Form 355sc - Domestic Or Foreign Security Corporation Return

2011

Form 355SC

Massachusetts

Domestic or Foreign Security

Department of

Corporation Return

Revenue

For calendar year 2011 or taxable year beginning

ending

U.S. Principal Business Code

Federal Identification number (FID)

Name of corporation: 3___________________________________________________________________________________________________________________________

Principal business address: _______________________________________________________________________________________________________________________

Principal business address in Massachusetts: _________________________________________________________________________________________________________

Check appropriate box

(see instructions)

11. Is the corporation incorporated within Massachusetts? 3

Yes

2. Date of charter 3 ______________________________________________

13. 3

Class 1 security corporation

Class 2 security corporation

4. Date corporation first classified as security corporation _________________

15. Date business began in Massachusetts 3 ________________________________

6. State or country of incorporation __________________________________

17. Average number of employees in Massachusetts 3 ________________________

8. Is a Taxpayer Disclosure Statement enclosed? 3

Yes

19. Has the U.S. government changed your taxable income for any prior year which has not yet been reported to Massachusetts? 3

Yes

10. Corporation’s books are in the care of ______________________________________________ Title ________________________________________________________

11. If first return: 3

new business

business had predecessor

12. If final return: 3

business terminated

business has successor

13. Does this entity continue to qualify for classification as a security corporation? 3

Yes

If “Yes”, please enclose a statement explaining any changes in corporate activity since you were last granted security corporation classification.

14. Has this corporation elected to file or participate in the filing of a U.S. consolidated return? 3

Yes

No. FID of parent _________________________________________

15. U.S. form(s) and schedule(s) filed for this tax year: 3

1120

1120-RIC

851

5471

1120S

1120-REIT

Computation of Excise

Use whole dollar method

11. Total U.S. income (from U.S. Form 1120 or appropriate form) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 1

12. State and municipal bond interest not included in line 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 2

13. Adjustments to income. See instructions (enclose schedule) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 3

14. Massachusetts gross income. Add lines 1 through 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4

15. Class 1 excise, if applicable (line 4) $ _____________________ × .0033 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

16. Class 2 excise, if applicable (line 4) $ _____________________ × .0132 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6

17. Excise before credits (line 5 or 6, whichever applies) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7

18. Vanpool Credit and carryover (from Schedule VP) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 8

19. Film Incentive Credit. Certificate number 3

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 9

10. Economic Development Incentive Program Credit. Certificate number 3

. . . . . . . . . . . . . . . . . . . . . . . . . 3 10

11. Historic Rehabilitation Credit. Certificate number 3

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 11

12. Medical Device Credit. Certificate number 3

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 12

13. Brownfields Credit. Certificate number 3

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 13

14. Low-Income Housing Credit. Building Identification number 3

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 14

15. Excise after credits. Subtract the total of lines 8 through 14 from line 7. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15

456

16. Minimum excise (cannot be prorated). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16

17. Excise due before voluntary contribution (line 15 or line 16, whichever is larger) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17

18. Voluntary contribution for endangered wildlife conservation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 18

19. Excise due plus voluntary contribution. Add lines 17 and 18 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 19

20. 2010 overpayment applied to 2011 estimated tax . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 20

21. 2011 estimated tax payments (do not include amount in line 20) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 21

22. Payments made with extension . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 22

23. Amount overpaid. Subtract line 19 from total of lines 20 through 22 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23

24. Amount of line 23 to be credited to 2012 estimated tax. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 24

25. Amount of line 23 to be refunded. Subtract line 24 from line 23 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 25

26. Balance due. Subtract total of lines 20 through 22 from line 19 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26

27. M-2220 penalty 3 _________________________ Other penalties 3 _________________________ . . . . . . . . . . . . . . . . Total penalty

28. Interest on unpaid balance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Total due 3 28

29. Total payment due at time of filing. Make remittance payable to Commonwealth of Massachusetts . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 29

Under penalties of perjury, I declare that to the best of my knowledge and belief, this return and enclosures are true, correct and complete.

Signature of appropriate officer (see instructions)

Date

Social Security number

Title

Signature of paid preparer

Date

Employer Identification number

Address

If you are signing as an authorized delegate of the appropriate corporate officer, check here

and enclose Massachusetts Form M-2848, Power of Attorney. Privacy act notice

available upon request. Mail to: Massachusetts Department of Revenue, PO Box 7067, Boston, MA 02204.