Form 512-S - Oklahoma Small Business Corporation Income Tax Return - 2012 Page 17
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17512-sa
Nonresident
2
0
1
Shareholder Agreement
2
I,
, the undersigned, do agree I will
file an Oklahoma Income Tax Return for the taxable year ending
.
I will include, in Oklahoma adjusted gross income, my share of distributed or undistributed
taxable income or net operating loss of the corporation named below to the extent such
income, gain or loss, is at the corporate level, derived from sources within Oklahoma. I
further state I made and executed this agreement for the purpose of filing it with the fol-
lowing named corporation to be submitted with the Oklahoma Small Business Corporation
Income Tax Return, Form 512-S, filed by the corporation for the taxable year indicated
above.
Corporation
Street Address or Post Office Box
City
State
Zip
Federal Employer Identification Number
Signature of Shareholder Executing Agreement
Social Security Number or
Federal Employer
Identification Number
Dated this
day of
,
.
Corporation Please Note:
This agreement must be filed with the original Small Business Corporation Income Tax
Return, Form 512-S, for each nonresident shareholder. Otherwise, the corporation shall
be taxed on that part of the corporation’s net taxable income allocable to the shares of
stock owned by the nonresident shareholder. Once the agreement has been signed, it is
irrevocable for this taxable year.
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