Form M4x - Amended Franchise Tax Return/claim For Refund - 2010 Page 2
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5M4X
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31 Amount from line 30 (total credits and tax paid) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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32 Refund amount from original Form M4, line 18 (see instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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33 Subtract line 32 from line 31 (if result is less than zero, enter the negative amount) . . . . . . . . . . . . . . . . .
34
34 Amount from line 22C . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
35 Tax you owe. If line 34 is more than line 33, subtract line 33 from line 34
35
(if line 33 is a negative amount, see instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
36
36 If you failed to timely report federal changes or the IRS assessed a penalty (see instructions) . . . . . . . . .
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37 Add line 35 and line 36 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
38
38 Interest (see instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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39 AMOUNT DUE (add lines 37 and 38) . Skip line 40 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Check payment method:
Electronic (see instructions)
Check (attach PV64)
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40 REFUND . If line 33 is more than line 34, subtract line 34 from line 33 . . . . . . . . . . . . . . . . . . . . . . . . . . . .
If you have a refund, you must enter your banking information below.
Account type:
Routing number
Account number
(use an account not associated with any foreign accounts)
Checking
Savings
I declare that this return is correct and complete to the best of my knowledge and belief
Authorized signature
Title
Date
Daytime phone
I authorize the
Minnesota
Signature of preparer
PTIN
Date
Daytime phone
Department
of Revenue to
discuss this tax
Print name of person to contact within corporation to discuss this return
Title
Daytime phone
return with the
preparer .
Explain net changes below and show computations in detail. Enclose the list of changes, amended schedules and amended federal
Form 1120X, if any . Mail to: Minnesota Revenue, Mail Station 1255, St . Paul, MN 55146-1255 .
EXPLANATION OF CHANGE—Explain below each change in detail. If the changes involve items requiring supporting informa-
tion, be sure to attach the appropriate schedule, statement or form to Form M4X to verify the correct amount . If you need
more space, enclose another sheet .
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