Form 355x - Amended Corporation Excise Return (Page 2 of 4) in pdf

Refund/Tax Due

Column A

Column B

Column C

As originally filed

Net increase or (decrease)

Corrected amount

17 Excise due plus voluntary contribution

and recapture (from other side). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17

. . . . . . . . . ¨ 18

18 Credit from

19 Massachusetts estimated tax payments. Do not include

amount in line 18. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ¨ 19

20 Payments made with extension. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ¨ 20

21 Amount paid with original return . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ¨ 21

22 Other payments made after filing original return. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ¨ 22

23 Total payments. Add lines 18 through 22 in column C . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23

24 Overpayment, if any, as shown or as adjusted on the original return . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ¨ 24

25 Net payments. Subtract line 24 from line 23 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25

26 Amount of refund. If line 25 is greater than line 17, column C, enter difference . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26

27 Additional tax due. If line 25 is less than line 17, column C, enter the difference . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27

28 Late file penalties $ _________________ Late pay penalty $ ________________ M-2220 $ _______________ . . . . . . . . . . . . . . . . . ¨ 28

29 Interest. (If filed after the due date of the return, see instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ¨ 29

30 Total amount due. Add lines 27, 28 and 29 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ¨ 30

Explanation of Changes

31 Explanation of changes. Enter the line number for which you are reporting a change and give the reason for each change. If you need more space than is provided below,

attach an additional sheet of paper. Also, attach all additional information, supporting forms and schedules.

_________________________________________________________________________________________________________________________________________

Refund Application

32 Refund Application (Substitute application for abatement). For refund requests as shown in line 26 on this amended return, and filed after the due date of the original

return, the taxpayer named herein makes application for abatement of the tax assessed for the period stated pursuant to the applicable Massachusetts General Laws, Chap-

ters 63 and 121A. Consent is hereby given, pursuant to Chapter 58A, section 6, for the Commissioner of Revenue to act upon this amended return after six months from the

date of filing. This consent is provided to protect my rights where processing of my refund is delayed for any reason. My consent may be withdrawn at any time. If I refuse

consent by striking out this section, or by withdrawing my consent, the refund will be denied (1) at the expiration of six months from the date of filing or (2) at the date con-

sent is withdrawn, whichever is later.

Declaration

Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my

knowledge and belief, it is true, correct and complete. Declaration of preparer (other than taxpayer) is based on all information of which he/she

has knowledge.

Signature of appropriate officer (see instructions)

Date

Soc. Security number

Title

Individual or firm signature of preparer ¨

Date

Employer Identification number