Form 1065n - Nebraska Return Of Partnership Income - 2016
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Nebraska Return of Partnership Income
FORM 1065N
2016
for the calendar year January 1, 2016 through December 31, 2016 or other taxable year
beginning
,
and ending
,
Name Doing Business As (dba)
PLEASE DO NOT WRITE IN THIS SPACE
Legal Name
Street or Other Mailing Address
City
State
Zip Code Business Class. Code (See Instr.)
Date Business Began in Nebraska
Principal Business Activity in Nebraska
Federal ID Number
Nebraska ID Number
Does the partnership have nonresident individual partners?
II
YES (Complete Schedule
)
NO
Type of Organization
Partnership
Limited Liability Company
Electing Large Partnership
Publicly Traded Partnership
Other (describe) ___________________
Check the applicable boxes:
(1)
Initial Nebraska Return
(3)
Change in Address
(5)
Amended Return
(7)
Form 3800N Attached
(2)
Final Return
(4)
Change in Name
(6)
Form 7004 Attached
(8)
Distributed Form 3800N Credit
1 Ordinary business income (line 22, Federal Form 1065) ..............................................................
1
00
2 Nebraska adjustments increasing ordinary business income (line 8, Schedule A) .......................
2
00
3 Nebraska adjustments decreasing ordinary business income (line 18, Schedule A) ....................
3
00
4 Nebraska adjusted income (line 1 plus line 2 minus line 3; Electing Large Partnerships enter
4
amount from line 11, Nebraska Schedule ELP) .............................................................................
00
5 Income reported to Nebraska (enter line 4 above or line 3, Schedule I, if applicable) ..................
5
00
If line 5 shows a loss, skip lines 6 and 7 and go to line 8.
6 Income reported to Nebraska subject to withholding (enter the Column (F), Schedule II total)....
6
00
7 Nebraska income tax withheld for nonresident individual partners (enter the Column (G),
Schedule II total) ...........................................................................................................................
7
00
8 Form 3800N credit and recapture .................................................................................................
8
00
9 Tax deposited with Form 7004N and 2016 estimated income tax payments .................................
9
00
10 TAX DUE if line 7 plus line 8 minus line 9 is greater than zero.
Check this box if your
payment is being made electronically. ........................................................................................... 10
00
11 Overpayment to be REFUNDED if line 7 plus line 8 minus line 9 is less than zero ...................... 11
00
Under penalties of perjury, I declare that as taxpayer or preparer, I have examined this return, including accompanying schedules and statements,
and to the best of my knowledge and belief, it is correct and complete.
sign
here
Signature of Partner or Member
Date
Email Address
(
)
Title
Phone Number
paid
preparer’s
Preparer’s Signature
Date
Preparer’s PTIN
use only
(
)
Print Firm’s Name (or yours if self-employed), Address and Zip Code
EIN
Daytime Phone
Paper filers must attach a copy of the federal return and supporting schedules to this return.
All filers are encouraged to e-file their return including schedules K-1N.
Mail this return and payment to: Nebraska Department of Revenue, PO Box 94818, Lincoln, NE 68509-4818.
revenue.nebraska.gov, 800-742-7474 (NE and IA), 402-471-5729
8-284-2016
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