Form Ia 1040c - Composite Individual Income Tax Return

2001 IA 1040C

Composite Individual Income Tax Return

Partnerships, Subchapter S Corporations, Trusts and Limited

Liability Companies for filing on behalf of Nonresident

Partners, Shareholders, Beneficiaries or Members

For Calendar Year 2001

MAIL TO

or fiscal year beginning ____/____, 2001, and ending ____/____, 20____

COMPOSITE RETURN PROCESSING

DEPARTMENT OF REVENUE AND FINANCE

PLEASE NOTE: A copy of Federal Schedule K-1 for ALL Iowa nonresidents

PO BOX 10469

must be attached to this return, regardless of whether or not they are reporting

DES MOINES IA 50306-0469

income or remitting tax with this form.

STEP 1

Complete Company Name

Taxpayer Identification Number

Name

Current Mailing Address (number, street, apartment number, suite)

and

Check One Only

Address

This return is for:

Post Office Box

Partners

Shareholders

City, State and ZIP Code

Beneficiaries

Name of Contact Person

Daytime Telephone Number

Members

STEP 2

Figure Your

Enter the number of individuals whose Iowa-source income exceeds the

Exemption

minimum amount required to be included in this return. See instructions. ............. s _____ X $40 = _________

Credits

1. Enter the total Iowa-source income of all individuals whose Iowa-source income

STEP 3

exceeds the minimum amount required to be included in this return. ............................................................. 1 . s ______________ .00

Composite

Income

2. Deduction in lieu of Federal tax deduction. See instructions. ..................... 2 . s _________________ .00

STEP 4

3. Standard deduction. See instructions. .............................................................. 3 . s _________________ .00

Figure

Your

4. Total deductions. ADD lines 2 and 3. ...................................................................................................................... 4 .

_______________ .00

Deductions

5. Composite taxable income. SUBTRACT line 4 from line 1. ............................................................................... 5 .

_______________ .00

6. Computed tax. Apply line 5 to rate schedule on back. .................................. 6 . s _________________ .00

STEP 5

7. Minimum tax. See instructions. .......................................................................... 7 . s _________________ .00

Figure

Your Tax

8. Total tax. ADD lines 6 and 7. .................................................................................................................................. 8 .

_______________ .00

9. Personal exemption credits - Nonrefundable. See Step 2 above. ............. 9 . s _________________ .00

STEP 6

10. Other nonrefundable credits. See instructions. ............................................ 10. s _________________ .00

Figure

Your

11. Total nonrefundable credits. ADD lines 9 and 10. .............................................................................................. 1 1 .

_______________ .00

Credits

12. Balance. SUBTRACT line 11 from line 8. If less than zero, enter zero. ........................................................ 12. s _______________ .00

13. Estimate payments for 2001 and/or prior-year credit carryover ............ 1 3 . s _________________ .00

14. Other credits. See instructions. ..................................................................... 1 4 . s _________________ .00

15. Total credits. ADD lines 13 and 14. .................................................................................................................... 1 5 .

_______________ .00

16. If line 15 is more than line12, SUBTRACT line 12 from line 15. This is the amount you OVERPAID. .. 1 6 . s _______________ .00

STEP 7

17. Amount of line 16 to be REFUNDED to you ....................................................................................................... 1 7 . s _______________ .00

Figure

Your

18. Amount of line 16 to be applied to your 2002 estimate tax ........................ 1 8 . s _________________ .00

Refund or

19. If line 15 is less than line 12, SUBTRACT line 15 from line 12. This is the AMOUNT OF TAX YOU OWE. . 1 9 . s _______________ .00

the

Amount

20. Penalty. See instructions. ..................................................................................................................................... 2 0 . s _______________ .00

You Owe

21. Interest. See instructions. .................................................................................................................................... 2 1 . s _______________ .00

22. TOTAL AMOUNT DUE. ADD lines 19, 20 and 21, and enter here. ............................................................. 2 2 . s _______________ .00

Make your check payable to TREASURER, STATE OF IOWA

April 30, 2002

SIGN AND DATE YOUR RETURN

FOR A CALENDAR YEAR FILER, THIS RETURN IS DUE BY

I (We), the undersigned, declare under penalty of perjury that I (we) have examined this return and attachments, and, to the best of my (our) knowledge and belief, it

is a true, correct, and complete return. Declaration of preparer (other than taxpayer) is based on all information of which the preparer has any knowledge.

Preparer’s Signature: _____________________________________ Date __________

Signature of Officer: _________________________________________ Date ________

Preparer’s ID No.: _________________________________________

Title: ___________________________________________________________

Firm Name: ______________________________________________________________

Daytime Telephone Number: ______________________________________

Preparer’s Address: _______________________________________________________

41-006a (10/04/01)