Form Ri-1120x - Rhode Island Amended Business Corporation Tax Return Page 3

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RI-1120X

Name

Federal employer identification number

page 3

Schedule E - Explanation of changes to income, deductions, credits, etc. Enter the line reference for which a change is

reported, and give the reason for the change. Show any computation in detail. Attach any schedules needed.

Schedule H - Franchise Tax Calculation

1. Number of Shares of Authorized Stock

5. Multiply line 4 times $2.50

2. Par Value per Share of Stock (No par value = $100)

6. Apportionment Ratio from Schedule J, line 5

3. Authorized Capital. Multiply line 1 times line 2

7. Franchise Tax. Multiply line 5 times line 6, but

4. Divide line 3 by $10,000.00

not less than $500.00

500.00

Schedule J - Apportionment

Check if utilizing an alternative allocation apportionment

COLUMN A

COLUMN B

calculation allowed under 44-11-14.1 through 44-11-14.6.

EVERYWHERE

1a.

Average net

1. a. Inventory ....................................................................................

1b.

book value

b. Depreciable assets ....................................................................

1c.

c. Land...........................................................................................

1d.

d. Rent (8 times annual net rental rate).........................................

1e.

e. Total ...........................................................................................

_._ _ _ _ _ _

1f.

f. Ratio in Rhode Island, line 1e, column A divided by line 1e, column B.............................................................................

Receipts

2. a. Gross receipts - Rhode Island Sales.........................................

2a.

Gross receipts - Sales Under 44-11-14 (a) (2) (i) (B)...............

2b.

b. Dividends ...................................................................................

2c.

c. Interest........................................................................................

2d.

d. Rents ..........................................................................................

2e.

e. Royalties .....................................................................................

2f.

f. Net capital gains .........................................................................

2g.

g. Ordinary income .........................................................................

2h.

h. Other income ..............................................................................

2i.

i. Income exempt from federal taxation .........................................

2j.

j. Total ............................................................................................

k. Ratio in Rhode Island, line 2j, column A divided by line 2j, column B ...............................................................................

2k.

_._ _ _ _ _ _

Salaries

3. a. Salaries and wages paid or incurred - (see instructions) ..........

3a.

b. Ratio in Rhode Island, line 3a, column A divided by line 3a, column B.............................................................................

3b.

_._ _ _ _ _ _

Ratio

4 Total of Rhode Island Ratios shown on lines 1f, 2k and 3b ...................................................................................................

_._ _ _ _ _ _

5. Apportionment Ratio. Line 4 divided by 3 or by the number of ratios. Enter here and on page 1, Sch A, col C, line 5........

_._ _ _ _ _ _