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Attachment Sequence No. 1120S-03
MISSOURI DEPARTMENT OF REVENUE
SCHEDULE
MO-NRS
S CORPORATION
NONRESIDENT SCHEDULE
REV. (12-2012)
COMPLETE THIS SCHEDULE FOR EACH NONRESIDENT SHAREHOLDER WHO HAS MISSOURI SOURCE INCOME.
CORPORATION NAME
MO TAX I.D. NUMBER
CHARTER NUMBER
FEDERAL I.D. NUMBER
NONRESIDENT SHAREHOLDER’S NAME
PART 1 — S CORPORATION’S DISTRIBUTIVE SHARE ITEMS
SOCIAL SECURITY NUMBER
MISSOURI SOURCE
(a)
(b)
(c)
(d)
(e)
FEDERAL
MO
FEDERAL
AMOUNT
MISSOURI SOURCE
SCHEDULE K
%
SCHEDULE K-1
00
00
00
00
1. Ordinary business income (loss) ....................................................
00
00
00
00
2. Net rental real estate income (loss) .................................................
00
00
00
00
3. Other net rental income (loss) (Federal Schedule K, Line 3c) .........
00
00
00
00
4. Interest income .................................................................................
00
00
00
00
5a. Ordinary dividends...........................................................................
00
00
00
00
5b. Qualified dividends ..........................................................................
00
00
00
00
6. Royalties ..........................................................................................
00
00
00
00
7. Net short-term capital gain (loss).....................................................
00
00
00
00
8a. Net long-term capital gain (loss) ......................................................
00
00
00
00
8b. Collectibles (28%) gain (loss) .........................................................
00
00
00
00
8c. Unrecaptured section 1250 gain......................................................
00
00
00
00
9. Net section 1231 gain (loss) ............................................................
00
00
00
00
10. Other income (loss) .........................................................................
00
00
00
00
11. Section 179 deduction .....................................................................
00
00
00
00
12a. Contributions ...................................................................................
00
00
00
00
12b. Investment interest expense............................................................
00
00
00
00
12c. Section 59 (e)(2) expenditures ........................................................
00
00
00
00
12d. Other deductions .............................................................................
PART 2 — SHARE OF MISSOURI S CORPORATION ADJUSTMENT — NONRESIDENT SHAREHOLDERS
(a)
(b)
(c)
(d)
(e)
The lines below and Column (a) correspond to
MISSOURI
SHAREHOLDER’S
MISSOURI
MO
MISSOURI
the lines on Form MO-1120S.
S CORPORATION
S CORPORATION
SOURCE
%
SOURCE
ADJUSTMENT
ADJUSTMENT
ADDITIONS
00
00
1. Net state and local income taxes deducted on Federal Form 1120S
00
00
2. Net state and local bond interest (except Missouri).........................
00
00
3.
Partnership
Fiduciary
Other adjustments .................
4. Donations claimed for the Food Pantry Tax Credit that were
deducted from federal taxable income,
00
00
Section 135.647, RSMo...................................................................
00
00
5. Total of Lines 1 through 4 ................................................................
SUBTRACTIONS
00
00
6. Net interest from exempt federal obligations ....................................
7. Amount of any state income tax refund
00
00
included in federal ordinary income .................................................
00
00
8. Federally taxable — Missouri exempt obligations ...........................
9.
Partnership
Fiduciary
Other adjustments
Build America and Recovery Zone Bond Interest
00
00
Missouri Public-Private Transportation Act ................................
10. Missouri depreciation basis adjustment
00
00
(Section 143.121.3(7), RSMo) .........................................................
11. Depreciation recovery on qualified property that is sold
00
00
(Section 143.121.3(9), RSMo) .........................................................
00
00
00
00
12. Total of Lines 6 through 11 ..............................................................
00
00
00
00
13. Missouri S corporation adjustment — NET ADDITION ...................
00
00
00
00
14. Missouri S corporation adjustment — NET SUBTRACTION ...........
NOTE: Each item shown in Parts 1 and 2, Columns (d) and (e) should be entered on the appropriate lines of Form MO-NRI of each nonresident shareholder.
For Privacy Notice, see instructions.
MO-NRS (12-2012)