Utah Partnership/Limited Liability Partnership/Limited Liability Company Return of Income
TC-65G
TC-65 Schedule G
Clear form
Rev. 12/06
Partnership/Limited Liability Partnership/Limited Liability Company Name
Taxable Year Ending
Employer Identification Number
General Partners/Managing Members
Please make any corrections in the space provided
Individual
Corporation
SSN/EIN: ________________________
Partnership
Limited Liability Partnership
Limited Liability Company
Name: ________________________
Address: ________________________________________________
City: ________________________________________________
State: ________________ ZIP Code: ______________________
Telephone: _________________________
Date Affiliated: ________________ Date Withdrawn: ________________
Individual
Corporation
SSN/EIN: ________________________
Partnership
Limited Liability Partnership
Limited Liability Company
Name: ________________________
Address: ________________________________________________
City: ________________________________________________
State: ________________ ZIP Code: ______________________
Telephone: _________________________
Date Affiliated: ________________ Date Withdrawn: ________________
Individual
Corporation
SSN/EIN: ________________________
Partnership
Limited Liability Partnership
Limited Liability Company
Name: ________________________
Address: ________________________________________________
City: ________________________________________________
State: ________________ ZIP Code: ______________________
Telephone: _________________________
Date Affiliated: ________________ Date Withdrawn: ________________
Individual
Corporation
SSN/EIN: ________________________
Partnership
Limited Liability Partnership
Limited Liability Company
Name: ________________________
Address: ________________________________________________
City: ________________________________________________
State: ________________ ZIP Code: ______________________
Telephone: _________________________
Date Affiliated: ________________ Date Withdrawn: ________________