Form Rct-125 - Cooperative Agriculture Association Corporate Net Income Tax Report

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RCT-125 (9-97) I
COOPERATIVE AGRICULTURE ASSOCIATION
Page 1
CORPORATE NET INCOME TAX REPORT
MAIL THIS FORM WITH REMITTANCE PAYABLE TO
THE PA DEPARTMENT OF REVENUE ALONG WITH
FIRST REPORT
AMENDED REPORT
PAYMENT TRANSMITTAL FORM (REV-856S) TO
(Newly Incorporated/
Franchised)
THE PA DEPARTMENT OF REVENUE, DEPT .
COMMONWEALTH OF PENNSYLVANIA
280407, HARRISBURG,PA 17128-0407.
LAST REPORT
COVERS LESS THAN
COMPOSITE
DEPARTMENT OF REVENUE
(Going out-of-existence)
A FULL 12-MO. PERIOD
REPORT
IMPORTANT
THIS REPORT IS DUE ON OR BEFORE THE 15TH
NAME
(Place Preprinted Label Here)
ACCOUNT ID
OF APRIL OR FOR AN ASSOCIATION REPORTING
ON A FISCAL YEAR BASIS, ON OR BEFORE THE
15TH DAY OF THE FOURTH MONTH AFTER THE
STREET ADDRESS
ENTITY ID (EIN)
CLOSE OF ITS FISCAL YEAR.
A PENALTY FOR LATE FILING WILL BE IMPOSED IN
THE AMOUNT OF 10% ON THE FIRST $1000 OF
TAX PERIOD ENDING
CITY
STATE
ZIP CODE
TAX, 5% ON THE NEXT $4000 AND 1% ON EVERY
THING IN EXCESS OF $5000.
19
TO THE COMMONWEALTH OF PENNSYLVANIA, DEPARTMENT OF REVENUE, HARRISBURG, PENNSYLVANIA
The above Cooperative Agricultural Association submits the following report of its net income for the year stated above.
THIS REPORT IS REQUIRED UNDER THE PROVISIONS OF THE ACT OF MAY 23, 1945, P.L. 893.
In case the entire business transacted by the association is transacted within this Commonwealth, net income for the calendar year or fiscal year shall
be only an amount equal to the sum of the dividends declared or declared and paid on the shares of common and preferred stock during the year.
In case the entire business is not transacted by the association within this Commonwealth, the tax imposed by this act shall be based upon such portion
of the net income for the calendar or the fiscal year, as defined herein as shall be attributed to business transacted in this Commonwealth by multiplying such
net income by a fraction of which the numerator is the gross receipts received from business transacted within the Commonwealth and of which the denomi-
nator is the amount of the gross receipts received from all the business.
GENERAL INFORMATION
Date of incorporation or organization
Created under the Act of
The association’s books are in care of
Located at
STREET
CITY
STATE
ZIP CODE
How many places of business does the association maintain in Pennsylvania?
How many places of business does the association maintain outside of Pennsylvania?
GROSS RECEIPTS (IF MORE SPACE IS NECESSARY, ATTACH RIDER.)
ASSIGNABLE TO PENNSYLVANIA
ASSIGNABLE OUTSIDE PENNSYLVANIA
PLACE OF BUSINESS
AMOUNT
PLACE OF BUSINESS
AMOUNT
TOTAL
TOTAL
TOTAL OF ALL GROSS RECEIPTS
COMPUTATION OF TAX
1. Net income (dividends declared or declared and paid, Schedule A Line 10) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $
2. Tax (4% of Item 1) - Leave blank if entire business is not transacted in Pennsylvania . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3. Allocating percentage (Determination of allocating percentage below) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
4. Net income allocated to Pennsylvania . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
5. Tax (4% of Item 4)
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $
6. Penalty (for failure to file report within time limit prescribed by law) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $
7. Amount due Commonwealth. If remitting payment by Electronic Funds Transfer (EFT), place an “X” in this block . . . . . . . .
$
Mail completed tax report to the PA Department of Revenue at the address listed above. Beginning 01/01/94 payments of $20,000 or more must be
remitted by EFT. To participate in the EFT program, the Department first must receive your completed Authorization Agreement. For EFT questions only,
call 1-800-892-9816.
DETERMINATION OF ALLOCATION PERCENTAGE
Divide (a) by (b) to Obtain Decimal - Carry Out Decimal Six Places
(a) Gross Receipts Assignable to Pennsylvania
$
=
(b) Gross Receipts from all Business
$
AFFIRMATION OF ASSOCIATION OFFICER
, of
I,
(NAME)
(TITLE)
, hereby affirm under penalties prescribed by law that this report
(NAME OF ASSOCIATION)
(including any accompanying schedules and statements) has been examined by me and to the best of my knowledge and belief is a true, correct and complete report.
(
)
(DATE OF AFFIRMATION)
(SIGNATURE OF OFFICER)
(TELEPHONE NUMBER)
TO BE COMPLETED BY ASSOCIATION OFFICER

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