Form Sc 1120 - 'C' Corporation Income Tax Return Page 5

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SC1120
Page 5
SCHEDULE I
RESERVED
CORPORATIONS INCLUDED IN CONSOLIDATED RETURN
SCHEDULE J
AFFILIATED CORPORATION NO.
1.
Name
2.
Incorporated under the laws of the State of
3.
Location of the Registered Office of the Corporation in the State of South Carolina is
In the City of
Registered Agent at such address is
4.
Location of principal office (street address)
Nature of principal business in S.C.
5.
The total number of authorized shares of capital stock, itemized by class and series, if any, within each class is as follows:
NUMBER OF SHARES
CLASS
SERIES
6.
The total number of issued and outstanding shares of capital stock itemized by class and series, if any, within each class is as follows:
NUMBER OF SHARES
CLASS
SERIES
7.
The names and business addresses of the directors (or individuals functioning as directors) and principal officers in the Corporation are:
(If additional space is necessary, attach separate schedule).
NAME
TITLE
BUSINESS ADDRESS
8.
Date Incorporated
Date commenced business in the State of South Carolina was
9.
Date of this report
FEIN
SC File #
10. If Foreign Corporation, the date qualified to do business in the State of South Carolina is
11. Was the name of the Corporation changed during the year?
Give old name
12. The Corporation's books are in the care of
Located at (street address)
13. Corporate Mailing Address
14. The total amount of stated capital per balance sheet is:
A. Total paid in Capital Stock (cannot be a negative amount) . . . . . . . . . . . . $
B. Total paid in Capital Surplus (cannot be a negative amount) . . . . . . . . . . .$
C. Total amount of stated Capital (cannot be a negative amount) . . . . . . . . . $
For additional affiliated corporations, include additional Schedule Js as needed.
30915029

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