Form Mo 1120x - Amended Corporation Income Tax Return - For Tax Years 1992 And Prior Page 2

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21. Overpayment - Column C, Line 20 less Line 13 .....................................................................................................u 21

22. Amount remitted or amount of overpayment to be contributed to the Trust Funds

Children’s Trust Fund

Veteran’s Trust Fund

u 22a

22b

23. Overpayment to be credited to Estimated Tax (see instructions) ...........................................................................u 23

24. Overpayment to be refunded (Line 21 less Lines 22a, 22b and 23) ......................................................... Refund u 24

25. Tax Due - Column C, Line 13 less Line 20 .............................................................................................................u 25

26. Underpayment of Estimated Tax (Attach

Form MO-2220

or Form 30C). ..............................................................u 26

27. Interest. ...................................................................................................................................................................u 27

28. Addition to Tax (for late filing or late payment). ......................................................................................................u 28

29. Total Due - Add Line 25 through Line 28. ............................................................................................. Total Due u 29

DOR Use Only

If a loss carryback or federal tax credit carryback is involved in this amended return, complete the following section. Consolidated federal and separate

Missouri filers should report figures attributable to this separate Missouri return and attach a copy of the Federal Consolidated Form 1139 or 1120X

showing the carryback or page 1 of the Federal Consolidated Form 1120 for the year of the loss to verify that only the separate company had

the loss. Also, enclose a copy of the consolidated income statement for this year and the year of the loss. (If NOL or Missouri tax credit carryback, enter

year that the credit first became available.)

M M D D Y Y

1. Year of loss ..................................................................................................................................................................

2. Total net capital loss carryback ....................................................................................................................................

3. Total net operating loss carryback ...............................................................................................................................

4. Federal income tax adjustment - Consolidated federal and separate Missouri filers must attach computations ............

If filing

Form

MO-MS, complete this portion of the form in its entirety using information from the

Form

MO-MS. (Select appropriate box)

1. Federal Net Operating Loss deduction ......................................................................................................................u

Three Factor Apportionment

Single Factor Apportionment

2. Total Missouri property values .......................

Amount of sales wholly in Missouri...........................................u

3. Total everywhere property values ..................

Amount of sales partly within and partly without Missouri ........u

4. Total Missouri wages and salaries .................

Amount of sales wholly without Missouri ..................................u

5. Total everywhere wages and salaries ............

Non-Missouri source income ....................................................u

6. Total Missouri sales. .......................................

7. Total everywhere sales ..................................

8. Nonbusiness income - all sources. .................

9. Nonbusiness income - Missouri sources. .......

I authorize the Director of Revenue or delegate to discuss my return and attachments with the preparer or any member of his or her firm, or if

internally prepared, any member of the internal staff.

Yes

If you pay by check, you authorize the Department of Revenue to process the check electronically. Any returned check may be presented

again electronically. Make check or money order payable to “Missouri Department of Revenue”. Include your Missouri tax identification

number on your check. Under penalties of perjury, I declare that the above information and any

DOR

attached supplement is true, complete, and correct.

Use Only

Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and

belief, it is true, correct, and complete. Declaration of preparer (other than taxpayer) is based on all information of which he or she has any knowledge.

As provided in

Chapter 143,

RSMo, a penalty of up to $500 shall be imposed on any corporation which files a frivolous return. I declare under penalties of

perjury that I employ no illegal or unauthorized aliens as defined under federal law and that I am not eligible for any tax exemption, credit or abatement

if I employ such aliens. I also declare that if I am a business entity, I participate in a federal work authorization program with respect to the employees working

in connection with any contracted services, and I do not knowingly employ any person who is an unauthorized alien in connection with any contracted services.

Signature of Officer (Required)

Title of Officer

Phone Number

Date Signed (MM/DD/YYYY)

(__ __ __) __ __ __ - __ __ __ __

__ __ /__ __ /__ __ __ __

Preparer’s Signature (Including Internal Preparer)

Preparer’s FEIN, SSN, or PTIN

Phone Number

Date Signed (MM/DD/YYYY)

(__ __ __) __ __ __ - __ __ __ __

__ __ /__ __ /__ __ __ __