Form Ia 1120 - Iowa Corporation Income Tax Return - 2014 Page 2
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4IA 1120 Page 2, 2014
Schedule A - Other Additions and Reductions
Enter Whole Dollars
Type of Income
Other Additions
Other Reductions
1 Percentage Depletion
2 TIP Credit from federal form 8846
3 Capital Loss Adjustments for filing status 2 or 3
4 Contribution Adjustments for filing status 2 or 3
5 Safe Harbor Lease — Rent
6 Safe Harbor Lease — Interest
7 Safe Harbor Lease — Depreciation
8 Depreciation Adjustment from IA 4562A
9 Tax Exempt Interest and Dividends. See instructions.
10 Iowa Tax Expense/Refund
11 Work Opportunity Credit Wage Reduction from federal form 5884
12 Alcohol & Cellulosic Biofuel Credit from federal form 6478
13 Foreign Dividend Exclusion from Schedule B
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14 Federal Securities Interest and Dividends. See instructions.
15 Other. Must include schedule.
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16
Totals
Enter total on line 3 of page 1.
Enter total on line 6 of page 1.
Schedule B - Foreign Dividend Exclusion
Enter Whole Dollars
Type of Dividend Income
Total Dividend
Exclusion
1 Less than 20% Owned
x
70%
2 20% to 80% Owned
x
80%
3 More than 80% Owned
x 100%
4 Dividend Gross Up (federal section 78)
x 100%
5
Total. Add lines 1 through 4.
Enter Total on line 13 of Schedule A.
Schedule C1 - Credits
Schedule C2 - Payments
Whole Dollars
Whole Dollars
Description
Amount
Description
Amount
1 Estimated Tax Payments
1 Fuel Credit. Include IA 4136.
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a Credit from prior period overpayment
2 Total Nonrefundable Credits. Include IA 148.
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b First, Date Paid:
3 Total Refundable Credits, excluding Fuel Credit.
c Second, Date Paid:
Include IA 148.
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d Third, Date Paid:
4 Total Credits. Add lines 1-3. Enter on page 1, line 20.
e Fourth, Date Paid:
f Other, Date Paid:
2 Voucher Payment
3 Other Payments. Include statement.
4 Total. Add lines 1-3. Enter on page 1, line 21.
Additional Information
1. Year business was started in Iowa:
2. Last period filed as S corporation (if any):
3. Information from the prior period Iowa return:
Corporation Name:
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Net Income/Loss:
FEIN:
4. If part of a federal consolidated group, please provide information about the corporate parent:
Corporation Name:
FEIN:
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Under penalties of perjury, I declare that I have examined this return and any schedules/statements, and, to the best of my knowledge
believe it to be true, correct and complete. If prepared by a person other than the taxpayer, the declaration is based on all information of
which there is any knowledge.
Officer’s signature:
Title:
Date:
Signature of preparer other than taxpayer:
Date:
Name and address of preparer or preparer’s employer:
Preparer’s Telephone No.: (
)
Preparer ID No.:
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42-001b (09/09/14)
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