Form Dtf-5 - Statement Of Financial Condition And Other Information - New York State Department Of Taxation And Finance Page 6

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Page 6 DTF-5 (12/08)
XV. Statement of Income - Corporation
Important: If the proposal is from a corporation, please furnish the information requested below
(from income tax returns, as adjusted, for
past two years and from records for current year from January 1 to date).
Type of corporation:
business
not‑for‑profit
P.C.
Attach a detailed statement of carry over/carry back loss intentions. If you do not intend to use this offset, attach a full explanation.
20
20
Jan. 1 to
20
A. Gross income
1. Gross sales or receipts
(subtract returns and allowances)
2. Cost of goods sold
3. Gross profit — trading or manufacturing
4. Gross profit — from other sources
5. Interest income
6. Rents and royalties
7. Gains and losses
(from Schedule D)
8. Dividends
9. Other
(specify)
Total income
B. Deductions
1. Compensation of officers
2. Salaries and wages
(not deducted elsewhere)
3. Rents
4. Repairs
5. Bad debts
6. Interest
7. Taxes
8. Losses
9. Dividends
10. Depreciation and depletion
11. Contributions
12. Advertising
13. Other
(specify)
14.
Total deductions
C. Net income
D. Nontaxable income
E. Unallowable deductions
XVI. Salaries Paid to Principal Officers and Dividends Distributed - Corporation
Important: If the proposal is from a corporation, please show salaries paid to principal officers for past three years and amounts distributed
in dividends, if any, during and since the taxable years covered by this offer.
20
20
20
A. Salaries paid to (name and title)
1.
, President
2.
, Vice President
3.
, Treasurer
4.
, Secretary
5.
6.
Total

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