Form Bca-1.35 - Allocation Factor Interrogatories - 1999 Page 2
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1
2PART II: COMPUTATION OF BUSINESS TRANSACTED
(Gross receipts — see notes on page 4)
Line
Line
(C)
(d)
The information below
reference
reference
Gross amount
Gross amount
is given as of
to
to
of business
of business
________________ , _______
IRS Form
IRS Form
transacted
transacted
(Month & Day)
(Year)
everywhere
at or from
1120
1120S
Illinois
Gross receipts, less returns
1c
1c
$ _______________
$ _______________
Dividends
4
4b (Sch. K)
$ _______________
$ _______________
Interest
5
4a (Sch. K)
$ _______________
$ _______________
Gross rents
6
3a (Sch. K)
and Line 2
(form 8825)
$ _______________
$ _______________
Gross royalties
7
4c (Sch. K)
$ _______________
$ _______________
Capital gains-
Sch. D
Sch. D
gross sales price
[Line 1
[Line 1
col. (d)]
col. (d)]
$ _______________
$ _______________
Sales of business
Form 4797
Form 4797
property - gross
[Line 2
[Line 2
sales price
col (d) and
col. (d) and
Line 22]
Line 22]
$ _______________
$ _______________
Other income
10
5
$ _______________
$ _______________
Non-taxable receipts:
Tax-exempt interest
Sch. M-1
Sch. M-1
or dividends
Line 7
Line 5a
$ _______________
$ _______________
Other
$ _______________
$ _______________
TOTAL GROSS RECEIPTS
$ ____________
$ ____________
(Gross Amount of Business Transacted)
IMPORTANT!
These interrogatories must be accompanied by a photocopy of the appropriate pages of the IRS Form 1120 or 1120S
containing the line references for all lines completed above. If the corporation is included in a consolidated return, the
appropriate schedules must also be provided.
The undersigned corporation has caused this statement to be signed by its duly authorized officers, each of whom
affirms, under penalties of perjury, that the facts stated herein are true.
Dated _______________________________ , _________
___________________________________________
(Month & Day)
(Year)
(Exact Name of Corporation)
attested by _____________________________________
by __________________________________________
(Signature of Secretary or Assistant Secretary)
(Signature of President or Vice President)
______________________________________________
_________________________________________
(Type or Print Name and Title)
(Type or Print Name and Title)
Page 2
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