Form 100 - California Corporation Franchise Or Income Tax Return - 2015 Page 3
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6Schedule Q Questions (continued from Side 2)
Country _____________________________________________
G Date incorporated (mm/dd/yyyy):
Where:
State
H Date business began in California or date income was first derived from California sources . . . . . . . . . . . . . . . . . . . . (mm/dd/yyyy)
I First return? . . . . . . . . . . . . . . . . . . .
Yes
No If “Yes” and this corporation is a successor to a previously existing business, check the appropriate box .
(1)
sole proprietorship (2)
partnership (3)
corporation (5)
other
joint venture (4)
(Attach statement showing name, address, and FEIN/SSN/ITIN of previous business .)
J “Doing business as” name . See instructions: . . . . . . . . . . . . . . . . . . . . . .
________________________________________________________________________
__________________________________________________________________________________________________________________________________
K At any time during the taxable year, was more than 50% of the voting stock:
1. Of the corporation owned by any single interest? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Yes
No
2. Of another corporation owned by this corporation? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Yes
No
3. Of this and one or more other corporations owned or controlled, directly or indirectly, by the same interests? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Yes
No
If 1 or 3 is “Yes,” enter the country of the ultimate parent . . . . . . . . . .
_________________________________________________________________
If 1, 2, or 3 is “Yes,” furnish a statement of ownership indicating pertinent names, addresses, and percentages of stock owned .
If the owner(s) is an individual, provide the SSN/ITIN .
L Has the corporation included a reportable transaction or listed transaction within this return? (See instructions for definitions) . . . . . . . . . . . . . . . . .
Yes
No
If “Yes,” complete and attach federal Form 8886 for each transaction .
M Is this corporation apportioning or allocating income to California using Schedule R? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Yes
No
N How many affiliates in the combined report are claiming immunity from taxation in California under Public Law 86-272?
___________________________________
O Corporation headquarters are: . . . . . . . . . . . . . . . . . . . . . . .
(1)
Within California (2)
Outside of California, within the U .S . (3)
Outside of the U .S .
P Location of principal accounting records ___________________________________________________________________________________________________
Q Accounting method: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(1)
Cash (2)
Accrual (3)
Other
R Does this corporation or any of its subsidiaries have a Deferred Intercompany Stock Account (DISA)? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Yes
No
If “Yes,” enter the total balance of all DISAs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
$ _______________________________________
S Is this corporation or any of its subsidiaries a RIC? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Yes
No
T Is this corporation treated as a REMIC for California purposes? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Yes
No
U Is this corporation a REIT for California purposes? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Yes
No
V Is this corporation an LLC or limited partnership electing to be taxed as a corporation for federal purposes? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Yes
No
If “Yes”, enter the effective date of the election (mm/dd/yyyy): . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . .
W Is this corporation to be treated as a credit union? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . .
Yes
No
X Is the corporation under audit by the IRS or has it been audited by the IRS in a prior year? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Yes
No
Y Have all required information returns (e .g . federal Forms 1099, 5471, 5472, 8300, 8865, etc .) been filed with the Franchise Tax Board? . . . . . .
N/A
Yes
No
Z Does the taxpayer (or any corporation of the taxpayer’s combined group, if applicable) own 80% or more of the stock of an insurance company? . . . . .
Yes
No
AA Did the corporation file the federal Schedule UTP (Form 1120)? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Yes
No
BB Does any member of the combined report own an SMLLC or generate/claim credits that are attributable to an SMLLC? . . . . . . . . . . . . . . . . . . . . .
Yes
No
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is
Sign
true, correct, and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge.
Here
Telephone
Title
Date
Signature
of officer
(
)
Officer’s email address (optional)
Date
PTIN
Paid
Check if self-
Preparer’s
employed
Preparer’s
signature
Use Only
FEIN
Firm’s name (or yours,
if self-employed)
Telephone
and address
(
)
May the FTB discuss this return with the preparer shown above? See instructions . . . . . . . . . . . . . . . . . .
Yes
No
Form 100
2015 Side 3
3603153
C1
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