Form 4h - Wisconsin Corporation Declaration Of Inactivity - 2016

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4H
Wisconsin Corporation
Form
Declaration of Inactivity
2016
For 2016 or taxable year beginning
and ending
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Complete form using BLACK INK .
Due Date: 15th day of 3rd month following close of taxable year.
Corporation Name
A1 Federal Employer ID Number (FEIN)
Number and Street
A2 Wisconsin Tax Number (WTN)
Suite Number
City
State
ZIP (+ 4 digit suffix if known) B State of Incorporation
and
Year
Enter abbrevia-
tion of state in
box, or if a
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C
Enter
if you have an extension of time to file. Enter extended due date
.
foreign country,
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enter below.
Corporation Balance Sheets
ENTER NEGATIVE NUMBERS LIKE THIS
 –1000
(a) Beginning of
(b) End of
Taxable Year
Taxable Year
NOT LIKE THIS
 (1000)
NO COMMAS; NO CENTS
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1 Cash . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1
00
.
.
2 Net trade notes and accounts receivable . . . . . . . . . . . . . . .
2
00
00
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3 Inventories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3
00
00
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4 Government obligations . . . . . . . . . . . . . . . . . . . . . . . . . . . .
4
00
00
.
.
5 Other current assets (attach schedule) . . . . . . . . . . . . . . . .
5
00
00
.
.
6 Loans to stockholders . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
6
00
00
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.
00
7 Mortgage and real estate loans . . . . . . . . . . . . . . . . . . . . . .
7
00
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8 Other investments (attach schedule) . . . . . . . . . . . . . . . . . .
8
00
00
.
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9 Net buildings and other fixed depreciable assets . . . . . . . . .
9
00
00
.
.
10 Net depletable assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
00
00
.
.
00
11 Land (net of any amortization) . . . . . . . . . . . . . . . . . . . . . . . 11
00
.
.
12 Intangible assets (amortizable only) . . . . . . . . . . . . . . . . . . . 12
00
00
.
.
13 Other assets (attach schedule) . . . . . . . . . . . . . . . . . . . . . . 13
00
00
.
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14 Total assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
00
00
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15 Accounts payable . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
00
00
.
.
16 Mortgages, notes, bonds payable in less than 1 year . . . . . 16
00
00
.
.
00
17 Other current liabilities (attach schedule) . . . . . . . . . . . . . . . 17
00
.
.
00
18 Loans from stockholders . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
00
.
.
00
19 Mortgages, notes, bonds payable in 1 year or more . . . . . . 19
00
.
.
00
00
20 Other liabilities (attach schedule) . . . . . . . . . . . . . . . . . . . . . 20
21 Capital stock:
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.
00
00
a Preferred stock . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21a
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.
00
00
b Common stock . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21b
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00
22 Paid-in or capital surplus . . . . . . . . . . . . . . . . . . . . . . . . . . . 22
00
.
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23 Retained earnings — Appropriated . . . . . . . . . . . . . . . . . . . 23
00
00
.
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24 Retained earnings — Unappropriated . . . . . . . . . . . . . . . . . 24
00
00
.
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25 Adjustments to shareholders’ equity . . . . . . . . . . . . . . . . . . 25
00
00
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26 Less: Cost of treasury stock . . . . . . . . . . . . . . . . . . . . . . . . . 26
00
00
.
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27 Total liabilities and stockholders’ equity . . . . . . . . . . . . . 27
00
00
IC-046

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