Form Ct-3-A - General Business Corporation Combined Franchise Tax Return - 2012 Page 14
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CT-3-A (2012)
Amended return information
If any member of the combined group is filing an amended return, mark an X in the box for any items that apply and attach documentation.
Final federal determination ...............
If marked, enter date of determination:
Net operating loss (NOL) carryback ...
Capital loss carryback ..........................
Federal return filed ......... Form 1139
Form 1120X ..........................................
Net operating loss (NOL) information
New York State combined group NOL carryover total available for use this tax year from all prior tax years ...
Federal NOL carryover total available for use this tax year from all prior tax years ........................................
New York State combined group NOL carryforward total for future tax years ...............................................
Federal NOL carryforward total for future tax years ........................................................................................
Designee’s name
Designee’s phone number
(print)
Third – party
Yes
No
(
)
designee
Designee’s e-mail address
(see instructions)
PIN
Certification: I certify that this return and any attachments are to the best of my knowledge and belief true, correct, and complete.
Printed name of authorized person
Signature of authorized person
Official title
Authorized
person
E-mail address of authorized person
Telephone number
Date
(
)
Firm’s name
Firm’s EIN
Preparer’s PTIN or SSN
Paid
(or yours if self-employed)
preparer
Signature of individual preparing this return
Address
City
State
ZIP code
use
only
E-mail address of individual preparing this return
Preparer’s NYTPRIN
Date
(see instr.)
See instructions for where to file.
434014120094
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