Form Cl-4 - Annual Report Of Electric Cooperative Corporation Property And Gross Receipts

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1350
STATE OF SOUTH CAROLINA
CL-4
DEPARTMENT OF REVENUE
ANNUAL REPORT OF ELECTRIC COOPERATIVE
(Rev. 5/4/10)
CORPORATION PROPERTY AND GROSS RECEIPTS
3135
Return for Period Ending
.
TAXPAYER ID INFORMATION
Do Not Write in This Space
SC FILE #
LICENSE FEE PERIOD ENDING
FEIN
14-0601
Audited by
Date
Change of Address
Amended
USE BLACK INK ONLY
This report must be filed on or before March 15. The license fee must accompany report.
Mail this return with remittance to:
SC Department of Revenue, Corporation Return, Columbia, SC 29214-0100.
PART I
COMPUTATION OF LICENSE FEE - ELECTRIC COOPERATIVES
1. Fair Market Value of Property Owned and Used in the Conduct of Business in South Carolina as determined
by the SC Department of Revenue for Property Tax Purposes for the Preceding Taxable year. . . . . . . .
1.
2. Fee Due: Line 1 x .001 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2.
Intrastate
Total
South Carolina
System
(B)
(A)
3. Operating Revenues. (Itemize):
$
$
$
$
4. Total Operating Revenues . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.
5. Other Receipts. (Itemize):
5.
6. Total Other Receipts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6.
$
$
7. Total Gross Receipts (Add Lines 4 and 6) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7.
$
8. Fee Due (Line 7, Column B x .003). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
8.
$
9. License Fee Due (Line 2 plus Line 8 but not less than $25.00) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
9.
$
10. Section 12-20-105 credit (See Instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10.
$
11. Total License Fee Due (Subtract Line 10 from Line 9 but not less than zero) . . . . . BALANCE DUE
11.
Make check payable to: SC Department of Revenue (Include Business Name, FEIN and SC File #)
I, the undersigned, a principal officer of the corporation for which this return is made declare that this return, including accompanying Annual
Report, statements and schedules, has been examined by me and is to the best of my knowledge and belief, a true and complete return.
Please
Sign
Signature of officer
Date
Title
Telephone Number
Here
Preparer's Printed Name
I authorize the Director of the Department of Revenue or delegate to
Yes
No
discuss this return, attachments and related tax matters with the preparer.
Preparer's telephone number
Date
Preparer's
Check if
Paid
signature
self-employed
Preparer's
Firm's name (or
PTIN or FEIN
Use Only
yours if self-employed)
and address
ZIP Code
31351026

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