Income Tax Return Form - Massillon Tax Department - 2004 Page 2

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ATTACH COPIES OF ALL FEDERAL SCHEDULES AND SUPPORTING STATEMENTS
LINE 1. NET PROFIT/LOSS (FORM 1041, 1065, 1120 1120S, ETC.)
1. $
SCHEDULE X
RECONCILIATION WITH FEDERAL INCOME TAX RETURN - Attach Schedules
SCHEDULE X - RECONCILIATION WITH FEDERAL INCOME TAX RETURN
ITEMS NOT DEDUCTIBLE
ADD
ITEMS NOT TAXABLE
DEDUCT
a. Capital Losses (Do Not include ordinary losses from Federal Form 4797)
$
n. Capital Gains (Do not include ordinary gains from Federal Form 4797)
$
b. Interest and / or other Expenses incurred in the production of non-taxable
o. Interest earned or accrued
income (at least 6% of Line r)
p. Dividends (Less Federal exclusion)
c. Income Taxes, City and State (if Deducted as Expense)
q. Other items not taxable (explain)
d. Net operating loss deduction per Federal return
e. Payments to partners per Federal Form 1065
f.
Retirement plan payments (Keogh, IRA, Tax Sheltered Annuity)
r.
Total deductions
g. Portion State of Ohio Franchise tax based on Income
h. Other items not deductible (explain)
m. Total Additions
LINE 2. EXCESS INCOME/DEDUCTIONS (SCHEDULE X LINE M MINUS LINE R)
2. $
LINE 3. RECONCILED NET PROFIT/LOSS (LINE 1 PLUS LINE 2)
3. $
SCHEDULE Y BUSINESS ALLOCATION FORMULA
a. LOCATED
b. LOCATED IN
c. PERCENTAGE
(b ÷ a)
EVERYWHERE
THIS MUNICIPALITY
STEP 1.
AVG. VALUE OF REAL & TANG. PERSONAL PROPERTY
GROSS ANNUAL RENTALS PAID MULTIPLIED BY 8
%
TOTAL STEP 1.
STEP 2.
GROSS RECEIPTS FROM SALES MADE AND/OR WORK
%
OR SERVICES PERFORMED
%
STEP 3.
WAGES, SALARIES, AND OTHER COMPENSATION PAID.
%
4.
TOTAL PERCENTAGES.
%
5.
AVERAGE PERCENTAGE (Divide Total Percentages By 3).
LINE 4. ALLOCATED NET PROFIT/LOSS (LINE 3 MULTIPLIED BY STEP 5 SCHEDULE Y)
4. $
LINE 5. NET OPERATING LOSS CARRY FORWARD
5. $(
)
ATTACH SCHEDULE
LINE 6. MASSILLON TAXABLE INCOME (LINE 4 PLUS LINE 5)
6. $
IF LOSS ENTER ZERO AND CARRY FORWARD TO NEXT YEAR
ENTER LINE 6 ON PAGE 1 LINE 1
SCHEDULE Z
Partners’ Distributive Shares of Net Income - From Federal Schedules 1065 K-1 and 1120S K-1
3. Distributive Shares
2. Resident
4. Other
5. Taxable
6. Amount
of Partners
Payments
Percentage
Taxable
Partner’s Social
Yes
No
Percent
Amount
1. NAME AND MUNICIPALITY OR TOWNSHIP OF EACH PARTNER
Security No.
$
$
$
7. TOTALS
100
$

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