Form M-990t - Unrelated Business Income Tax Return - 2012
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1
22012
Form M-990T
Massachusetts
Unrelated Business
Department of
Income Tax Return
Revenue
For calendar year 2012 or taxable year beginning
2012 and ending
Name of company
Federal Identification number
Mailing address
City/Town
State
Zip
Name of treasurer
Is a Taxpayer Disclosure Statement enclosed?
Yes
No
3
Excise Calculation
Use whole dollar method
01 Unrelated business taxable income (from U.S. Form 990T, line 34) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 1
02 Foreign, state or local income, franchise, excise or capital stock taxes deducted from U.S. net income. . . . . . . . . . . . . . . . . . 3 2
03 Section 168(k) “bonus” depreciation adjustment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 3
04 Section 31I and 31K intangible expense add back adjustment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 4
05 Federal NOL add back adjustment (from U.S. Form 990T, line 31). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 5
06 Loss carryover deduction (from Schedule E-2) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 6
07 Section 31J and 31K interest expense add back adjustment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 7
08 Federal production activity add back adjustment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 8
09 Abandoned building renovation deduction. . . . . . . . . . . . . . . . . . . . . . . . . . . . . Total cost 3 $ ____________________ × .10 3 9
10 Other adjustments, including research and development expenses (enclose explanation) . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 10
11 Income subject to apportionment. See instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
12 Income apportionment percentage (from Schedule F, line 5 or 1.0, whichever applies) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 12
13 Multiply line 11 by line 12. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
14 Income not subject to apportionment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 14
15 Add lines 13 and 14. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
16 Certified Massachusetts solar or wind power deduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 16
17 Taxable income. Subtract line 16 from line 15 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
18 Multiply line 17 by .08 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
19 Credit recapture (enclose Schedule(s) H and/or H-2) and/or additional tax on installment sales. See instructions . . . . . . . . 3 19
20 Excise due before credits. Add lines 18 and 19 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
Credits.
Any credit being claimed must be determined with respect to the unrelated business activity being
reported on this return.
21 Economic Opportunity Area Credit (from Schedule EOAC) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 21
22 Economic Development Incentive Program Credit. Certificate number 3
. . . . . . . . . . . . . . . . . . 3 22
23 Investment Tax Credit (from Schedule H) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 23
24 Vanpool Credit (from Schedule VP) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 24
25 Research Credit (from Schedule RC) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 25
26 Harbor Maintenance Tax Credit (from Schedule HM, line 21) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 26
27 Brownfields Credit. Certificate number 3
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 27
28 Low-Income Housing Credit. Building identification number 3
. . . . . . . . . . . . . . . . . . . . . . . . . . 3 28
29 Historic Rehabilitation Credit. Certificate number 3
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 29
30 Film Incentive Credit. Certificate number 3
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 30
31 Medical Device Credit. Certificate number 3
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 31
32 Life Science Company Investment Tax Credit under section 38U . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 32
33 Life Science Company FDA User Fee Credit under section 31M . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 33
34 Life Science Company Research and Development Credit under section 38W. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 34
35 Total credits. Add lines 21 through 34 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35
Under the 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 corporate officer (see instructions)
Social Security number
Telephone number
Date
Signature of paid preparer
Employer Identification number
Address
Date
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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Parent category: Financial