[0411]

[50411]

Dues; Contributions Rec’d

Interest on Certain

[0412]

[50412]

Invest/Loan/Obligations

Artistic/Cultural Activities

[0416]

Artistic/Cultural Activities

[50416]

Other (Explain below):

[0499]

Other (Explain below):

[50499]

Total

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(10-22-10)

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Form A-10 - Business & Occupation Activities Return - 2010 Page 4

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