Form Int-5 - Farmer'S Cooperative Credit Associations Intangible Property Tax Return - 2007

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MISSOURI DEPARTMENT OF REVENUE

DLN

2007

TAXATION BUREAU

573-751-2326

P.O. BOX 898, JEFFERSON CITY, MO 65105-0898

FARMER’S COOPERATIVE CREDIT ASSOCIATIONS

INT-5

INTANGIBLE PROPERTY TAX RETURN

2008 TAXABLE YEAR — BASED ON THE 2007 CALENDAR YEAR INCOME PERIOD.

DUE DATE April 15, 2008

FEDERAL ID NUMBER

ADDRESS CORRECTION

___ ___ ___ ___ ___ ___ ___ ___ ___

REQUESTED

NAME

ADDRESS

CITY, STATE, ZIP CODE

COUNTY

PART I

1. Gross income derived from all sources during 2007 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

2. Gross income derived from notes and mortgages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

3. Ratio of Line 2 to Line 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

4. Total of dividends declared and credited (whether paid or not) to share accounts of members in 2007 . . . . . .

5. Taxable portion of dividends (

% Line 3 multiplied by Line 4) . . . . . . . . . . . . . . . . . . . . . . . . . . .

6. Amount of tax for 2008 (2% of Line 5) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6A. Miscellaneous credits (attach schedule) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6A $

6B. Enterprise zone credit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6B $

6C. Missouri tax — Line 6 less Lines 6A and 6B . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6C $

7. Plus interest at the rate of 8% per annum of line 6C for payment after April 15, 2008. . . . . . . . . . . . . . . . . . . .

8. Total Amount Due

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

MAKE CHECK OR MONEY ORDER PAYABLE TO “FINANCIAL INSTITUTION TAX”. If you pay by check, you authorize the Department of Revenue to process the

check electronically. Any check returned unpaid may be presented again electronically. MAIL COMPLETED FORM AND ATTACHMENTS TO THE TAXATION BUREAU,

P.O. BOX 898, JEFFERSON CITY, MO 65105-0898.

PART II — POLITICAL SUBDIVISIONS TAXING THE REPORTING ASSOCIATION

This must be completed — Information shown on your Real or Personal Property Tax Receipt

Do Not Use

SUBDIVISIONS

NAME OR NUMBER