Form Br-25 - City Income Tax Return Business Return - 2003 Page 2

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BUSINESS NAME
EIN/F.ID. NUMBER
SCHEDULE X RECONCILIATION WITH FEDERAL INCOME TAX RETURN
1. INCOME PER ATTACHED FEDERAL RETURN (Form 1120, Line 28; Form 1120S, Sch. K, Line 23; Form 1120A, Line 24; or Form 1065,
“Analysis of Net Income (Loss)”, Line 1; Form 1041, Line 17; Form 990 T, Line 30) OR ATTACHED INCOME STATEMENT ................
$
2. A. ITEMS NOT DEDUCTIBLE (from Line 4H below) ............................................................................ ADD
B. ITEMS NOT TAXABLE (from Line 5F below) ...................................................................................DEDUCT
C. ENTER EXCESS OF LINE 2A OR 2B ................................................................................................................................................
$
D. PARTNERSHIP K-1 INCOME (OR LOSS) (deduct partnership gain, add partnership loss. See BR-25 Schedule E, Column 4)
......
$
3. ADJUSTED NET INCOME (Line 1 plus or minus Lines 2C and 2D). Enter in Part A or Schedule Y
$
ITEMS NOT DEDUCTIBLE
ADD
ITEMS NOT TAXABLE
DEDUCT
A. Capital gains, etc. ................ $
4. A. Capital losses deducted .....................................................................................
$
5.
B. Expenses attributable to non-taxable income (MINIMUM OF 5% OF LINE 5F )..
$
B. Interest earned or accrued .... $
C. Taxes based on income .....................................................................................
$
C. Dividends .............................. $
D. Guaranteed payment to partners
(if deducted on income statement) .............
$
D. Income from patents, etc. ..... $
E. Charitable contributions
...................................................................................
$
F. Adjustment for specially allocated expense items (see instructions)
.................
$
E. Other exempt income
(explain)
$
G. Other expenses not deductible (explain) ...........................................................
$
F. TOTAL DEDUCTIONS .......... $
H. TOTAL ADDITIONS (enter here and on Line 2A above) ....................................
$
Cannot be less than zero
Minimum not applicable to Partnership/Associations
Partnership/Association only
SCHEDULE Y (BUSINESS ALLOCATION FORMULA)
Use this schedule if engaged in business in more than one city and you do not have books and records which will disclose with reasonable accuracy what portion of
the net profits is attributed to that part of the business done within the boundaries of the city or cities involved. Otherwise, attach a separate income statement for each
city reported.
A. Located Everywhere
Step 1. Average net book value of real and tangible personal property ..................................................................
$
Gross annual rentals multiplied by 8 ..........................................................................................................
$
Total Step 1 ........................................................................................................................................................................
$
Step 2. Gross receipts from sales made and work or services performed ..........................................................................................
$
Step 3. Total wages, salaries, commissions and other compensation of all employees ...........................................................................
$
B. List city portion of the above 3 steps in spaces below and compute percentage of each appropriate city (B divided by A)
AVERAGE
TAXABLE INCOME
CITY
STEP 1
STEP 2
STEP 3
PERCENTAGE
$
$
$
COLUMBUS
Adjusted net income from Line 3,
$
Schedule X above.
%
%
%
%
$
$
$
$
GROVE CITY
$
%
%
%
%
Multiply this figure by the average
$
$
$
percentage for each City in the space
GROVEPORT
at the right.
$
%
%
%
%
$
$
$
OBETZ
Determine average percentage by
$
%
%
%
%
dividing total percentages by number
of percentages used.
$
$
$
CANAL WINCHESTER
$
%
%
%
%
The amounts of taxable income listed
$
$
$
in the right-hand column are to be
MARBLE CLIFF
entered on Business Return (BR-25),
$
%
%
%
%
Part A, Column C by the appropriate
city.
$
$
$
BRICE
NOTE: Step 3 must be
$
%
%
%
%
completed regardless of
$
$
$
profit or loss. Please report
LITHOPOLIS
$
only wages earned by
%
%
%
%
employees working in each
$
$
$
specific city.
HARRISBURG
$
%
%
%
%
$
$
$
EVERYWHERE ELSE
$
%
%
%
%
Total Adjusted Net Income
$
BR-25 Page 2/Rev. 10/03

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