Form Bpt-In - Alabama Business Privilege Tax Initial Privilege Tax Return - 2012
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1
2PRINT FORM
RESET
-This form has been enhanced to complete all calculations and
to compute the amount of tax due. Just key in your data prior to
FORM
121101BN
printing the form. If you choose to use the fill-in option, PLEASE
BPT-IN
2012
DO NOT HANDWRITE ANY OTHER DATA ON THE FORM
OTHER THAN YOUR SIGNATURE.
Alabama Department of Revenue
Alabama Business Privilege Tax Initial Privilege Tax Return
-It has also been enhanced to print a two dimensional (2D)
Initial Privilege Tax – This form is to be completed ONLY by taxpayers who incorporated, organized, qualified,
barcode. The PRINT FORM button MUST be used to generate
registered or started doing business in Alabama in 2012. NOTE: Initial returns must be filed within 2-1/2
the (2D) barcode which contains data entered on the form. The
months of incorporation, organization or qualification. See the detailed instructions on the Alabama Depart-
use of a 2D barcode vastly improves processing of your return
ment of Revenue Web site ( ).
and reduces the costs associated with processing your return.
Make check payable to: Alabama Department of Revenue
(Payment must be submitted with Form BPT-V, unless payment is made electronically)
Mail to: Alabama Department of Revenue, Business Privilege Tax Section
P.O. Box 327320, Montgomery, AL 36132-7320
Please enter the date the entity incorporated, organized,
qualified or registered in Alabama or started doing business in
•
•
Type of taxpayer (check only one):
1a.
C Corporation
1b.
Insurance Company
Alabama, whichever occurred first:
•
•
•
1c.
Financial Institution Group Member
1d.
LLE Taxed as Corporation
1e.
Real Estate Investment Trust
2a. Date of Qualification,
•
•
•
•
Incorporation or Organization
1f.
Business Trust
1g.
S Corporation
1h.
Limited Liability Entity
•
(mm/dd/yyyy)
1i.
Disregarded Entity
DO NOT FILE FORM BPT-IN AS AN ANNUAL RETURN
TAXPAYER INFORMATION
Find NAICS Code
Find Sec of State File #
3a. LEGAL NAME OF
FEIN NOT REQUIRED
•
BUSINESS ENTITY
3b. FEIN
(SEE INSTRUCTIONS)
3c. BPT ACCOUNT NO.
3d. SECRETARY OF STATE
3e. FEDERAL BUSINESS CODE NO.
•
•
(SEE INSTRUCTIONS)
ENTITY ID NO. (SEE SOS.ALABAMA.GOV)
(NAICS) (SEE )
3f. MAILING
ADDRESS
3g. CITY
3h. STATE
3i. ZIP CODE
4a. CONTACT PERSON
4b. CONTACT PERSON’S
CONCERNING THIS FORM
PHONE NO.
4c. TAXPAYER’S
E-MAIL ADDRESS
5a. County of incorporation or organization for all Alabama entities . . . . . . . . . . . . . .
5a
5b. State or country of incorporation or organization for all foreign entities . . . . . . . . .
5b
6a. Date of qualification or registration in Alabama for foreign entities . . . . . . . . . . . .
6a
6b. Date of incorporation or organization for all entities . . . . . . . . . . . . . . . . . . . . . . .
6b
6c. Date started doing business in Alabama . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
6c
6d. Telephone number of the taxpayer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
6d
7a. Name of registered agent in Alabama . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
7a
7b. FEIN or social security number . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
7b
7c. Street address . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
7c
7d. City, state, and zip code . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
7d
8a. Name of corporate president or primary member/partner. . . . . . . . . . . . . . . . . . .
8a
8b. Social security number . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
8b
8c. Street address . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
8c
8d. City, state, and zip code . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
8d
9a. Name of corporate secretary or secondary member/partner . . . . . . . . . . . . . . . .
9a
9b. Social security number . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
9b
9c. Street address . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
9c
9d. City, state, and zip code . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
9d
10. Kind of business done in Alabama . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
10
11. Principal place of business in Alabama . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
11
City, state, and zip code . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
12. Kind of business done generally . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
12
13. Mailing address of the principal place of business if outside State of Alabama . . .
13
City, state, and zip code . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
COMPUTATION OF AMOUNT DUE
•
Go to Page 2 of BPT-IN
14. Privilege tax due (Page 2, Part B, line 21) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
14
Amount Due
•
15. Penalty due (see instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
15
•
16. Interest due (see instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
16
•
17. Total privilege tax due (add lines 14, 15 and 16) (Form BPT-V must be submitted if payment is made by check). . . . . . . . . . . . . . . . . .
17
18. Check here if paid electronically:
19. Family LLE Election:
(Signature required below)
•
I authorize a representative of the Department of Revenue to discuss my return and attachments with my preparer.
Under penalties of perjury, I declare that I have examined this return and accompanying schedules and statements, and to the best of my knowledge
Please
and belief they are true, correct, and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge.
Sign
Title
Date
Your
Here
Signature
•
Preparer’s signature
Date
Paid
•
Firm’s name (or yours, if
E.I. No.
Preparer’s
self-employed) and address
•
ZIP Code
Use Only
Phone No.
Preparer’s SSN/PTIN
ADOR
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