CT-4
New York State Department of Taxation and Finance
General Business Corporation Franchise
Tax Return Short Form
Tax Law — Article 9-A
All filers must enter tax period:
beginning
ending
Final return
Amended return
(see instructions)
Employer identification number (EIN)
File number
Business telephone number
If you claim an
overpayment, mark
(
)
an X in the box
Legal name of corporation
Trade name/DBA
State or country of incorporation
Date received (for Tax Department use only)
Mailing name (if different from legal name above)
c/o
Date of incorporation
Number and street or PO box
Foreign corporations: date began
City
State
ZIP code
business in NYS
NAICS business code number
If address/phone
Audit (for Tax Department use only)
(from federal return)
If you need to update your address or phone
above is new,
information for corporation tax, or other tax
mark an X in the box
types, you can do so online. See Business
Principal business activity
information in Form CT-1.
See Form CT-3/4-I, Instructions for Forms CT-4, CT-3, and CT-3-ATT, before completing this return.
Metropolitan transportation business tax (MTA surcharge)
During the tax year did you do business, employ capital, own or lease property, or maintain an office in the
Metropolitan Commuter Transportation District (MCTD)? If Yes, you must file Form CT-3M/4M. The MCTD includes
the counties of New York, Bronx, Kings, Queens, Richmond, Dutchess, Nassau, Orange, Putnam,
Rockland, Suffolk, and Westchester.
........................................................................... Yes
No
(mark an X in the appropriate box)
A. Pay amount shown on line 43. Make payable to: New York State Corporation Tax
Payment enclosed
Attach your payment here. Detach all check stubs.
(See instructions for details.)
A
B. Federal return filed
:
Attach a complete copy of your federal return.
(you must mark an X in one)
Form 1120 ..................
Form 1120-H ..................................
Other:
Consolidated basis ....
Form 1120S ...................................
C. If you included a qualified subchapter S subsidiary (QSSS) in this return, mark an X in the box and attach
Form CT-60-QSSS. ..................................................................................................................................................................
D. Have you underreported your tax due on past returns? To correct this without penalty, visit our Web site (see Need help?).
E. Do you have an interest in, or have you rented, real property located in New York State?
(mark an X
If Yes, enter the county
......................................... Yes
No
in the appropriate box)
F. Has there been a transfer or acquisition of controlling interest in the entity during the last 3 years?
(mark an X
........................................................................................................................................... Yes
No
in the appropriate box)
G. Do you have an interest in any partnerships? ( mark an X in the appropriate box ) .............................................. Yes
No
H. Did you include a disregarded entity in this return? ( mark an X in the appropriate box ) ..................................... Yes
No
If Yes, enter the name and EIN below. If more than one, attach list with names and EINs.
446001120094
Legal name of disregarded entity
EIN