Form 4t - Wisconsin Exempt Organization Business Franchise Or Income Tax Return - 2015 Page 2
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32015 Form 4T
Page
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17 Nonrefundable credits (from Schedule CR) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
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18 Net income tax paid to other states . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
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19 Add lines 17 and 18 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
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20 Subtract line 19 from line 16. If line 19 is greater than line 16, enter zero (0). This is net tax . . . 20
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21 Tax from line 10 or 20 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
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22 Economic development surcharge (see instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22
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23 Endangered resources donation (decreases refund or increases amount owed) . . . . . . . . . . . 23
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24 Veterans trust fund donation (decreases refund or increases amount owed) . . . . . . . . . . . . . . 24
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25 Add lines 21 through 24 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25
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26 Estimated tax payments less refund from Form 4466W. . . 26
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27 Wisconsin tax withheld . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27
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28 Refundable credits (from Schedule CR) . . . . . . . . . . . . . . 28
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29 Amended Return Only – amount previously paid . . . . . . . . 29
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30 Add lines 26 through 29 . . . . . . . . . . . . . . . . . . . . . . . . . . . 30
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31 Amended Return Only – amount previously refunded . . . . 31
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32 Subtract line 31 from 30 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32
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33 Interest, penalty, and late fee due (from Form U, line 17 or 26).
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If you annualized income on Form U, check (ü) the space after the arrow . . . . . . . . . .
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34 Tax due. If the total of lines 25 and 33 is larger than line 32, subtract line 32 from the total of
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lines 25 and 33 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34
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35 Overpayment. If line 32 is larger than the total of lines 25 and 33, subtract the total of lines
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25 and 33 from line 32 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35
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Enter amount of line 35 you want credited on 2016 estimated tax
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36
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37 Subtract line 36 from line 35. This is your refund . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37
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38 Enter total gross receipts from all unrelated trade or business activities . . . . . . . . . . . . . . . . . 38
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Additional Information Required
1 Person to contact concerning this return:
Phone #:
Fax #:
2 City and state where books and records are located for audit purposes:
3 Are you the sole owner of any limited liability companies (LLCs)?
Yes
No
If yes, complete Schedule DE and include with this
return. Did you include the incomes of these entities in this return?
Yes
No
4 Did you purchase any taxable tangible personal property or taxable services for storage, use, or con sumption in Wisconsin without payment
of a state sales or use tax?
If yes, you may owe Wisconsin use tax. See instructions for how to report use tax.
Yes
No
(You will not be liable for Wisconsin use tax if you hold a Wisconsin Certificate of Exempt Status.)
5 List the locations of your Wisconsin operations:
Do you want to allow another person to discuss this return with the department?
Complete the following.
Third
Yes
No
Phone Number
Personal Identification Number (PIN)
Party
Print
Designee’s
Designee
Name
Under penalties of law, I declare that this return and all attachments are true, correct, and complete to the best of my knowledge and belief.
Signature of Officer or Trustee
Title
Date
Preparer’s Signature
Preparer’s Federal Employer ID Number
Date
You must file a copy of your federal Form 990-T or 4720, including attachments, with your Form 4T.
If you are not filing your return electronically, make your check payable to and mail your return to:
Wisconsin Department of Revenue
PO Box 8908
Madison WI 53708-8908
Go to Page 3
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