Form 40 - Corporation Income Tax Return - 2013 Page 2

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North Dakota Office of State Tax Commissioner
2013 Form 40, page 2
Name as shown on return
Federal employer I.D.
Schedule SA: Statutory adjustments
This schedule is to be used by all corporations regardless of filing method.
Additions
(CA) 1
1 Federal net operating loss deduction (Federal Form 1120, line 29a)
2 Special deductions (Federal Form 1120, line 29b)
(CB) 2
3 All income taxes, franchise or privilege taxes measured by income, which were deducted
(CC) 3
to determine federal taxable income
(CF) 4
4 Interest on state and local obligations (Excluding North Dakota obligations)
(CD) 5
5 Contribution to endowment fund credit
(CE) 6
6 Contribution to housing incentive fund credit adjustment
(CQ) 7
7 Domestic production activity deduction
(CG) 8
8 Other additions (Attach worksheet)
9
9 Total additions (Add lines 1 through 8. Enter amount here and on Form 40, page 1, line 2)
Subtractions
(CH) 10
10 Tax refunds received in 2013 (Attach worksheet)
(CI) 11
11 Interest on United States obligations (Attach statement regarding obligations)
(LS) 12
12 Allocable income (Attach worksheet)
(LT) 13
13 Related expenses (Attach worksheet)
(LD) 14
14 Balance (Subtract line 13 from line 12)
(CM) 15
15 IC-DISC distribution to a non-corporate owner (See instructions)
(CO) 16
16 Others subtractions (Attach worksheet)
17 Total subtractions (Add lines 10, 11, 14, 15 and 16. Enter amount here and on Form 40, page 1, line 3)
17
The following questions must be answered
No
Yes
1 Has the IRS issued a Final Determination that affects a previously filed North Dakota return
®
1
that has not been reported to North Dakota?
®
2
2 Is this return for a tax-exempt organization required to report unrelated business taxable income?
3 Has this corporation filed as a cooperative, a Foreign Sales Corporation, or a Domestic International
®
3
Sales Corporation for federal purposes?
4 Is this return for an entity, or does the return include an entity, that filed a Financial Institution Tax return
®
®
(Form 35) for 2012? If yes, mark the circle to indicate if this is an S corporation.
4
5 Does this corporation use the combined report method in any other states? If yes, attach a statement
®
5
showing all states where the combined report method is used
6 Does this corporation file its federal income tax return as a member of a
consolidated group? If yes, please enter the Federal Employer I.D. No. under
6
®
which the consolidated return is filed.
(AM)
7 Does the numerator of the apportionment factor on page 1, line 5 include the property, payroll and/or sales
®
7
of more than one corporation required to file in this state? If yes:
Filing method circle on page 1, line 1 must have been marked b1 or c1.
®
How many corporations are included in the numerator?
Complete North Dakota Schedule CR, Parts I, II and III reporting the activities of
each company apportioning income to North Dakota.
8 If this return is filed using the water's edge method, indicate which year of the five-year election this
®
return represents. (List number: 1 through 5)
9
®
9 Is this a limited liability company?
10 Are any single member LLC's with business activity or apportionment factors in North Dakota included
®
10
in this return? (If yes, attach schedule with names and Federal Employer I.D. Numbers)
11 Is this corporation or any of its affiliates included in this return a captive real estate investment trust
11
(REIT)? (If yes, attach schedule with names and Federal I.D. numbers of all captive REITS)
®
12 Has this corporation changed names, been involved in a merger, reorganization or
takeover during this tax year? If so, provide former name and details of change.
®
(former name)

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