Fillable Form 1120n - Nebraska Corporation Income Tax Return

Nebraska Corporation Income Tax Return

FORM 1120N

2013

for the taxable year January 1, 2013 through December 31, 2013 or other taxable year

beginning

, 2013 and ending

PLEASE DO NOT WRITE IN THIS SPACE

Name Doing Business As (dba)

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

24 —

Check the appropriate box:

Initial Nebraska Return

Final Nebraska Return

Change in Address

Exempt Organization

Cooperative Meeting IRC § 6072(d)

7004 Attached

Corporation Filing Status

(Answer questions A through D, as applicable.)

C. Are you filing as a unitary group in any other state?

A. Does this corporation own at least 50% of another corporation; or is

(1)

YES

(2)

it owned at least 50% by another corporation?

D. Check the method used to determine Nebraska income

(1)

YES

(2)

(check only one):

(1)

Combined report of a controlled group of corporations

If Yes, attach Federal Form 851 or a schedule of affiliated

(2)

Separate report by a member of a controlled group

corporations and federal IDs. Answer questions B, C, and D.

of corporations (attach supporting documentation)

B. Is one single Nebraska return being filed for the entire group?

(3)

Alternate method (attach Nebraska Department of Revenue approval)

(1)

YES

(2)

All corporations required to file must complete this page. Schedules A, I, II, III, and IV must be completed when appropriate.

1 Federal gross sales or receipts, less returns and allowances ......................................................................

2 Federal taxable income (see instructions) ....................................................................................................

3 Federal net operating loss deduction ................................................................. 3

4 Federal capital loss carryover ............................................................................ 4

5 Other adjustments (enter amount from line 10 of the attached Nebr. Sch. A ) .... 5

6 Total adjustments (add lines 3 and 4, plus or minus line 5) .........................................................................

7 Adjusted federal taxable income (line 2 plus or minus line 6) ......................................................................

8 Nebraska taxable income before Nebraska carryovers (see instructions)....................................................

9 Nebraska capital loss carryover (see instructions) .......................................................................................

10 Line 8 minus line 9 ....................................................................................................................................... 10

11 Nebraska net operating loss carryover (see instructions – attach worksheet) .............................................

12 Net Nebraska taxable income (line 10 minus line 11) ................................................................................... 12

13 Nebraska tax (from tax rate schedule in instructions) .................................................................................. 13

14 Premium tax credit (see instructions — attach schedule) .................................... 14

15 Community Development Assistance Act credit (attach Form CDN) .................. 15

16 Form 3800N nonrefundable credit (attach Form 3800N) .................................... 16

17 Total nonrefundable credits (total of lines 14, 15, and 16) ............................................................................ 17

18 Nebraska tax after nonrefundable credits. Subtract line 17 from line 13 (if line 17 is more than line 13, enter -0-) ..

19 Form 3800N refundable credit (attach Form 3800N) .......................................... 19

20 Tax deposited with Form 7004N ......................................................................... 20

21 2013 estimated tax payments (minus any Form 4466N adjustment).................. 21

22 Beginning Farmer credit and Nebraska income tax withheld (see instructions) 22

23 Total payments (total of lines 19, 20, 21, and 22) ......................................................................................... 23

24 Balance Due (line 18 minus line 23)

Check this box if payment is made by Electronic Funds Transfer

Penalty for underpayment of est. tax (see inst.) Include penalty in line 24 and show here:

25 Overpayment (line 23 minus line 18) ........................................................................................................... 25

26 Amount on line 25 to be credited to 2014 estimated tax ............................................................................... 26

27 Overpayment to be refunded (line 25 minus line 26). Complete lines 28a, 28b, and 28c to receive your

refund electronically. ...................................................................................................................................... 27

28a Routing Number

28b Type of Account

Checking

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.)

28c Account Number

(see instructions)

28d

Check this box if this refund will go to a bank account outside the United States.

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