Form Il-1023-C - Composite Income And Replacement Tax Return - 2012 Page 3
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3Illinois Department of Revenue
Year ending
Composite Return
Schedule BC
Month
Year
Membership
Attach to your Form IL-1023-C
IL Attachment no. 1
Write your name as shown on your Form IL-1023-C.
Write your
federal employer identification number (FEIN).
Identify the members included in your composite return
A
B
C
D
E
F
Composite return
payment amount
Check the box if the
reported to this
Partner or
member is an Illinois resident
member on
Social Security number
Shareholder type Share of income
and is included based on
Schedule
K-1-P.
Name and Address
or FEIN
(See instructions.)
or loss (%)
department-approved petition. (See instructions.)
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Schedule BC (R-12/12)
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