Form 480.20 - Corporation Income Tax Return

Corporation - Page 4

Form 480.20

Rev. 04.13

Compensation to Officers

Percentage of time

Percentage of stocks owned

Name of officer

Social security number

devoted to

Compensation

industry or business

Common

Preferred

Total compensation to officers (Enter in Part V, line 20) .................................................................................................................................

Questionnaire

Yes No

If a foreign corporation, indicate if the trade or business in Puerto Rico

(1)

was held as a branch ......................................................

(9c)

........................................................................

If a branch, indicate the percent that represents the income from sources

(1) Did more than 80% of the total income was derived from activities

within Puerto Rico from the total income of the corporation: ________%

exclusively related to fishing or transportation of passengers or

Did the corporation keep any part of its records on a computerized system

(9c1)

cargo or lease? ..................................................................

(3)

during this year? .........................................................................

d) Residential property outside of Puerto Rico? ......................................

(9d)

The corporation's books are in care of:

(1) Did more than 80% of the total income was derived from activities

Name

(9d1)

exclusively related to the lease of property to non related persons? ...

Address __________________________________________________

10.

Did the corporation claim expenses connected to:

__________________________________________________________

(10a)

a) Housing (except business employees) .....................................

E-mail _____________________________________________________

b) Employees attending conventions or meetings outside Puerto Rico

Telephone _________________________________________________

(10b)

or the United States? ...........................................................

Indicate the accounting method used for book (tax) purposes:

11.

Did the corporation distribute dividends other than stock dividends or

Cash

Accrual

distributions in liquidation in excess of the corporation's current and

Other (specify):

accumulated earnings? .....................................................................

(11)

Did the corporation file the following documents?:

12.

Is the corporation a partner in any special partnership? (If more than one,

(a) Informative Return (Forms 480.5, 480.6A, 480.6B) ...................

(6a)

(12)

submit detail) ..............................................................................

(b) Withholding Statement (Form 499R-2/W-2PR) ...........................

(6b)

Name of the special partnership _________________________________

If the gross income of the entity or of the controlled group exceeds

Employer identification number _________________________________

$3,000,000, are financial statements audited by a CPA licensed in Puerto

13.

Did you receive exempt income? (Submit Schedule IE Corporation) ............

(13)

Rico included with this return? ...........................................................

(7)

14.

Enter the amount corresponding to charitable contributions to municipalities

Number of employees during the year:____________________________

included in Part V, line 41: ________________________________________

Did the corporation claim expenses connected to the ownership, use,

15.

Indicate if insurance premiums were paid by an unauthorized

maintenance and depreciation of:

(15)

insurer ........................................................................................

(9a)

(a) Vehicles? ...................................................................................

16.

Employer's number assigned by the Department of Labor and Human

(b) Vessels? ...................................................................................

(9b)

Resources:

(1) Did more than 80% of the total income was derived from activities

17.

Number of stockholders: __________________________________

exclusively related to fishing or transportation of passengers or

(9b1)

cargo or lease? ................................................................

OATH

We, the undersigned, president (or vice-president, or other principal officer) and treasurer (or assistant treasurer), or agent of the corporation for which this income

tax return is made, each for himself declare under penalty of perjury, that this return (including schedules and statements attached) has been examined by us, and to

the best of our knowledge and belief, is a true, correct, and complete return, made in good faith, pursuant to the Puerto Rico Internal Revenue Code of 2011, as

amended, and the Regulations thereunder.

____________________________________________

President's or vice-president's signature

Treasurer's or assistant treasurer's signature

_________________________________________

Agent

SPECIALIST'S USE ONLY

I declare under penalty of perjury that this return (including schedules and statements attached) has been examined by me, and to the best of my knowledge and belief is a true, correct,

and complete return. The declaration of the person who prepares this return is with respect to the information received, and this information may be verified.

Registration number

Date

Self-employed Specialist

Specialist's name (Print)

Firm's name

Specialist's signature

Zip Code

Address

NOTE TO TAXPAYER

Indicate if you made payments for the preparation of your return:

Yes

No. If you answered "Yes", require the Specialist’s signature and registration number.