Form M4 - Corporation Franchise Tax Return - 2012

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2012 M4
Corporation Franchise Tax Return 2012
Tax year beginning
, 2012, and ending
FEIN
Minnesota tax ID
Name of corporation/designated filer
Current address
Check if new address
Business activity code (from federal)
Are you filing a combined income return? . . . .
Yes
No
City
State
Zip code
Is this your final C corporation return? If yes, indicate if:
Former name (if changed since 2011 return)
Withdrawn
Dissolved
Merged
S corp election
This corporation is (place an X in the boxes that apply):
Federal consolidated common parent name (if different)
FEIN
a co-op
in bankruptcy
Has a federal examination been finalized? (list years)
Report changes to federal income tax
within 180 days of final determination.
Is a federal examination now in progress? (list years)
If there is a change in tax, you must report
Tax years and expiration date(s) of federal waivers:
it on Form M4X.
You must round amounts
to nearest whole dollar
1
1 Minnesota tax liability (from M4T, line 23) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2
2 Minnesota Nongame Wildlife Fund donation (see instructions, pg. 5) . . . . . . . . . . . . . . . . . . .
3
3 Add lines 1 and 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
4
4 Enterprise Zone Credit (attach Schedule EPC) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
5
5 Jobs Credit for participating in a Job Opportunity Building Zone (JOBZ) (attach Schedule JOBZ) . .
6
6 Credit for increasing research activities (from RD, line 29) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
7 Historic Structure Rehabilitation Credit (attach credit certificate)
7
and enter NPS project number:
. . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
8
8 Credit for tuberculosis testing on cattle (see instructions, pg. 5) . . . . . . . . . . . . . . . . . . . . . . . . . . . .
9
9 Amount credited from your 2011 return . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
10
10 Total corporate estimated tax payments made for 2012 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
11
11 2012 extension payment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
12
12 Add lines 4 through 11 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
13
13 Tax due. If line 3 is more than line 12, subtract line 12 from line 3 . . . . . . . . . . . . . . . . . . . . . . . . .
14
14 Penalty (see instructions, pg. 5) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
15
15 Interest (see instructions, pg. 5) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
16
16 Additional charge for underpayment of estimated tax (attach Schedule M15C) . . . . . . . . . . . . . . . .
17 AMOUNT DUE. If you entered an amount on line 13, add lines 13 through 16.
17
Payment method:
Electronic (see inst., pg. 2), or
Check (attach Form PV41) . . . . . . . . . . .
18 Overpayment. If line 12 is more than the sum of lines 3 and 16, subtract line 3 and line 16
18
from line 12. If line 12 is less than the sum of lines 3 and 16, see instructions, pg. 5 . . . . . . . . . .
19
19 Amount of line 18 to be credited to your 2013 estimated tax . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
20
20 REFUND. Subtract line 19 from line 18 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
If you have a refund, you must enter your banking information below.
Account type:
Routing number
Account number
(use an account not associated with any foreign banks)
Checking
Savings
I declare that this return is correct and complete to the best of my knowledge and belief.
Authorized signature
Title
Date
Daytime phone
I authorize the
Minnesota
Department of
Signature of preparer
PTIN
Date
Daytime phone
Revenue to
discuss this tax
return with the
Print name of person to contact within corporation to discuss this return
Title
Daytime phone
preparer.
Attach a complete copy of your federal return including schedules as filed with the IRS. If you’re paying by check, attach Form PV41.
Mail to: Minnesota Revenue, Mail Station 1250, St. Paul, MN 55145-1250

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