Form Psa - Alabama Business Privilege Tax Return And Annual Report - 2004 Page 3
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1
2
3Tax Rate Schedule
Chart 1 Privilege Tax Rate Schedule
Chart 2 Maximum Privilege Tax Amounts
Federal Taxable Income, before net operating loss deduction and special
$3,000,000 financial institutions groups, insurance companies subject to
deductions, apportioned and allocated to Alabama: $___________________
Alabama Insurance Premium Tax.
$
15,000 regular C corporations, S corporations, regulated utilities, real estate
If Taxable Income of The Taxpayer Is:
investment trusts, limited liability entities, business trusts,
At Least
But Less Than
The Tax Rate Shall Be
disregarded entities, and insurance companies not subject to
$
1
.00025 ($0.25 per $1,000)
Alabama Insurance Premium Tax.
$
1
$ 200,000
.00100 ($1.00 per $1,000)
$
500 electing family limited liability entity.
$ 200,000
$ 500,000
.00125 ($1.25 per $1,000)
$
100 certain corporations not engaged in any business other than holding
$ 500,000
$2,500,000
.00150 ($1.50 per $1,000)
title to property and paying expenses thereof.
$2,500,000
.00175 ($1.75 per $1,000)
If this entity filed an Alabama Income Tax Return or an Alabama Financial
Institution Excise Tax Return using a different FEIN than the one listed on this
Form PSA, please enter that number here:
_________________________________________________________________
Schedule E – Initial Privilege Tax Calculation
THIS SECTION IS TO BE COMPLETED ONLY BY ENTITIES WHO INCORPORATED, ORGANIZED, QUALIFIED, REGISTERED OR STARTED DOING BUSINESS IN
ALABAMA DURING THE TAX YEAR. Enter the date the entity incorporated, organized, qualified, registered, or started doing business in Alabama, whichever occurred
first: mm/dd/yy ______/______/______. Complete Schedule A as of this date.
1 Total Net Worth from Schedule A, line 6, 10, or 16 (see instructions, part IV) . . . . . . . . . . . . . . . . . . . .
1
2 Total exclusions from Schedule B, line 7 (see instructions, part IV) . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2
3 Net worth subject to apportionment (line 1 minus line 2) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3
.
4 Alabama property factor as of the initial day (see instructions, part IV) . . . . . . . . . . . . . . . . . . . . . . . . .
4
— — — — %
— — —
5 Taxable net worth (line 3 multiplied by line 4). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
5
6 Total deductions from Schedule B, line 19 (see instructions, part IV). . . . . . . . . . . . . . . . . . . . . . . . . . .
6
7 Taxable Alabama net worth (line 5 minus line 6) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
7
.00025
8 Tax rate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
8
9 Gross tax due (multiply line 7 by line 8) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
9
.
10 Ratio of the days remaining in the calendar year divided by 365 (see instructions, part IV) . . . . . . . . .
10
— — — — %
— — —
11 Tax due (multiply line 9 by line 10) ($100 minimum) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
11
I authorize a representative of the Department of Revenue to discuss my return and attachments with my preparer.
UNDER PENALTIES OF PERJURY, I declare that I have examined this return and accompanying schedules and statements and, to the best of my knowledge and
belief, they are true, correct, and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge.
Please
Sign Here
Your
Signature**
Title
Date
Date
Phone number
Preparer’s social security no.
Paid
Preparer’s
signature
Preparer’s
Firm’s name (or yours,
E.I. No.
Use Only
if self-employed)
ZIP Code
and address
**Paid preparers may sign in lieu of an officer IF a power of attorney is on file with the Department of Revenue or attached to this return.
CHECK LIST
Have The Following Forms Been Attached To Form PSA?
Pages 1 through 4 of the unconsolidated federal return.
For insurance companies, pages 1 through 8 of the
federal return and the balance sheet.
Copy of Alabama income tax apportionment schedule
(for multi-state taxpayers).
Documentation to validate all exclusions and
deductions.
Enclose payment of amount due on line 20 (minimum
$100.00).
Page 3
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