Schedule Rt - Wisconsin Related Entity Expenses Disclosure Statement - 2013

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Schedule
Wisconsin
RT
Related Entity Expenses
2013
Disclosure Statement
Wisconsin Department
File with Wisconsin Form 1, 1NPR, 2, 3, 4, 4T, 5, or 5S
of Revenue
Identifying Number
Taxpayer Name (or name of combined group member, if applicable)
Part I Addition Modification for Related Entity Expenses
1 Interest Expenses
Identification Number
Name of Related Entity / Payee
Amount
1a
1a
.00
1b
1b
.00
1c Total for additional related entities reported on separate schedules . . . . . . . . . . . . . . . . . . . . . . . . . .
1c
.00
1d
1d Add lines 1a through 1c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
.00
2 Rent Expenses
Identification Number
Name of Related Entity / Payee
Amount
2a
2a
.00
2b
2b
.00
2c Total for additional related entities reported on separate schedules . . . . . . . . . . . . . . . . . . . . . . . . . .
2c
.00
2d
2d Add lines 2a through 2c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
.00
3 Management Fees
Identification Number
Name of Related Entity / Payee
Amount
3a
3a
.00
3b
3b
.00
3c Total for additional related entities reported on separate schedules . . . . . . . . . . . . . . . . . . . . . . . . . .
3c
.00
3d
3d Add lines 3a through 3c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
.00
4 Intangible Expenses
Identification Number
Name of Related Entity / Payee
Amount
4a
4a
.00
4b
4b
.00
4c Total for additional related entities reported on separate schedules . . . . . . . . . . . . . . . . . . . . . . . . . .
4c
.00
4d
4d Add lines 4a through 4c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
.00
5 Total addition modification.
Add the amounts on lines 1d, 2d, 3d, and 4d. This is the amount
you must add back to your federal income. To determine the amount eligible for a deduction,
5
.00
continue to Part II . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
IC-075

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