Form 63 Fi - Financial Institution Excise Return

Refund or Tax Due

24 2011 overpayment applied to 2012 estimated tax . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 24

25 2012 estimated tax payments (do not include amount in line 24) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 25

26 Payments made with extension . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 26

27 Pass-through entity withholding. Payer Identification number 3

. . . . . . . . . . . . . . . . . . . . . 3 27

28 Refundable Film Credit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 28

29 Refundable Dairy Credit. Certificate number 3

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 29

30 Refundable Life Science Credit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 30

31 Refundable Life Science Jobs Credit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 31

32 Refundable Economic Development Incentive Program Credit. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 32

33 Refundable Conservation Land Credit. Certificate number 3

. . . . . . . . . . . . . . . . . . . . . . . 3 33

34 Total tax payments. Add lines 24 through 33. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34

35 Amount overpaid. If line 23 is smaller than line 34, subtract line 23 from line 34 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35

36 Amount overpaid to be credited to 2013 estimated tax . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 36

37 Amount overpaid to be refunded. Subtract line 36 from line 35 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 37

38 Balance due. If line 34 is smaller than line 23, subtract line 34 from line 23 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38

39 M-2220 penalty . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 39

40 Late file/pay penalties . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 40

41 Total penalties. Add lines 39 and 40 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41

42 Interest on unpaid balance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 42

43 Total payment due at time of filing. Add lines 38, 41 and 42.

Make remittance payable to: Commonwealth of Massachusetts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 43

Disclosure Schedule

1 Enter the amount claimed as a deduction for contributions to bad debt reserve from the corporation’s federal return for

the taxable year . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 1

2 Enter the amount of bad debts that actually went bad during the taxable year . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 2

3 Enter the amount of capital loss claimed federally that was treated as an ordinary loss, per IRC sec. 582(c). . . . . . . . . . . . 3 3

4 Enter the total amount of capital gains claimed on U.S. Form 1120 or 1120S . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 4

5 Enter the amount of total income as reported on U.S. Form 1120, line 11 or 1120S, line 6 . . . . . . . . . . . . . . . . . . . . . . . . . . 3 5

Schedule A. Taxable Income

1 Gross receipts or sales (from U.S. Form 1120, line 1c) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 1

2 Net income (from U.S. Form 1120, line 28) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 2

3 State and municipal bond interest not included in federal net income (total from Schedule B, col. d). . . . . . . . . . . . . . . . . . . 3 3

4 Foreign, state or local income, franchise, excise or capital stock taxes deducted from federal net income . . . . . . . . . . . . . . 3 4

5 Portion of net capital loss carryover used to reduce capital gain on U.S. Schedule D . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 5

6 Section 168(k) “bonus” depreciation adjustment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 6

7 Other income not included in line 2. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 7

8 Section 31I and 31J intangible and interest expense add back. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 8

9 Federal production activity add back. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 9

10 Adjusted income. Add lines 2 through 9. If a loss, enter “0” . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

11 Abandoned Building Renovation deduction. Total cost $ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . × .10 = 3 11

12 Dividends deduction (from Schedule D, line 5) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 12

13 Exception(s) to the add back of interest and/or intangible expenses (enclose schedule) . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 13

14 Total deductions. Add lines 11 through 13 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14

15 Income subject to apportionment. Subtract line 14 from line 10. If loss, enter “0” . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 15

16 Income apportionment percentage (from Schedule E, line 5 or 100%, whichever applies) . . . . . . . . . . . . . . . . . . . . . . . . . . 3 16

17 Income taxable in Massachusetts. Multiply line 15 by line 16. If a loss, enter “0.” Enter result here and in line 1 of return 3 17