Schedule Sk-1 - Shareholder'S Massachusetts Information - 2013
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FOR PRIVACY ACT NOTICE,
SEE INSTRUCTIONS.
Schedule S -1 Shareholder’s Massachusetts Information
2013
TAXPAYER IDENTIFICATION NUMBER
NAME OF SHAREHOLDER
ADDRESS
CITY/TOWN/POST OFFICE
STATE
ZIP + 4
FEDERAL IDENTIFICATION NUMBER (FID)
NAME OF S CORPORATION
ADDRESS
CITY/TOWN/POST OFFICE
STATE
ZIP + 4
Type of shareholder:
Individual resident
Individual nonresident
Trust or estate
Bank
Exempt organization
Did the S corporation participate in one or more installment sales transactions?:
Yes
No
If Yes, indicate whether information has been communicated to the shareholder to calculate an addition to Massachusetts tax under M.G.L. Ch. 62C,
sec. 32A based on the following Internal Revenue Code (IRC) provisions (check all that apply):
IRC 453A
IRC 453(l)(2)(B)
If a loss, mark an X in box at left
5
SHAREHOLDER’S DISTRIBUTIVE SHARE
1
Massachusetts ordinary income or loss (from Schedule S, line 25). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
2
Separately stated deductions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
3
Add lines 1 and 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
4
Credits available
a. Taxes paid to another jurisdiction (residents only) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4a
b. Lead Paint Credit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4b
c. Economic Opportunity Area Credit. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4c
d. Economic Development Incentive Program Credit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4d
e. Brownfields Credit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4e
f. Low-Income Housing Credit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4f
g. Historic Rehabilitation Credit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4g
h. Refundable Film Credit. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4h
i. Film Incentive Credit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4i
j. Medical Device Credit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4j
k. Refundable Dairy Credit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4k
l. Refundable Life Science Credit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4l
m.Life Science Company Tax Credit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4m
n. Refundable Economic Development Incentive Credit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4n
o. Conservation Land Credit. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4o
p. Employer Wellness Program Credit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4p
q. Total credits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4q
BE SURE TO CONTINUE SCHEDULE SK-1 ON OTHER SIDE
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