Form 1120-Sn - Nebraska S Corporation Income Tax Return - 2013
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1
2Nebraska S Corporation Income Tax Return
FORM 1120-SN
2013
for the calendar year January 1, 2013 through December 31, 2013 or other taxable year
beginning
,
and ending
,
Name Doing Business As (dba)
PLEASE DO NOT WRITE IN THIS SPACE
Legal Name
Street or Other Mailing Address
City
State
Zip Code
Business Classification Code
Date Business Began in Nebraska
Principal Business Activity in Nebraska
Federal ID Number
Nebraska ID Number
Does the S corporation have nonresident individual shareholders?
24 —
YES (Complete Schedule II.)
NO
Check applicable box(es):
(1)
Initial Nebraska Return
(3)
Change in Address
(5)
Form 7004 Attached
(7)
Distributed Form 3800N Credit
(2)
Final Return
(4)
Amended Return
(6)
Form 3800N Attached
Do not file if all shareholders are Nebraska residents and all income is derived from Nebraska sources.
1 Ordinary business income (line 21, Federal Form 1120S) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1
00
2 Nebraska adjustments increasing ordinary business income (line 7, Schedule A) . . . . . . . . . . . . .
2
00
3 Nebraska adjustments decreasing ordinary business income (line 17, Schedule A) . . . . . . . . . . .
3
00
4 Nebraska adjusted income (line 1 plus line 2 minus line 3) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
4
00
5 Income reported to Nebraska (enter line 4 above or line 3, Schedule I, if applicable) . . . . . . . . . .
5
00
If line 5 shows a loss, skip lines 6 through 10 and go to line 11.
6 Percent of ownership by nonresident individual shareholders. . . . . . . . . . .
6
%
7 Percent of ownership by nonresident individual shareholders for whom
Nebraska Nonresident Income Tax Agreements, Forms 12N, are attached
7
%
8 Percent of income subject to withholding (line 6 minus line 7) . . . . . . . . . .
8
%
9 Income reported to Nebraska subject to withholding (line 5 multiplied by line 8) . . . . . . . . . . . . . .
9
00
10 Nebraska income tax withheld for nonresident individual shareholders (multiply line 9 by .0684) . 10
00
11 Form 3800N credit and recapture . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
00
12 Tax deposited with Form 7004N and 2013 estimated tax payments . . . . . . . . . . . . . . . . . . . . . . . 12
00
13 TAX DUE if line 10 plus line 11 minus line 12 is greater than zero . . . . . . . . . . . . . . . . . . . . . . . . . 13
00
14 Overpayment if line 10 plus line 11 minus line 12 is less than zero . . . . . . . . . . . . . . . . . . . . . . . . 14
00
15 Amount on line 14 you want credited to 2014 estimated tax . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
00
16 Overpayment to be REFUNDED (line 14 minus line 15). Lines 17a, 17b, and 17c must be
completed. Complete line 17d if appropriate (see instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
00
17a Routing Number
17b Type of Account
1 = Checking
2 = Savings
(Enter 9 digits - the first two digits must be 01 through 12, or 21 through 32.
Use the checking or savings account number from an actual check, not a deposit slip.)
17c 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.)
17d
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
E-Mail 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
A copy of the federal return and supporting schedules must be attached to this return.
If more than 50 Federal Schedules K-1, submit copies and supporting schedules on CD-R media only.
Mail this return and payment to: Nebraska Department of Revenue, PO Box 94818, Lincoln, NE 68509-4818.
8-287-2013
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