Form Tc-20s, Schedule K Shareholders' Pro Rata Share Items Page 2

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TC-20S, Schedule K-1
TC-20S K1 2012
20226
Shareholder’s Share of Utah Income, Deductions and Credits
S corporation Information
Shareholder’s Share of Utah Income, Deductions and Credits
A S corporation’s EIN: _ _ _ _ _ _ _ _ __ _ _ _ _ __ ___
_________ _ _ _ _ . 00
1. Utah ordinary business income (loss)
B S corporation’s name, address, city, state and ZIP Code:
____ ____ _ __ _ _ . 00
2. Utah net rental real estate income (loss)
____ _____ _ _ __ . 00
3. Utah other net rental income (loss)
_________ _ _ _ _ . 00
4a. Utah U.S. government interest income
_________ _ _ _ _ . 00
4b. Utah municipal bond interest income
Shareholder Information
____ _____ _ _ __ . 00
4c. Utah other interest income
C Shareholder’s SSN or EIN: _ _ _ _ _ __ _ _ _ _ _ __ __
_ _______ _ _ _ __ . 00
5. Utah ordinary dividends
D Shareholder’s name, address, city, state and ZIP Code:
___ _____ _ __ _ _ . 00
6. Utah royalties
____ _____ _ _ __ . 00
7. Utah net short-term capital gain (loss)
____ _____ _ _ __ . 00
8. Utah net long-term capital gain (loss)
E Percentage of ownership: _ _ _ _ _ __ _ _ _ _ __ ___
___ _____ _ __ _ _ . 00
9. Utah net Section 1231 gain (loss)
Other Information
_ _______ _ _ _ __ . 00
10. Recapture of Section 179 deduction
11. Utah other income (loss) (describe)
______ ________
_________ _ _ _ _ . 00
______ ________
_________ _ _ _ _ . 00
______ ________
_________ _ _ _ _ . 00
_________ _ _ _ _ . 00
12. Utah Section 179 deduction
_________ _ _ _ _ . 00
13. Utah contributions
_________ _ _ _ _ . 00
14. Utah investment interest expense
___ _____ _ __ _ _ . 00
15. Utah Section 59(e)(2) expenditures
___ _____ _ __ _ _ . 00
16. Foreign taxes paid or accrued
Note:
To complete lines 1 through 17:
17. Utah other deductions (describe)
_______ _______
________ _ _ _ _ _ . 00
_______ _______
________ _ _ _ _ _ . 00
_______ _______
_________ _ _ _ _ . 00
All filers complete lines 18 though 20.
18. Utah nonrefundable credits:
Tax Commission Use Only
Credit name
Code
Amount
______ ____
___
_ _______ _ _ _ __ . 00
______ ____
___
_ _______ _ _ _ __ . 00
______ ____
___
_ _______ _ _ _ __ . 00
19. Utah refundable credits:
Credit name
Code
Amount
______ ____
___
_ _______ _ _ _ __ . 00
______ ____
___
_ _______ _ _ _ __ . 00
______ ____
___
_ _______ _ _ _ __ . 00
________ _ _ _ _ _ . 00
20. Utah tax withheld on behalf of shareholder
___
“X” if withholding waiver applied for:

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