Form 512e - Oklahoma Return Of Organization Exempt From Income Tax - 2012

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Oklahoma Return of Organization
Form 512E - 2012
Exempt from Income Tax
AMENDED
Section 501(c) of the Internal Revenue Code
RETURN!
For the year January 1 - December 31, 2012, or other taxable year
If this is an
Amended Return
beginning:
ending:
place an
2012
‘X’ here
,
,
Name of Organization
Address (number and street)
City, State and Zip
Federal Employer Identification Number
OFFICE USE ONLY
Date Qualified for Tax Exempt Status
Enter the name and address used on your return for prior year (if same, write “same”). If none filed, give reason.
Part 2: Statement of Unrelated Business Taxable Income
(Please read instructions on pages 2-4)
Total Federal
Allocable Oklahoma
A. Total unrelated trade or business income -
applicable Federal Form(s) 990
B. Total unrelated trade or business deductions -
applicable Fed. Form(s) 990
C. Unrelated business taxable income - Enter here and on line 1 below
Income Subject to Tax
1. Unrelated business taxable income - from statement above (allocable to Oklahoma) .............
00
1
00
2. Other net income - enclose schedule .......................................................................................
2
3. Oklahoma taxable income (total of lines 1and 2) ......................................................................
00
3
Tax Computation
00
4. Tax at 6% of line 3 (If Trust - See Rate Schedule on page 2) ..................................................
4
00
5. Amount paid on 2012 estimate .................................................................................................
5
00
6. Oklahoma withholding
(enclose Form 1099, Form 500A, Form 500B or other withholding statement).
6
00
7. Add lines 5 and 6 and enter amount .........................................................................................
7
00
8. Overpayment (if line 7 is larger than line 4 enter amount overpaid) ........................................
8
00
9. Amount of line 8 to be credited to 2013 estimated tax .............................................................
9
Line 10 instructions provide you the opportunity to make a financial gift from your refund to a variety of Oklahoma
organizations. Place the line number of the organization from the instructions to this form in the box below and enter
the amount you are donating. If giving to more than one organization, put a “99” in the box and attach a schedule
showing how you would like your donation split.
00
10. Donations from your refund..........................
$2
$5
$ ___________ ....
10
00
11. Add lines 9 and 10 and enter amount .......................................................................................
11
12. Amount to be refunded to you (line 8 minus line 11) ..................................................... Refund
00
12
Is this refund going to or through an account that is located outside of the United States?
Direct Deposit Note:
Yes
No
Deposit my refund in my:
Routing
All refunds must be by direct deposit.
checking account
Number:
See Direct Deposit Information on
Account
page 4 for details.
savings account
Number:
13. Tax Due (if line 4 is larger than line 7 enter tax due) .................................................. Tax Due
00
13
14. Donation: Public School Classroom Support Fund ........
$2
$5
$ __________ ....
00
14
(For information regarding this fund, see page 4, #17)
00
15. For delinquent payment, add penalty of 5% _____ plus interest at 1 1/4% per month .............
15
00
16. Underpayment of estimated tax interest (enclose Form OW-8-P) .............................................
16
Balance Due
00
17. Total tax, donation, penalty and interest due -
Add lines 13-16; pay in full with return..
17
Part 3: Signature and Verification
Under penalty of perjury, I declare the information contained in this document, attachments and schedules are true and correct to the best of my knowledge and belief.
Check this box if
Signature of Officer
Date
Signature of Preparer
Date
the Oklahoma Tax
or Trustee
Commission
may discuss this
Preparer’s Address
Print Name
return with your
tax preparer.
Title
Phone Number
Phone Number:
Preparer’s PTIN:
with Area Code

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