Form Ft 1120 - Corporation Franchise Tax Report - 2013 Page 8
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82013
Corporation name
Franchise tax I.D.#
Tax year
FT 1120
Rev. 12/12
Schedule A-1 – Nonrefundable Credits
Ohio Revised
Code (R.C.)
Credits must be claimed in the order listed. R.C. 5733.98
Section
1. Credit for qualifying affi liated groups (due to related entity and related member
00
adjustments)........................................................................................................................... 5733.068
1.
00
2. Credit for recycling and litter prevention donations ............................................................... 5733.064
2.
00
3. Credit for maintaining railroad crossing warning devices ........................................................ 5733.43
3.
00
4. Job retention credit (attach credit certifi cate) ................................................................. 5733.0610(B)
4.
00
5. Credit for qualifi ed research expenses.................................................................................. 5733.351
5.
00
6. Credit for eligible new employees in an enterprise zone......................................................... 5709.66
6.
00
7. Ethanol plant investment credit ............................................................................................... 5733.46
7.
00
8. Credit for grape production property ....................................................................................... 5733.32
8.
9. Technology investment credit (attach credit certifi cate from Technology and Enterprise
00
Advisory Board)....................................................................................................................... 5733.35
9.
00
10. Enterprise zone day care and training credits ......................................................................... 5709.65 10.
00
11. Research and development loan repayment credit (attach credit certifi cate) .......................... 5733.352 11.
00
12. Credit for taxes paid by a qualifying pass-through entity .....................................................5733.0611 12.
00
13. Total nonrefundable credits. Enter here and on Schedule A, line 19 ................................................... 13.
Ohio Revised
Code (R.C.)
Schedule A-2 – Refundable Credits
Section
00
1. Refundable jobs creation credit................................................................................................. 122.17
1.
00
2. Refundable credit for tax withheld by the Ohio Lottery Commission............................ 5733.98(A)(33)
2.
00
3. Refundable Ohio historic preservation credit ...........................................................................149.311
3.
00
4. Refundable motion picture credit ............................................................................... 122.85, 5733.59
4.
00
5. Total refundable credits. Enter here and on Schedule A, line 24 .........................................................
5.
Questionnaire (you must complete this schedule)
1. Corporation tax records are in care of (name, please print)
Telephone number
E-mail address
2. Is this corporation a member of a consolidated U.S. 1120?
Yes
No. If “yes,” enter the name and FEIN of the common parent:
Name
FEIN
and the number of corporations that are included in the consolidated U.S. group
3. Is the corporation currently under audit by the IRS?
Yes
No If “yes,” what years?
Does the corporation currently have IRS audits under appeal?
Yes
No If “yes,” what years?
What was the last year the IRS redetermined the corporation’s federal taxable income?
4. During the taxable year, did this corporation make payments to, or receive payments from, a “related member” as defi ned in R.C.
5733.042?
Yes
No
5. During 2011 or 2012, was this corporation the survivor of a merger with another corporation that was subject to the Ohio franchise tax?
Yes
No
6. If you entered any nonbusiness income on page 1, line 4, indicate the state(s) to which you reported such income as business in-
come
7. Is the taxpayer a “related member” to a real estate investment trust (REIT) or is a REIT a related member to the taxpayer?
Yes
No If “yes,” please identify the REIT by name, address and FEIN
8. During the taxable year, did the taxpayer have a direct or indirect equity interest of 20% or more in any pass-through entity?
Yes
No
9. During the taxable year or any of the three preceding taxable years, did the taxpayer, directly or indirectly, participate in any tax shelter
with respect to which registration is required under I.R.C. section 6111?
Yes
No
Declaration and signatures (an offi cer or managing agent of the corporation must sign this declaration)
I declare under penalties of perjury that this report (including any accompanying
political party, a candidate for election or nomination to public offi ce, or a political
schedule or statement) has been examined by me and to the best of my knowledge
action committee, legislation campaign fund or organization that supports or opposes
and belief is a true, correct and complete return and report, and that this corporation
any such candidate or in any manner used any of its money for any partisan political
has not, during the preceding year, except as permitted by R.C. sections 3517.082,
purpose whatever, or for reimbursement or indemnifi cation of any person for money
3599.03 and 3599.031, directly or indirectly paid, used or offered, consented, or
or property so used.
agreed to pay or use any of its money or property for or in aid of or opposition to a
Date
Signature of offi cer or managing agent
Title
Date
Signature of preparer other than taxpayer based on all information of which
Title
preparer has knowledge (see Ohio form FT 1120 general instructions, item #16).
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