Form 611x - Amended Akaska Corporation Net Income Tax Return - 2011

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611X
AMENDED ALASKA CORPORATION NET
Department
Use Only
INCOME TAX RETURN
FSN.SEQ
ENVELOPE
Federal EIN
EIN used on original return, if different
For the tax year
ended:
Name
Name used on original return, if different
Address
Phone number
Fax number
City
State
Zip +4
Contact phone number
E-mail address
Contact person
Title
Check if under Audit at this time by the Alaska Department of Revenue
Note: Complete Form 611N to carry back net operating losses and net capital losses
(a)
(b)
(c)
As originally reported
Net change
Correct
or as adjusted
(Attach explanation)
Amount
1. Apportionable income
2. Alaska apportionment factor
3. Alaska apportioned income
4. Non-business income (loss)
5. Alaska Items
6. Alaska Income (total of lines 3, 4, 5)
7. Alaska net operating loss deduction
8. Alaska Taxable Income
9. Alaska Income Tax
10. Other Taxes
11. Federal-based credits
12. Total Tax (Total of lines 9, 10, 11)
13. Incentive Credits
14. Alaska Education Credit
15. Net Alaska income tax. (Total of lines 12, 13, 14)
16. Net payments. (Total previous payments less total previous refunds, credits, penalties and interest )
17. (a) If tax on line 15, column (c) is larger than net payments on line 16, enter tax due
(b) Interest on amount on line 14(a) from __/__/__ to __/__/__
(See instructions for interest rates)
(c) Total amount due
18. If prepayments on line 16 are larger than tax on line 15, column (c), enter overpayment
to
ADDITIONAL REQUIRED INFORMATION: An Explanation of changes and a complete copy of the federal amended return, if filed, must be provided
constitute a complete amended return.
I declare, under penalties of perjury, that I have examined this application and accompanying schedules and statements, and to the best of my knowledge and belief it is
true, correct, and complete. Preparer’s declaration is based on all information of which preparer has any knowledge.
Officer’s signature
Date
Title
Preparer’s signature
Date
Preparer’s SSN or PTIN
Check if Self-Employed
Firm’s name
EIN
check if DOR may dicuss this return
with the preparer (see Instructions)
Firm’s address
City
State
Zip + 4
Validation#
CFWD
Mail to: ALASKA DEPARTMENT OF REVENUE
REFUND
TAX DIVISION
PO BOX 110420
APPROVED
611X
JUNEAU AK 99811-0420
DATE
0405-611X Rev 09/11
Retain a copy for your records

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