Form Mo-1120x - Amended Corporation Income Tax Return - For Tax Years 1992 And Prior Page 2

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FORM MO-1120X

PAGE 2

REFUND OR TAX DUE

21. Overpayment - Column C, Line 20 less Line 13 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

22. Amount remitted or amount of overpayment to be contributed to the Trust Funds

Children’s Trust Fund

Veterans Trust Fund

22a.

22b.

23. Overpayment to be credited to Estimated Tax (see instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

REFUND

24. Overpayment to be refunded (Line 21 less Lines 22a, 22b and 23) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

25. TAX DUE - Column C, Line 13 less Line 20 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

26. Underpayment of Estimated Tax (Attach Form MO-2220 or Form 30C) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

27. Interest . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

28. Addition to Tax (for late filing or late payment) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

TOTAL DUE

29. TOTAL DUE - Add Line 25 through Line 28 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

DOR USE ONLY

PART 1 - LOSS CARRYBACK OR TAX CREDIT CARRYBACK

If a Loss Carryback or Tax Credit Carryback is involved in this amended return, complete the following. Consolidated Federal/Separate Missouri filers

should report figures attributable to this separate Missouri return and attach a copy of the Federal Consolidated Form 1139 or 1120X showing the carryback

or page 1 of the Federal Consolidated Form 1120 for the year of the loss to verify that only the separate company had the loss. Also, enclose a copy of the

consolidated income statement for this year and the year of the loss.

1. Year of Loss . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

2. Total Net Capital Loss Carryback . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

3. Total Net Operating Loss Carryback . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

4. Federal Income Tax Adjustment - Consolidated Federal/Separate Missouri filers must attach computations . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

PART 2 - ALLOCATION AND APPORTIONMENT OF INCOME

IF FILING FORM MO-MS, COMPLETE THIS PORTION OF THE FORM IN ITS ENTIRETY USING INFORMATION FROM THE FORM MO-MS. (CHECK APPROPRIATE BOX)

1. Federal Net Operating Loss deduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

THREE FACTOR APPORTIONMENT

SINGLE FACTOR APPORTIONMENT

2. Total Missouri property values . . . . . . . . . . . . . . . . . . .

Amount of sales wholly in Missouri. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

3. Total everywhere property values . . . . . . . . . . . . . . . . .

Amount of sales partly within and partly without Missouri . . . . . . . . . . . . . . . . . . . . .

4. Total Missouri wages/salaries . . . . . . . . . . . . . . . . . . . .

Amount of sales wholly without Missouri . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

5. Total everywhere wages/salaries . . . . . . . . . . . . . . . . .

Non-Missouri source income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6. Total Missouri sales . . . . . . . . . . . . . . . . . . . . . . . . . .

7. Total everywhere sales . . . . . . . . . . . . . . . . . . . . . . . .

8. Nonbusiness income - all sources . . . . . . . . . . . . . . . . .

9. Nonbusiness income - Missouri sources . . . . . . . . . . . .

AUTHORIZATION/NON-AUTHORIZATION

I authorize the Director of Revenue or delegate to discuss my return and attachments with the preparer or any member of his/

YES

DOR

her firm, or if internally prepared, any member of the internal staff.

USE

If you pay by check, you authorize the Department of Revenue to process the check electronically. Any returned check may be presented again electronically.

ONLY

SIGNATURE - PLEASE SIGN BELOW

Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of

preparer (other than taxpayer) is based on all information of which he/she has any knowledge. As provided in Chapter 143, RSMo, a penalty of up to $500 shall be imposed on any corporation which files a

frivolous return. I declare under penalties of perjury that I employ no illegal or unauthorized aliens as defined under federal law and that I am not eligible for any tax exemption, credit or abatement if I employ such

aliens. I also declare that if I am a business entity, I participate in a federal work authorization program with respect to the employees working in connection with any contracted services, and I do not knowingly employ

any person who is an unauthorized alien in connection with any contracted services.

SIGNATURE OF OFFICER

DATE (MM/DD/YYYY)

PREPARER’S SIGNATURE

DATE (MM/DD/YYYY)

_ _ / _ _ / _ _ _ _

TITLE OF OFFICER

PHONE NUMBER

PREPARER’S ADDRESS AND ZIP CODE

PHONE NUMBER

(_ _ _) _ _ _ - _ _ _ _

MAKE CHECK OR MONEY ORDER PAYABLE TO “MISSOURI DEPARTMENT OF REVENUE”. INCLUDE YOUR MISSOURI TAX IDENTIFICATION