1250012205
Revenue ID
RCT-125
PAGE 2 OF 3
(09-14)
CALCULATION OF TAX
USE WHOLE DOLLARS ONLY
1.
1.
Net Income (Dividends declared or declared and paid, Schedule A, Line 9)
2.
Allocation Decimal (Schedule B, Line 3)
2.
3.
Net Income allocated to Pennsylvania (Line 1 times Line 2)
3.
4.
Tax (4 percent of Line 3)
4.
SCHEDULE A--RECONCILIATION OF BEGINNING AND
ENDING UNAPPROPRIATED RETAINED EARNINGS
1.
Balance--Beginning of Year
1.
2.
2.
Net Income per Books
3.
Other Increases (Attach Schedule)
3.
4.
4.
Total (Sum of Lines 1 through 3)
Deductions:
5.
Patronage refunds
5.
6.
6.
Transferred to reserves
7.
Statutory reserve
7.
8.
8.
Other Decreases (Attach Schedule)
9.
9.
Dividends on capital stock declared or declared and paid
10. Total Decreases (Total Line 5 through Line 9)
10.
11.
11. Balance - End of year (Line 4 minus Line 10)
SCHEDULE B - DETERMINATION OF ALLOCATION DECIMAL
1.
1.
Total gross receipts assignable to Pennsylvania
2.
Total gross receipts from all business
2.
3.
3.
Allocation decimal (Divide Line 1 by Line 2 and carry to six decimal places)
1250012205
Preparer’s Information:
Firm Name
Individual Preparer Name
Firm FEIN
Phone
Address
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City
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or PTIN
State
ZIP
I affirm under penalties prescribed by law this report, including any accompanying schedules and statements, has been prepared by me and to the best of my
knowledge and belief is a true, correct and complete report.
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