Form 355sc Draft - Domestic Or Foreign Security Corporation Return - 2014
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1
22014
Form 355SC
Massachusetts
Domestic or Foreign Security
Department of
Corporation Return
Revenue
An exact copy of U.S. Forms 1120 or 1120-RIC, including all applicable schedules and forms required to substantiate the Massachusetts excise,
must be made available to the Department of Revenue upon request. Any changes or amendments to any U.S. amount must be explained in detail.
For calendar year 2014 or taxable period beginning
2014 and ending
Name of corporation
U.S. Principal Business Code
Federal Identification number
3
3
3
Principal business address
City/Town
State
Zip
Principal business address in Massachusetts
City/Town
State
Zip
1 Is the corporation incorporated within Massachusetts? 2 Date of charter
3 Class 1 security corporation
Class 2 security corporation
Yes
No
Yes
No
Yes
No
3
3
3
3
4 Date corporation first classified as security corporation 5 Date business began in Mass.
6 State or country of incorporation
7 Avg. number of employees in Mass.
3
3
8 Is a Taxpayer Disclosure Statement enclosed?
9 Most recent year audited by IRS
Have the adjustments been reported to Massachusetts?
Yes
No
Yes
No
3
3
10 Corporation’s books are in the care of
Title
11 Corporation (check one only)
New
Terminated
Has predecessor
Has successor
3
12 Does this entity continue to qualify as a security corporation? If Yes, enclose statement explaining changes in corporate activity since last qualified.
Yes
No
3
13 Is the corporation participating in the filing of a U.S. consolidated return?
Federal Identification number of parent
Yes
No
3
14 U.S. form(s) and schedule(s) filed for this tax year
1120
1120-RIC
851
5471
1120S
1120-REIT
3
Computation of Excise
Use whole dollar method
11 Total U.S. income (from U.S. Form 1120 or appropriate form) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 1
12 State and municipal bond interest not included in line 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 2
13 Adjustments to income. See instructions (enclose schedule) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 3
14 Massachusetts gross income. Add lines 1 through 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
15 Class 1 excise, if applicable (line 4) $ _____________________ × .0033 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
16 Class 2 excise, if applicable (line 4) $ _____________________ × .0132 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
17 Excise before credits (line 5 or 6, whichever applies) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
18 Vanpool Credit and carryover (from Schedule VP). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 8
19 Film Incentive Credit. Certificate number 3
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 9
10 Economic Development Incentive Program Credit. Certificate number 3
. . . . . . . . . . . . . . . . . 3 10
11 Historic Rehabilitation Credit. Certificate number 3
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 11
12 Medical Device Credit. Certificate number 3
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 12
13 Brownfields Credit. Certificate number 3
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 13
14 Low-Income Housing Credit. Building Identification number 3
. . . . . . . . . . . . . . . . . . . . . . . . . 3 14
15 Employee Wellness Program Credit. Certificate number 3
. . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 15
16 Certified Housing Development Credit. Certificate number 3
. . . . . . . . . . . . . . . . . . . . . . . . . . 3 16
17 Excise after credits. Subtract the total of lines 8 through 16 from line 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
456
18 Minimum excise (cannot be prorated) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
19 Excise due before voluntary contribution (line 17 or line 18, whichever is larger) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
20 Voluntary contribution for endangered wildlife conservation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 20
21 Excise due plus voluntary contribution. Add lines 19 and 20. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 21
Under penalties of perjury, I declare that to the best of my knowledge and belief, this return and enclosures are true, correct and complete.
Signature of appropriate officer (see instructions)
Date
Social Security number
Title
Signature of paid preparer
Date
Employer Identification number
Address
If you are signing as an authorized delegate of the appropriate corporate officer, check here
and enclose Massachusetts Form M-2848, Power of Attorney.
The Privacy Act Notice is available upon request. Mail to: Massachusetts Department of Revenue, PO Box 7067, Boston, MA 02204.
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