Form Ia 1120 - Iowa Corporation Income Tax Return - 2013 Page 2
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4IA 1120 Page 2 2013
Schedule A - Other Additions and Reductions
Enter Whole Dollars
Type of Income
Other Additions
Other Reductions
1 Percentage Depletion
2 TIP Credit from federal form 8846
3 Capital Loss Adjustments for filing status 2 or 3
4 Contribution Adjustments for filing status 2 or 3
5 Safe Harbor Lease — Rent
6 Safe Harbor Lease — Interest
7 Safe Harbor Lease — Depreciation
8 Depreciation Adjustment from IA 4562A
9 Tax Exempt Interest and Dividends. See instructions.
10 Iowa Tax Expense/Refund
11 Work Opportunity Credit Wage Reduction from federal form 5884
12 Alcohol & Cellulosic Biofuel Credit from federal form 6478
13 Foreign Dividend Exclusion from Schedule B
14 Federal Securities Interest and Dividends. See instructions.
15 Other. Must attach schedule.
16
TOTALS
Enter total on line 3 of page 1.
Enter total on line 6 of page 1.
Schedule B - Foreign Dividend Exclusion
Enter Whole Dollars
Type of Dividend Income
Total Dividend
Exclusion
1 Less than 20% Owned
x 70%
2 20% to 80% Owned
x 80%
3 More than 80% Owned
x 100%
4 Dividend Gross Up (federal section 78)
x 100%
5
TOTAL. Add lines 1 through 4.
Enter Total on line 13 of Schedule A.
Schedule C2 - Payments
Schedule C1 - Credits
Whole Dollars
Whole Dollars
Description
Amount
Description
Amount
1 Estimated Tax Payments
1 Motor Fuel Credit. Include IA 4136.
a Credit from prior period overpayment
2 Total Nonrefundable Credits. Include IA 148.
b First, Date Paid:
3 Total Refundable Credits, excluding Motor Fuel Credit.
c Second, Date Paid:
Include IA 148.
d Third, Date Paid:
4 Total Credits. Add lines 1-3. Enter on page 1, line 20.
e Fourth, Date Paid:
f Other, Date Paid:
2 Voucher Payment
3 Other Payments. Attach statement.
4 Total. Add lines 1-3. Enter on page 1, line 21.
Additional Information
1. Year business was started in Iowa: __________
2. Last period filed as S corporation (if any): _____________
3. Information from the prior period Iowa return:
Corporation Name: _______________________________________________________________________________________
Net Income/Loss: ___________________________
FEIN: ____________________________________________
4. If part of a federal consolidated group, please provide information about the corporate parent:
Corporation Name: __________________________________
FEIN: ____________________________________________
Under penalties of perjury, I declare that I have examined this return, any attached schedules/statements, and, to the best of my knowledge,
believe it to be true, correct and complete. If prepared by a person other than the taxpayer, the declaration is based on all information of which
there is any knowledge.
Officer’s Signature: _________________________________ Title: ______________________ Date: __________________
Signature of Preparer Other than Taxpayer: __________________________________________ Date: _____________________
Name and Address of Preparer or Preparer’s Employer:
________________________________________________ Preparer’s Telephone No.: _______________________________
________________________________________________ Preparer’s ID No.: ______________________________________
______________________________________________
_________________________________________________________
42-001b
(09/11/13)
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