Form 1120x - Amended U.s. Corporation Income Tax Return
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41120X
OMB No. 1545-0132
Amended U.S. Corporation
For tax year ending
Form
Income Tax Return
(Rev. January 2011)
▶
Department of the Treasury
(Enter month and year.)
Internal Revenue Service
Employer identification number
Name
Please
Type
Number, street, and room or suite no. (If a P.O. box, see instructions.)
or
Print
City or town, state, and ZIP code
Telephone number (optional)
Enter name and address used on original return (If same as above, write “Same.”)
Internal Revenue Service Center
where original return was filed
Fill in applicable items and use Part II on the back to explain any changes
(a) As originally
(b) Net change —
Income and Deductions (see instructions)
Part I
(c) Correct amount
reported or as
increase or (decrease) —
previously adjusted
explain in Part II
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Total income .
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1
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2
Total deductions
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3
Taxable income. Subtract line 2 from line 1 .
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4
Total tax .
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4
Payments and Credits (see instructions)
5 a Overpayment in prior year allowed as a credit .
5a
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b Estimated tax payments .
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5b
c Refund applied for on Form 4466 .
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5c
d Subtract line 5c from the sum of lines 5a and 5b .
5d
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e Tax deposited with Form 7004 .
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5e
f Credit from Form 2439
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5f
g Credit for federal tax on fuels and other refundable
credits .
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5g
6
Tax deposited or paid with (or after) the filing of the original return .
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7
Add lines 5d through 6, column (c)
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7
8
Overpayment, if any, as shown on original return or as later adjusted .
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9
Subtract line 8 from line 7
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9
Tax Due or Overpayment (see instructions)
Tax due. Subtract line 9 from line 4, column (c). If paying by check, make it payable to the
10
“United States Treasury” .
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10
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11
Overpayment. Subtract line 4, column (c), from line 9 .
11
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Refunded
12
Enter the amount of line 11 you want: Credited to 20
Estimated tax
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Under penalties of perjury, I declare that I have filed an original return and that I have examined this amended return, including accompanying
schedules and statements, and to the best of my knowledge and belief, this amended return is true, correct, and complete. Declaration of preparer
Sign
(other than taxpayer) is based on all information of which preparer has any knowledge.
Here
Signature of officer
Date
Title
Print/Type preparer's name
Preparer’s signature
Date
PTIN
Paid
Check
if
self-employed
Preparer
Firm’s name
▶
Firm's EIN
▶
Use Only
Firm’s address
▶
Phone no.
1120X
For Paperwork Reduction Act Notice, see instructions.
Form
(Rev. 1-2011)
Cat. No. 11530Z
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