Form 1120-Sn - Nebraska S Corporation Income Tax Return - 2003
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4Nebraska S Corporation Income Tax Return
FORM 1120-SN
for the calendar year January 1, 2003 through December 31, 2003 or
ne
2003
dep
other taxable year
of
beginning
,
and ending
,
nebraska
PLEASE DO NOT WRITE IN THIS SPACE
department
of revenue
Name
Street or Other Mailing Address
City
State
Zip Code
Check here if you need to receive a printed booklet from
the Nebraska Department of Revenue next year.
Business Classification Code
Date Business Began in Nebraska
Federal Identification Number
Nebraska Identification Number
24 —
Check applicable box(es):
(1)
Initial Return
(2)
Final Return
(3)
Amended Return: Reason for Amending _____________________________
(4)
Form 3800N Attached
Do not file if all shareholders are Nebraska residents and all income is derived from Nebraska sources.
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1 Ordinary income (line 21, Federal Form 1120S) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
2 Nebraska adjustments increasing ordinary income (line 9, Schedule II) . . . . . . . . . . . . . . . . . . . . . . 2
3 Line 1 plus line 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
4 Nebraska adjustments decreasing ordinary income (line 20, Schedule II) . . . . . . . . . . . . . . . . . . . . . 4
5 Nebraska adjusted income (line 3 minus line 4) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
$
6 Income reported to Nebraska (enter line 5 above or line 3, Schedule I, if applicable)
6
If line 6 shows a loss, omit lines 7 through 11
7 Percent of ownership by nonresident individual shareholders . . . . . . . . . . . . . 7
%
8 Percent of ownership by nonresident individual shareholders for whom
Nebraska Nonresident Income Tax Agreements, Forms 12N, are attached . . . 8
%
9 Percent of taxable income subject to withholding (line 7 minus line 8) . . . . . . . 9
%
$
10 Income subject to withholding (line 6 multiplied by line 9) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
10
11 Nebraska income tax withheld for nonresident shareholders (multiply line 10 by .0684) . . . . . . . . .
11
12 Recapture of 3800N credit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
12
13 Total of lines 11 and 12 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
13
14 Tax deposited with Form 7004N and 2003 estimated tax payments . . . . . . . . . . . . . . . . . . . . . . . .
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15 TAX DUE if line 13 is greater than line 14 (line 13 minus line 14) . . . . . . . . . . . . . . . . . . . . . . . . . . .
15
16 Overpayment if line 14 is greater than line 13 (line 14 minus line 13) . . . . . . . . . . . . . . . . . . . . . . . .
16
17 Amount on line 16 you want credited to 2004 estimated tax . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
17
$
18 Overpayment to be REFUNDED (line 16 minus line 17) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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Under penalties of perjury, I declare that as taxpayer or preparer I have examined this return, including accompanying schedules
and statements, and to the best of my knowledge and belief, it is correct and complete.
sign
here
Signature of Officer
Date
Signature of Preparer Other than Taxpayer
Date
(
)
(
)
Title
Phone Number
Address
Phone Number
A COPY OF THE FEDERAL RETURN AND SUPPORTING SCHEDULES MUST BE ATTACHED TO THIS RETURN
Mail this return and payment to: NEBRASKA DEPARTMENT OF REVENUE, P.O. BOX 94818, LINCOLN, NE 68509-4818
Visit our Web site: , or call 1-800-742-7474 (toll free in NE and IA) or 1-402-471-5729.
8-287-2003
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