Form Ct-1120 Pic - Connecticut Information Return For Passive Investment Companies
ADVERTISEMENT
1
2
3Form CT-1120 PIC
Department of Revenue Services
State of Connecticut
I
nformation Return
PO Box 2974
Hartford CT 06104-2974
for Passive Investment Companies
(Rev. 12/13)
Complete this form in blue or black ink only. See instructions on reverse.
Enter Income Year Beginning ____________________________, ________, and Ending __________________________, ________
Passive investment company (PIC) name
CT Tax Registration Number
Taxpayer
Number and street
PO Box
DRS use only
Please
–
– 20
type
City or town
State
ZIP code
Federal Employer ID Number (FEIN)
or print.
Check and Complete All Applicable Boxes
5. Indicate the method used to determine the number of full-time
1. Date PIC began commercial operations: __________________
equivalent employees. See Instructions.
Date PIC began commercial operations in CT: _____________
Actual time or business records
Safe harbor method elected:
2. Parent company’s name: ______________________________
____ First 30 days of taxable year
__________________________________________________
____ Average of first three months of taxable year
CT Tax Registration Number: __________________________
6.
Indicate the method used to allocate expenses and employee
3. Is a common paymaster used:
Yes
No
costs to the PIC. See instructions.
If Yes, indicate the common paymaster’s:
I.R.C. §482 type method
Name: _____________________________________________
Safe harbor method elected:
__________________________________________________
____ Percentage of time
____ Percentage of loans
CT Tax Registration Number: ___________________________
The PIC hereby affirms that the applicable period selected under
4. Did the PIC have at least five full-time equivalent employees in
the safe harbor methods in either Line 5 or Line 6 is representative
Connecticut for the period covered by this return:
of, or generally no less than, its level of employment for the entire
year.
Yes
No
7.
Amount of expenses and employee costs to be allocated to the
If Yes, indicate the number of PIC employees:
PIC: _____________________________________________
Full-time: _______________ Part-time: _________________
Attach detailed schedule. See instructions.
Dual: _________ See instructions.
8.
Amount of the PIC’s total gross receipt: _________________
Attach detailed schedule.
If No, the company does not qualify as a PIC. Do not file this
return.
9.
Amount of total dividends issued by the PIC: _____________
Attach detailed schedule.
10. PIC apportionment fraction: ___________________________
Carry to six places. Complete and attach Form CT-1120A-FS,
Corporation Business Tax Return Apportionment Computation
of Income From Financial Service Company Activities.
Declaration: I declare under penalty of law that I have examined this return (including any accompanying schedules and statements) and, to the
best of my knowledge and belief, it is true, complete, and correct. I understand the penalty for willfully delivering a false return or document to the
Department of Revenue Services (DRS) is a fine of not more than $5,000, or imprisonment for not more than five years, or both. The declaration of
a paid preparer other than the taxpayer is based on all information of which the preparer has any knowledge.
Corporate officer’s name (print)
Corporate officer’s signature
Date
Corporate officer’s email address (print)
Sign Here
Title
Telephone number
(
)
Keep a
Paid preparer’s signature
Date
Preparer’s SSN or PTIN
copy
of this
return for
Firm’s name and address
FEIN
your
records.
Telephone number
(
)
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Financial