3 of 4
2006 Form 4I
Page
Under penalties of law, I declare that this return and all attachments are true, correct, and complete to the best of my knowledge and belief.
Signature of Officer
Title
Date
Preparer’s Signature
Preparer’s Federal Employer ID Number
Date
Attach a copy of your federal return, related schedules, and annual statement.
Make your check payable to and mail your return to:
Wisconsin Department of Revenue
PO Box 8908
Madison, WI 53708-8908
Schedule 1 – Additions to Federal Taxable Income
.
00
1 Loss carryforward deducted in the calculation of federal taxable income . . . . . . . . . . . . . . . . .
1
2 Dividend income received to the extent used as a deduction in determining federal
.
00
taxable income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2
.
00
3 Interest income that is not included in federal taxable income . . . . . . . . . . . . . . . . . . . . . . . . .
3
.
00
4 State taxes accrued or paid . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
4
.
00
5 Extraterritorial income exclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
5
.
00
6 Federal section 179 expense deduction in excess of Wisconsin deduction . . . . . . . . . . . . . . .
6
7 Federal depreciation/amortization in excess of Wisconsin depreciation/amortization
.
00
(attach schedule) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
7
8 Amount by which the federal basis of assets disposed of exceeds the Wisconsin basis
.
00
(attach schedule) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
8
.
00
9 Additional deduction for insurers required to discount unpaid losses . . . . . . . . . . . . . . . . . . . .
9
.
00
10 Research credits computed (from Sch. R, lines 15 or 28 and 32) . . . . . . . . . . . . . . . . . . . . . . . 10
.
00
11 Development zones credits computed (from Sch. DC, lines 5, 13, and 21) . . . . . . . . . . . . . . . 11
.
12 Early stage seed investment credit (from Sch. VC, line 10) . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
00
.
13 Health Insurance Risk-Sharing Plan (HIRSP) assessment credit computed . . . . . . . . . . . . . . 13
00
14 Other (list):
a
14a
b
14b
c
14c
d
14d
e
14e
.
00
Add lines 14a through 14e . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
.
00
15 Total (enter on Form 4I, page 1, line 2) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
Go to Page 4
*C34I06991*