Form Il-1023-C - Composite Income And Replacement Tax Return 2010 Page 3

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Illinois Department of Revenue
Year ending
Composite Return
____ ____
Schedule BC
Month
Year
Membership
Attach to your Form IL-1023-C
IL Attachment no. 1
Write your name as shown on your Form IL-1023-C.
Write your
federal employer identifi cation number (FEIN).
_____________________________________________________________
___ ___ - ___ ___ ___ ___ ___ ___ ___
Identify the members included in your composite return
A
B
C
D
E
F
Check the box if the
Pass-through
Partner or
member is an Illinois resident
entity payment
Social Security number
Shareholder type Share of income
and is included based on
amount.
Name and Address
or FEIN
(See instructions.)
or loss (%)
department-approved petition. (See instructions.)
1
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________________________________
_________________
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_________
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2
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_________________
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3
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________________________________
________________________________
_________________
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4
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________________________________
________________________________
________________________________
_________________
______
_________
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5
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________________________________
________________________________
________________________________
_________________
______
_________
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6
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________________________________
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________________________________
_________________
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7
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_________________
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8
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*030901110*
Schedule BC (R-12/10)
Reset
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