California Form 568 - Limited Liability Company Return Of Income

TAXABLE YEAR

CALIFORNIA FORM

2002

568

Limited Liability Company Return of Income

For calendar year 2002 or fiscal year beginning month ________ day _______ year 2002, and ending month ________ day ________ year ________ .

Limited liability company name (type or print)

D Secretary of State file number

A Principal business activity name

(same as federal)

DBA

E Date business started in California

B Principal product or service

(same as federal)

Number and street (or PO Box number if mail is not delivered to street address)

PMB no.

F Enter total assets at end of year.

See instructions.

C Principal business code

City or town

State

ZIP Code

b $

(same as federal)

I Check applicable box

(1)

Initial return

H FEIN

b (2)

G Check accounting method:

Final

(3)

Amended

b (1)

Cash

(2)

Accrual

(3)

Other (attach explanation)

return

Yes No

J J J J J Enter the maximum number of members in the LLC at any time during the

Q Q Q Q Q Are any members in this LLC also LLCs or partnerships? .

year. Attach a California Schedule K-1 (568) for each of these members . b

R R R R R Does the LLC meet all the requirements shown in the

Yes No

K K K K K Is this LLC an investment partnership? See instructions . . . . . . . . . . . . . . b

instructions for Question R? . . . . . . . . . . . . . . . . . . . . . . . .

Yes No

L L L L L Is this LLC apportioning income to California using Schedule R? . . . . . . . b

S S S S S Is this LLC a member or partner in another LLC

Yes No

M M M M M Was there a distribution of property or a transfer (for example,

or partnership? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes No

by sale or death) of an LLC interest during the taxable year? . . . . . . . . . . b

T T T T T Is this LLC a publicly traded partnership as defined in

Yes No

N N N N N Is this LLC under audit by the IRS or has it been audited in a prior year? . . .

IRC Section 469(k)(2)? . . . . . . . . . . . . . . . . . . . . . . . . . . . .

O O O O O Did this LLC or its subsidiary(ies) have a transfer or acquisition

U U U U U (1) Is this LLC a business entity disregarded for tax

Yes No

purposes? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . b

of more than 50% in control or ownership? (See Instructions – Penalties

Yes No

May Apply.) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . b

(2) If yes, see instructions and complete Side 1 and

Yes No

P P P P P (1) Does the LLC have any foreign nonresident members? . . . . . . . . . . . b

Side 3. Are there credits or credit carryovers

Yes No

(2) Does the LLC have any nonresident members? . . . . . . . . . . . . . . . . . . b

attributable to the disregarded entity? . . . . . . . . . . b

(3) Were Form 592, Form 592-A, and Form 592-B filed for these

V V V V V Is the LLC required to complete federal Form 8271?

Yes No

members? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . b

If “Yes,” see instructions . . . . . . . . . . . . . . . . . . . . . . . . . . .

1 Total income from Limited Liability Company Income Worksheet, line 19 . . . . . . . . . . . . . . . . . . . . . . . . . . b

2 Limited Liability Company fee. See instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . b

3 2002 annual Limited Liability Company tax. See instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . b

4 Nonconsenting nonresident members’ tax liability from Schedule T . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Attach

check

5 Total tax and fee. Add line 2, line 3, and line 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6 Amount paid with form FTB 3537 and 2002 form FTB 3522 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

money

7 Overpayment from prior year allowed as a credit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

order

here.

8 Nonresident Withholding Credit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

9 Total payments. Add line 6, line 7, and line 8 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

10 Tax and fee due. If line 5 is more than line 9, subtract line 9 from line 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . .

11 Overpayment. If line 9 is more than line 5, subtract line 5 from line 9 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

12 Amount of line 11 to be credited to 2003 tax or fee . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . .

13 Amount to be refunded. Subtract line 12 from line 11 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

, , , , ,

14 Penalties and interest. See instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . .

, , , , ,

15 Total amount due. Add line 10 and line 14. Pay this amount with this return . . . . . . . . . . . . . . . . . . . . . . . . 15

Single Member LLC Information and Consent — Complete only if the LLC is disregarded.

Federal TIN/SSN

Sole Owner’s Name (as shown on owner’s return)

SOS File No.

Return filed with the FTB by the Owner

Street Address, City, State, and ZIP Code

(1) Form 540

(5) Form 541

Consent statement: I consent to the jurisdiction of the State of California to tax my LLC income and agree to file returns and pay tax as may be required

(2) Form 100

(6) Form 100S

by the Franchise Tax Board.

(3) Form 565

(7) Form 568

Signature

Date

Title

(4) Other _________________

Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is

Please

true, correct, and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge.

Sign

Telephone

Here

(

)

Signature of officer

Date

Preparer’s SSN/PTIN

Check if

Preparer’s