Form 4a - Wisconsin Apportionment Data For Combined Groups - 2013

4A

Wisconsin Apportionment Data for

Form

Combined Groups

2013

File with Wisconsin Form 4

Wisconsin Department

Read instructions before filling in this form

of Revenue

Designated Agent Name

Federal Employer ID Number

Part I Apportionment Factor Denominators

(a)

(b)

(c)

Company Name

Denominator

FEIN

(abbreviate as necessary)

(From column (b) of Form 4A-1

or Part II of Form 4A-2)

1

1a

2

2a

3

3a

4

4a

5

5a

6

6a

7 Total denominators from additional companies reported on separate schedules . . . . . 7a

8 Add lines 1a through 7a in column (c) . This is the combined group's apportionment

factor denominator . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8a

Part II Apportionment Factor Numerators and Members' Percentages

(a)

(b)

(c)

Member's Wisconsin Percentage of

Company Number

Numerator

Combined Unitary Income

(Corresponds to numbers 1 through 6 in Part I)

(From column (a) of Form 4A-1

or Part II of Form 4A-2)

(Divide amount in column (b) by

amount on Part I, line 8a)

.

1 . . . . . . . . . . . . . . . .

1b

1c

%

.

2 . . . . . . . . . . . . . . . .

2b

2c

%

.

3 . . . . . . . . . . . . . . . .

3b

3c

%

.

4 . . . . . . . . . . . . . . . .

4b

4c

%

.

5 . . . . . . . . . . . . . . . .

5b

5c

%

.

6 . . . . . . . . . . . . . . . .

6b

6c

%

7 Total from additional companies reported on separate schedules . . . . . . . 7c

.

%

Part III Combined Group's Wisconsin Apportionment Percentage

8 Add lines 1c through 7c in Part II, column c .

This is the apportionment percentage to enter on Form 4, line 8 . . . . . . . . 8c

.

%

IC-021