Form 355sc - Domestic Or Foreign Security Corporation Return - Massachusetts Department Of Revenue - 2013

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2013
Form 355SC
Domestic or Foreign Security
Corporation Return
Massachusetts
Department of
Revenue
An exact copy of U.S. Forms 1120 or 1120-RIC, including all applicable schedules and forms required to substantiate the Massachusetts excise,
must be made available to the Department of Revenue upon request. Any changes or amendments to any U.S. amount must be explained in detail.
For calendar year 2013 or taxable period beginning
2013 and ending
Name of corporation
U.S. Principal Business Code
Federal Identification number
Principal business address
City/Town
State
Zip
3
3
3
Principal business address in Massachusetts
City/Town
State
Zip
1 Is the corporation incorporated within Massachusetts? 2 Date of charter
3 Class 1 security corporation
Class 2 security corporation
Yes 
No
Yes 
No
Yes 
No
4 Date corporation first classified as security corporation 5 Date business began in Mass.
6 State or country of incorporation
7 Avg. number of employees in Mass.
3
3
3
3
8 Is a Taxpayer Disclosure Statement enclosed?
9 Most recent year audited by IRS
Have the adjustments been reported to Massachusetts?
3
3
Yes 
No
Yes 
No
10 Corporation’s books are in the care of
Title
11 Corporation (check one only)
3
3
New 
Terminated 
Has predecessor 
Has successor
12 Does this entity continue to qualify as a security corporation? If Yes, enclose statement explaining changes in corporate activity since last qualified.
3
Yes 
No
13 Is the corporation participating in the filing of a U.S. consolidated return?
Federal Identification number of parent
3
Yes 
No
14 U.S. form(s) and schedule(s) filed for this tax year
3
1120 
1120-RIC 
851 
5471 
1120S 
1120-REIT
3
Computation of Excise
11 Total U.S. income (from U.S. Form 1120 or appropriate form) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 1
Use whole dollar method
12 State and municipal bond interest not included in line 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 2
13 Adjustments to income. See instructions (enclose schedule) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 3
14 Massachusetts gross income. Add lines 1 through 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
15 Class 1 excise, if applicable (line 4) $ _____________________ × .0033 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
16 Class 2 excise, if applicable (line 4) $ _____________________ × .0132 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
17 Excise before credits (line 5 or 6, whichever applies) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
18 Vanpool Credit and carryover (from Schedule VP). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 8
19 Film Incentive Credit. Certificate number 3
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 9
10 Economic Development Incentive Program Credit. Certificate number 3
. . . . . . . . . . . . . . . . . 3 10
11 Historic Rehabilitation Credit. Certificate number 3
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 11
12 Medical Device Credit. Certificate number 3
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 12
13 Brownfields Credit. Certificate number 3
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 13
14 Low-Income Housing Credit. Building Identification number 3
. . . . . . . . . . . . . . . . . . . . . . . . . 3 14
15 Employee Wellness Program Credit. Certificate number 3
. . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 15
16 Excise after credits. Subtract the total of lines 8 through 15 from line 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
456
17 Minimum excise (cannot be prorated) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
18 Excise due before voluntary contribution (line 16 or line 17, whichever is larger) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
456
19 Voluntary contribution for endangered wildlife conservation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 19
20 Excise due plus voluntary contribution. Add lines 18 and 19. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 20
456
21 2012 overpayment applied to 2013 estimated tax . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 21
22 2013 estimated tax payments (do not include amount in line 21) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 22
23 Payments made with extension . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 23
24 Amount overpaid. Subtract line 20 from total of lines 21 through 23 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24
456
Under penalties of perjury, I declare that to the best of my knowledge and belief, this return and enclosures are true, correct and complete.
Signature of appropriate officer (see instructions)
Date
Social Security number
Title
Signature of paid preparer
Date
Employer Identification number
Address
If you are signing as an authorized delegate of the appropriate corporate officer, check here
and enclose Massachusetts Form M-2848, Power of Attorney.
The Privacy Act Notice is available upon request. Mail to: Massachusetts Department of Revenue, PO Box 7067, Boston, MA 02204.

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