Nyc Schedule M (Form Nyc-3l) - Merger, Aquisition And Consolidation Information Report - 2000
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1
2N Y C
NEW YORK CITY DEPARTMENT OF FINANCE
2000
S C H E D U L E
MERGER, ACQUISITION
M
AND CONSOLIDATION
F I N A N C E
INFORMATION REPORT
NEW YORK
N Y C - 3 L
3
ATTACH TO FORM NYC-
L
of
Name
EMPLOYER IDENTIFICATION NUMBER
taxpayer
General Infor mation
P A R T 1
1.
Type of transaction: ( )
Merger
Acquisition
Consolidation
....................................................................
2.
Date transaction completed: ________/________/________
If this transaction was completed before July 1, 1989, stop here and attach a copy of this form to your tax return
3.
Indicate your role in the transaction: ( )
Target
Acquirer
Member of the affiliated group that in-
cludes the target or acquiring corporation
-
L i s t t h e n a m e s a n d E m p l o y e r I d e n t i f i c a t i o n N u m b e r s o f t h e p a r t i c i p a n t s -
Target name
EIN
Acquirer name
EIN
Affiliated group members' names
EIN
4.
Was this transaction between members of an affiliated group?
Yes
No
5.
Was this transaction an acquisition resulting from redemption of stock qualified under Section 303 of the
Internal Revenue Code (redemptions generally intended to pay estate taxes and administrative expenses)?
Yes
No
6.
Was this an acquisition made by an entity controlled by a majority of the employees of the target
corporation or a trust for the exclusive benefit of such employees?
Yes
No
If you answered Yes on line 4, 5 or 6, stop here and attach a copy of this form to your tax return.
Acquirer Infor mation
P A R T 2
A
.
During the taxable year or within the three immediately preceding taxable years:
1. if the taxpayer was an acquiring person in a corporate acquisition, did the value (at cost) of the acquirer's total interest
Yes
No
in the target corporation (at any time during the year in which the acquisition occurred) exceed $5 million?
2. if the taxpayer has acquired assets of the target corporation, did the value (at cost) of the assets acquired exceed
Yes
No
$5 million? (see instructions)
3. if the taxpayer was a surviving corporation with respect to a corporate merger or consolidation, did the target
Yes
No
corporation's total business, investment and subsidiary capital exceed $5 million?
4. is the taxpayer a member of an affiliated group which includes a corporation described
Yes
No
in A1, A2 or A3?
B.
Where the taxpayer is the acquiring person or the surviving corporation in a corporate merger or consolidation, does its total
Yes
No
interest expense and/or the interest expense of its affiliated group exceed $1 million for the tax year for which this form is filed?
C.
Did the total interest expense of the acquiring person or the surviving corporation and/or its affiliated group for the tax year in
Yes
No
which the acquisition, merger or consolidation occurred exceed $1 million?
Ratio Computation Worksheet -
P A R T 3
(Read Instr uctions for Par t 2 before completing this par t)
- TOTAL
(COL. A)
- ACQUIRER
(COL. B)
- TARGET
(A+B)
YEAR of ACQUISITION, MERGER or CONSOLIDATION:
Average assets
Average liabilities
Average equity
PRIOR YEAR:
Average assets
Average liabilities
Average equity
TOTAL
TOTAL
DEBT/ASSET RATIO:
DEBT/EQUITY RATIO:
Prior year
Prior year
Year of Acquisition, Merger or Consolidation
Current year
%
%
Percent change
Percent change
PART 3 is continued on page 2 of this form.
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