Form 720 - Kentucky Corporation Income And License Tax Return

Form 720 (2001)

Page 2

SCHEDULE Q—KENTUCKY CORPORATION QUESTIONNAIRE

IMPORTANT: Questions 4—12 must be completed by all cor-

6. Did any corporation, individual, partnership, trust or asso-

porations. If this is the corporation’s initial return or if the cor-

ciation at any time during the taxable year own 50 percent

poration did not file a return under the same name and same

or more of the corporation’s voting stock? o Yes o No

federal I.D. number for the preceding year, questions 1, 2 and

If "Yes," attach a schedule listing the name, address and

3 must be answered. Failure to do so may result in a request

federal I.D. number of the entity.

for a delinquent return.

7. If the corporation has a KNOL for the taxable year and is

electing to forego the net operating loss carryback period,

check here o.

1. Indicate whether: (a) o completely new business;

(b) o successor to previously existing business which was

8. Is the corporation a partner in a partnership doing business

organized as: (1) o corporation; (2) o partnership; (3) o sole

in Kentucky? o Yes o No

proprietorship; or (4) o other

If "Yes," list name and federal I.D. number of the partnership

If successor to previously existing business, give name,

Did the corporation have property or payroll in Kentucky,

address and federal I.D. number of the previous business

other than partnership property or payroll? o Yes o No

organization.

9. Was this return prepared on: (a) o cash basis, (b) o accrual

basis, (c) o other

10. Is the corporation a public service corporation subject to

2. List the following Kentucky account numbers. Enter N/A

taxation under KRS 136.120? o Yes o No

for any number not applicable.

11. (a) Did the corporation file a Kentucky intangible property

Employer Withholding

tax return for January 1, 2002? o Yes o No

Sales and Use Tax Permit

(b) Did the corporation file a Kentucky tangible personal

Consumer Use Tax

property tax return for January 1, 2002? o Yes o No

Unemployment Insurance

Coal Severance and/or

Processing Tax

3. If a foreign corporation, enter the date qualified to do busi-

12. Is the corporation currently under audit by the Internal

__ __

/ __ __ / __

Revenue Service? o Yes o No

ness in Kentucky.

If "Yes," enter years under audit

4. The corporation’s books are in care of: (name and address)

If the Internal Revenue Service has made final and unap-

pealable adjustments to the corporation’s taxable income

which have not been reported to this Cabinet, check

here o and file Form 720X, Amended Kentucky Corporation

5. Did the corporation at any time during the taxable year own

Income Tax and Corporation License Tax Return, for each

50 percent or more of the voting stock of another corpora-

year adjusted and attach a copy of the final determination.

tion, either domestic or foreign? o Yes o No

OFFICER INFORMATION (Failure to Provide Requested Information May Result in a Penalty)

Has the officer information entered below changed from the last return filed?

Yes

President’s Name:

Treasurer’s Name:

President’s Home Address:

Treasurer’s Home Address:

President’s Social Security Number:

Treasurer’s Social Security Number:

Vice President’s Name:

Secretary’s Name:

Vice President’s Home Address:

Secretary’s Home Address:

Vice President’s Social Security Number:

Secretary’s Social Security Number:

I, the undersigned, declare under the penalties of perjury, that I have examined these returns, including all accompanying schedules and statements, and to the best of

my knowledge and belief, they are true, correct and complete.

41A7200023

Signature of principal officer or chief accounting officer

Date

Name and Social Security or federal identification number of person or firm preparing return

Form 720 - Kentucky Corporation Income And License Tax Return - 2001 Page 2

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