Form 1120xn - Amended Nebraska Corporation Income Tax Return Page 2
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6FORM 1120XN
Nebraska Schedule I — Apportionment and Allocation of Income
Schedules
Nebraska Schedule II — Explanation of Changes
I and II
Name on Form 1120XN
Nebraska ID Number
24 –
Nebraska Schedule I — Apportionment and Allocation of Income
All factors must be rounded to six decimal places and entered as a percent.
(See instructions for restrictions on allocation of income.)
Nebraska Amount
Nebraska
As Reported
Correct
or Adjusted
Amount
1 Adjusted federal taxable income (line 4, Form 1120XN) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
2 Allocable, nonapportionable income, minus related expense (from line 14 below) . . . . . . . . . . 2
3 Taxable income subject to apportionment (from line 1 minus line 2) . . . . . . . . . . . . . . . . . . . . . 3
4 Nebraska apportionment factor (line 13 below) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
%
%
5 Taxable income apportioned to Nebraska (line 3 multiplied by line 4) . . . . . . . . . . . . . . . . . . . . 5
6 Allocable, nonapportionable income allocated to Nebraska (from line 15 below) . . . . . . . . . . . 6
7 Nebraska taxable income (line 5 plus line 6). Enter here and on line 5, Form 1120XN . . . . . . . 7
(B)
(E)
(C)
(D)
(A)
Nebraska Amount
Nebraska Percent
Nebraska Net Change
Nebraska Correct
Apportionment Factors
As Reported
(Total of Column D
Total
(explain below)
Amount
or Adjusted
Divided by Column A)
8 Property . . . . . . . . . . . . . . . .
8
%
9 Payroll . . . . . . . . . . . . . . . . .
9
%
10 Sales or gross receipts . . . . 10
%
11 Total percent (total of lines 8 through 10). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
%
12 Three-factor apportionment formula (line 11 divided by 3). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
%
13 Nebraska apportionment factor (special phase-in rules apply for tax years 1987-1992 — see specific
instructions). Enter here and on line 4 above . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
%
Change in Net
Net Nonapportionable
Net Nonapportionable
Nonapportionable
Allocation of Nonapportionable Income
Income As Reported
Income As
Income
or Adjusted
Amended
(explain below)
14 Income allocated to all states. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
15 Income allocated to Nebraska (tax years before 1984 only) . . . . . . . . . . 15
Nebraska Schedule II — Explanation of Changes
• Reference net change (Column B) and line number.
• Attach additional sheets or schedules if necessary.
Electronic Funds Transfer
• Complete the information below to have your refund directly deposited into your bank account.
Routing Number
Type of Account
Checking
Savings
(Enter 9 digits, first two digits must be 01 through 12, or 21 through 32;
use an actual check or savings account number, not a deposit slip)
Account Number
(Can be up to 17 characters. Omit hyphens, spaces, and special symbols. Enter from left to right and leave any unused boxes blank.)
Check this box if this refund will go to a bank account outside the United States (see instructions).
Under penalties of perjury, I declare that as taxpayer or preparer I have examined this return, including accompanying schedules and statements, and to the best of my
knowledge and belief, it is correct and complete.
sign
here
Signature of Officer
Date
Email Address
(
)
Title
Phone Number
paid
preparer’s
Preparer’s Signature
Date
Preparer’s PTIN
use only
(
)
Firm’s Name (or yours if self-employed), Address, and Zip Code
EIN
Daytime Phone
For Nebraska Department of Revenue Use Only
Previous Penalty
Previous Interest
Other
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