Form Rct-101xd - Amended Pa Corporate Tax Report printable pdf download

AMENDED

DEPARTMENT USE ONLY

RCT-101XD (7-02) I

10164021049

PA CORPORATE

DATE RECEIVED

TAX REPORT 20

P A D E P A R T M E N T O F R E V E N U E

RCT-101XD

B U R E A U O F C O R P O R A T I O N T A X E S

D E P T . 2 8 0 7 0 1

H A R R I S B U R G , P A 1 7 1 2 8 - 0 7 0 1

DLN

STEP A

Tax Period Beginning

Ending

■

Tax Period

2. Print or type Corporation Name, Account ID, Entity ID (EIN) and Address.

STEP B

❒

Check if address change (Complete and file Form REV-854).

Corporation

■

❒

Check if 2000 report has been settled.

Name

❒

Check here if tax report is prepared by Tax Practitioner and you ONLY require name and address label.

and

■

DR6

DR7

Corporation Name

Account ID

❒

✔

Address

TAX DLN

Number and Street

Entity ID (EIN)

City or Town, State, and Zip Code

STEP C

Calculation of Tax

1. Income to be Apportioned-as filed (RCT-101, Section C, Line 7)

2. Increase for Bonus Depreciation (Column C, Schedule B-3)

3. Decrease for Additional PA Depreciation (Column H, Schedule B-3)

4. Income to be Apportioned without Depreciation Adjustments

(Line 1 + Line 2 – Line 3)

5. Apportionment as filed (RCT-101, Section C, Line 8)

6. Amended Income Apportioned to PA (Line 4 x Line 5)

7. Non-business income (or loss) allocated to PA (RCT-101, Section C, Line l0)

8. Amended Taxable income or loss (Line 6 + Line 7)

9. Less Net Operating Deductions (from RCT-103)

Cannot exceed $2,000,000

10. Amended PA Taxable Income (Line 8 – Line 9)

11. Amended PA CNI Tax (Line 10 x .0999)

12. PA CNI Tax as filed (RCT-101, Section C, Line 14)

13. Additional PA CNI Tax Due to Depreciation Adjustments (Line 11 – Line 12)

Method of

Payment

Check Attached

Paid via EFT

Credit Transfer Instructions Attached

❒

■

14.

Check here to mail settlement notice AND requests for additional information to preparer’s address. Preparer’s address must be printed or typed below.

STEP G

TAX PREPARER’S

Sign

PRINT INDIVIDUAL PREPARER OR FIRM’S NAME

INDIVIDUAL OR FIRM’S SIGNATURE OF PREPARER

Mailing Address

Here

15.

INDIVIDUAL OR FIRM’S STREET ADDRESS

PRINT NAME OF PREPARER

CITY

STATE

ZIP CODE

TELEPHONE NUMBER

E-MAIL ADDRESS

(

)

I hereby affirm under penalties prescribed by law that this report (including any accompanying schedules and statements) has been examined by me and to

STEP H

the best of my knowledge and belief is a true, correct and complete report. If prepared by a person other than the taxpayer, his declaration is based

Signature

on all information of which he has any knowledge.

SIGNATURE OF OFFICER OF COMPANY

DATE

TELEPHONE NUMBER

(

)

16.

Sign Here X

PRINT OFFICER NAME