Form 1120xn - Amended Nebraska Corporation Income Tax Return

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Amended Nebraska Corporation Income Tax Return
FORM
1120XN
Taxable year beginning
,
and ending
,
PLEASE DO NOT WRITE IN THIS SPACE
Name Doing Business As (dba)
Legal Name
Street or Other Mailing Address
City
State
Zip Code
Federal ID Number
Nebraska ID Number
24 –
Name and Address Used on Original Return (if same as above, write “same”)
A Is an amended federal return being filed?
B Has the original federal return been
C Has a Federal Form 872 or 872-A been filed for
D Has the corporation been advised
changed or corrected by the IRS?
the year you are amending?
that the original 1120N is being or
YES
NO
will be audited?
YES
NO
YES
NO
If Yes, attach a complete copy of Federal
YES
NO
Form 1120X.
If Yes, identify office:
If Yes, attach a copy of the Form 872 or 872-A.
Corporation Filing Status. Answer questions E through H, as applicable.
H Check the method used to determine Nebraska income
E Does this corporation own at least 50% of another
F Is one single Nebraska return being filed for the
corporation; or is it owned at least 50% by another
entire group?
(check only one):
corporation?
Combined report of a controlled group of corporations
YES
NO
YES
NO
Separate report by a member of a controlled group of
G Are you filing as a unitary group in any other state?
If Yes, attach Federal Form 851 or a schedule of
corporations (attach supporting documentation)
affiliated corporations and federal identification numbers.
YES
NO
Alternate method (attach Department of Revenue approval)
Answer questions F, G, and H.
(A) As Originally Reported
(B) Net Change (Explain
Computation of Tax
(C) Correct Amount
or As Adjusted
on Reverse Side)
1 Federal gross sales or receipts less returns and allowances.
1
1
2 Federal taxable income . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2
2
3 Adjustments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3
3
4 Adjusted federal taxable income (line 2 plus or minus line 3)
4
4
5 Nebraska taxable income before adjustments . . . . . . . . . . . .
5
5
6 Adjustments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
6
6
7 Nebraska taxable income (line 5 plus or minus line 6). . . . . .
7
7
8 Nebraska tax . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
8
8
9 Premium tax credit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
9
9
10 Renewable energy source systems credit (1982-1987) . . . . . 10
10
11 Nebraska Endowment credit (attach statement) (2006-2009) . 11
11
12 Community Development Assistance Act credit. . . . . . . . . . . 12
12
13 Form 3800N nonrefundable credit . . . . . . . . . . . . . . . . . . . . . 13
13
14 Total nonrefundable credits (total of lines 9 through 13) . . . . 14
14
15 Nebraska tax after nonrefundable credits. Subtract line 14
from line 8 (if less than zero, enter -0-) . . . . . . . . . . . . . . . . . 15
15
16 Nebraska depreciation surcharge (see instructions) . . . . . . . 16
16
17 Total tax and depreciation surcharge (line 15 plus line 16) . . 17
17
18 Form 4136N credit (prior to 2005) . . . . . . . . . . . . . . . . . . . . . 18
18
19 Form 3800N refundable credit . . . . . . . . . . . . . . . . . . . . . . . . 19
19
20 Beginning Farmer credit and Nebraska income tax withheld . . . 20
20
21 Tax deposited with Form 7004N . . . . . . . . . . . . . . . . . . . . . . 21
21
22 Estimated payments (minus any Form 4466N adjustments)
22
22
23 Total payments (total of lines 18 through 22) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
24 Tax paid with original return, plus additional payments made after it was filed . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24
25 Line 23 plus line 24 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25
26 Overpayment allowed on original return, plus additional overpayments allowed after it was filed. . . . . . . . . . . . . . 26
27 Line 25 minus line 26. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27
28 Nebraska income tax and depreciation surcharge due (line 17 minus line 27) . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28
29 Penalty (see instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
30 Interest due . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30
31 BALANCE DUE (total of lines 28 through 30) Check this box if payment is being made by Electronic
Funds Transfer (EFT) or by credit card
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31
32 REFUND (line 27 minus line 17) The EFT section on the reverse side must be completed. . . . . . . . . . . . . . . . 32
COMPLETE REVERSE SIDE
Mail this return and remit payment (EFT, if required) to:
Nebraska Department of Revenue, PO Box 94818, Lincoln, NE 68509-4818.
revenue.nebraska.gov, 800-742-7474 (NE and IA), 402-471-5729
8-194-1971 Rev. 11-2013 Supersedes 8-194-1971 Rev. 10-2012

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