Form Ct-4 - General Business Corporation Franchise Tax Return Short Form - 2014 Page 5
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5Page 4 of 4 CT-4 (2014)
62 Total receipts entered on your federal return ...................................................................................
62
63 Interest deducted in computing FTI
63
.......................................................................
(see instructions)
64 Depreciable assets and land entered on your federal return ...........................................................
64
65 If the Internal Revenue Service (IRS) has completed an audit of any of your returns within the
last five years, list years:
66 If you are a member of an affiliated federal group, enter primary corporation name and EIN:
Name
EIN
67 If you are more than 50% owned by another corporation, enter parent corporation name and EIN:
Name
EIN
68 Are you claiming small business taxpayer status for lower ENI tax rates?
(see Small business
............... 68
Yes
No
taxpayer definition in the line 12 instructions of Form CT-3/4-I; mark an X in the appropriate box)
69 If you marked Yes on line 68, enter total capital contributions
69
............
(see worksheet in instructions)
70 Are you claiming qualified New York manufacturer status, which includes eligible qualified
New York manufacturers and qualified emerging technology companies (QETCs), for a lower
70
capital base tax rate and limitation?
Yes
No
(see instructions; mark an X in the appropriate box) .......................
71 Are you claiming qualified New York manufacturer or eligible qualified New York manufacturer
status for lower ENI tax rates?
............................. 71
Yes
No
(see instructions; mark an X in the appropriate box)
72 Are you claiming eligible qualified New York manufacturer status for a lower MTI rate or
fixed dollar minimum?
........................................... 72
Yes
No
(see instructions; mark an X in the appropriate box)
73 Are you a qualified entity of a New York State innovation hot spot that operates solely within
such New York State innovation hot spot and have elected to be subject only to the fixed dollar
....................................................................... 73
minimum tax base?
Yes
No
(mark an X in the appropriate box)
74 Are you claiming QETC status for a lower ENI rate?
(see instructions; mark an X in the
................................................................................................................................. 74
Yes
No
appropriate box)
75 Are you claiming qualified New York manufacturer or QETC status for a lower MTI rate or
fixed dollar minimum?
........................................... 75
Yes
No
(see instructions; mark an X in the appropriate box)
Amended return information
If filing an amended return, mark an X in the box for any items that apply and attach documentation.
Final federal determination ...............
If marked, enter date of determination:
Net operating loss (NOL) carryback ...
Capital loss carryback ..........................
Federal return filed .......... Form 1139
Form 1120X ..........................................
Net operating loss (NOL) information
New York State NOL carryover total available for use this tax year from all prior tax years ..........................
Federal NOL carryover total available for use this tax year from all prior tax years ........................................
New York State NOL carryforward total for future tax years ...........................................................................
Federal NOL carryforward total for future tax years ........................................................................................
Designee’s name
Designee’s phone number
(print)
Third – party
Yes
No
(
)
designee
Designee’s e-mail address
(see instructions)
PIN
Certification: I certify that this return and any attachments are to the best of my knowledge and belief true, correct, and complete.
Printed name of authorized person
Signature of authorized person
Official title
Authorized
person
E-mail address of authorized person
Telephone number
Date
(
)
Firm’s name
Firm’s EIN
Preparer’s PTIN or SSN
Paid
(or yours if self-employed)
preparer
Signature of individual preparing this return
Address
City
State
ZIP code
use
only
E-mail address of individual preparing this return
Preparer’s NYTPRIN
Date
(see instr.)
See instructions for where to file.
446004140094
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