Form 1065n - Nebraska Return Of Partnership Income - 2013

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Nebraska Return of Partnership Income
FORM 1065N
2013
for the calendar year January 1, 2013 through December 31, 2013 or other taxable year
beginning
,
and ending
,
2012
Name Doing Business As (dba)
PLEASE DO NOT WRITE IN THIS SPACE
Legal Name
Street or Other Mailing Address
City
State
Zip Code Business Class. Code (See Instr.)
Date Business Began in Nebraska
Principal Business Activity in Nebraska
Federal ID Number
Nebraska ID Number
Does the partnership have nonresident individual partners?
25 —
YES (Complete Schedule
)
NO
II
Type of Organization
Partnership
Limited Liability Company
Electing Large Partnership
Publicly Traded Partnership
Other (describe) ___________________
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
1 Ordinary business income (line 22, Federal Form 1065) ..............................................................
1
00
2 Nebraska adjustments increasing ordinary business income (line 8, Schedule A) .......................
2
00
3 Nebraska adjustments decreasing ordinary business income (line 18, Schedule A) ....................
3
00
4 Nebraska adjusted income (line 1 plus line 2 minus line 3; Electing Large Partnerships enter
4
amount from line 11, Nebraska Schedule ELP) .............................................................................
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 partners ............................ 6
%
7 Percent of ownership by nonresident individual partners 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 partners (line 9 multiplied 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 to be REFUNDED if line 10 plus line 11 minus line 12 is less than zero ................. 14
00
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 Partner or Member
Date
Email Address
(
)
Title
Phone Number
paid
preparer’s
Preparer’s Signature
Date
Preparer’s PTIN
use only
(
)
Print 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 K-1s, 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.
revenue.nebraska.gov, 800-742-7474 (NE and IA), 402-471-5729
8-284-2013

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