Form Nyc-115 Draft - Unincorporated Business Tax Report Of Change In Taxable Income Made By Internal Revenue Service And/or New York State Department Of Taxation And Finance - 2015
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4-115
UN IN CORP O RAT ED BU SI NE S S TAX R EP ORT
OF
CHANGE IN TAXABLE INCOME MADE BY INTERNAL
TM
REVENUE SERVICE AND/OR NEW YORK STATE
Department of
Finance
DEPARTMENT OF TAXATION AND FINANCE
FOR TAXABLE YEARS BEGINNING PRIOR TO JANUARY 1, 2015
TO BE FILED WITHIN 90 DAYS AFTER A FINAL DETERMINATION
For CALENDAR YEAR _________or FISCAL YEAR beginning ______________________ and ending _______________________
Name
Name
n
SOCIAL SECURITY NUMBER
Change
In Care of
Address (number and street)
Address
n
Change
PARTNERSHIPS, ESTATES AND TRUSTS ONLY,
ENTER EMPLOYER IDENTIFICATION NUMBER
City and State
Zip Code
Country (if not US)
Telephone Number
Taxpayer’s Email Address
A. If this form is filed by a member of a partnership to report a federal or New York State change affecting his/her share, give name and Employer Identification Number of partnership.
Name of member: _____________________________________________________________________________
EIN:
-
-
-
-
n
n
B. Enter date of Final Determination: (3)
Federal
New York State
Payment Amount
Payment
A.
A
Amount being paid electronically with this return
Calculation Of Unincorporated
COLUMN A
COLUMN B
COLUMN C
Business Tax - See Instructions.
Original Amount
Net Change
Correct
as last adjusted
From Page 2, Schedule A
Amount
1.
1.
Total income
1.
................................................................................
2.
2.
Taxable income
2.
.........................................................................
3.
Tax
3.
3.
....................................................................................................
4.
4.
Business tax credit
4.
...................................................................
5.
5.
Total tax
5.
.........................................................................................
6.
6.
UBT paid credit
6.
..........................................................................
7.
Unincorporated business tax
7.
7.
...............................................
8.
8.
Other credits
8.
................................................................................
9.
9.
Net tax
9.
(line 7 less line 8)
..........................................................
COLUMN D
COLUMN E
SUMMARY
Additional Tax Due
Refund Due
10. If amount in column C, line 9 is greater than amount in column A, enter
difference in column D
10.
(see instructions for treatment of prior NYC adjustments)
....................
11. If amount in column C, line 9 is less than amount in column A, enter
11.
difference in column E
11.
(see instructions for treatment of prior NYC adjustments)
.......................
12. Interest (see instructions)
12.
........................................................................................................................
see instructions)
13. Additional charges
13.
(
.................................................................................................
14. Total amount due (add lines 10, 12 and 13)
14.
...................................................................................
15. Refund due (enter amount from line 11 above)
15.
C E R T I F I C AT I O N
Firm's Email Address:
I hereby certify that this return, including any accompanying rider, is, to the best of my knowledge and belief, true, correct and complete.
I authorize the Dept. of Finance to discuss this return with the preparer listed below. (see instructions)....YES
n
_________________________________________
Preparer's Social Security Number or PTIN
Signature of taxpayer:
Title:
Date:
Preparer's
Preparer’s
signature:
printed name:
Date:
Firm's Employer Identification Number
n
Check if self-
employed
Firm's name
s Address
s Zip Code
60111591
NYC-115 - 2015
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