Form E-2012 - Combined Tax Return For Trusts & Estates
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1TAXABLE YEAR
COMBINED TAX RETURN
FORM E-2012
From:
to
FOR TRUSTS & ESTATES
ACCOUNT #
FEIN #
DUE DATE: 15th day of 4th month
Multnomah County
after taxable year end
Business Income Tax
FEDERAL BUSINESS CODE
(Calendar Year Filers: 4/15/2013)
City of Portland
Business License Tax
NAME
MAILING ADDRESS (Notify the Revenue Bureau if your business location address changes)
STATE
ZIP CODE
CITY
MAILING ADDRESS CHANGE?
CEASED PORTLAND/MULTNOMAH BUSINESS? (attach explanation)
AMENDED RETURN?
ATTACH FEDERAL FORM 1041 AND APPLICABLE SCHEDULES (E, D, etc.) ___
1.
Net Income or (Loss) before distribution .............................................................................................
1
2.
Business Income Tax & Business License Tax Add Back ...................................................................
2
3.
Total lines 1 and 2 ...............................................................................................................................
3
4.
Other income and deductions .............................................................................................................
4
5.
Subject Net Income (total lines 3 and 4) ..............................................................................................
5
Multnomah County Business Income Tax
Average Sum of Multnomah Employees in 2012:
8a.
8c
8.
County Gross Income
.........
8c = (8a ÷ 8b) Cannot be more than 1.0
.
=
8b.
Total Gross Income*
* *If less than $50,000, the taxpayer is exempt and should complete the Annual Exemption Request (see instructions if tenant-in-common)
9.
County Apportioned Net Income (line 5 x line 8c) ..............................................................................
9
(
)
10. Net Operating Loss Deduction (max 75% of line 9) ............................................................................
10
Enter as negative sum
11. Income Subject to Tax (line 9 minus line 10) ......................................................................................
11
12
12. Tax (line 11 x tax rate of 1.45%) MINIMUM $100 ...............................................................................
(
)
13
13. Prepayments .......................................................................................................................................
Enter as negative sum
14
14. Penalty ................................................................................................................................................
15. Interest ................................................................................................................................................
15
16. Balance Due or (Overpayment)
.........................................................
16
— Allocate overpayment on line 17
17.
REFUND:
CREDIT:
TRANSFER TO PORTLAND:
City of Portland Business License Tax
Average Sum of Portland Employees in 2012:
18a.
18. Portland Gross Income
...........
18c = (18a ÷ 18b) Cannot be more than 1.0
=
18c
.
18b.
Total Gross Income*
*If less than $50,000, the taxpayer is exempt and should complete the Annual Exemption Request (see instructions if tenant-in-common)
19
19. Portland Apportioned Net Income (line 5 x line 18c) ..........................................................................
(
)
20. Net Operating Loss Deduction (max 75% of line 19) ..........................................................................
20
Enter as negative sum
21. Income Subject to Tax (line 19 minus line 20) ....................................................................................
21
22. Tax (line 21 x tax rate of 2.2%) MINIMUM $100 .................................................................................
22
(
)
23. Prepayments .......................................................................................................................................
23
Enter as negative sum
24. Penalty ................................................................................................................................................
24
25. Interest ................................................................................................................................................
25
26. Balance Due or (Overpayment)
.........................................................
— Allocate overpayment on line 27
26
27.
REFUND:
CREDIT:
TRANSFER TO MULT CO:
DONATE TO “WORK FOR ART”:
COMBINED AMOUNT DUE WITH REPORT
28.
(total lines 16 and 26) Check #___________ ..........
28
Make check payable to City of Portland, 111 SW Columbia St., Suite #600, Portland, OR 97201-5840.
The undersigned declares that the information given on this report is true. The undersigned is authorized to act as a representative of the filer. Filers of
incomplete returns (including returns that have not reported the Average Sum of Employees) may be subject to civil penalties of up to $500.
Signature of Filer
__________________________________________
__________________
(
)_______________
Date
Filer’s Daytime Phone
Signature of Preparer
_______________________________________
__________________
___________________________
Date
Filer’s Email
Preparer’s Name/Address
____________________________________________________________
Preparer Phone
(
)__________________
REVENUE BUREAU (503) 823-5157
FAX (503) 823-5192
TDD (503) 823-6868
E-2012 Rev 1/11/2013
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