Form Ia 1120s - Iowa Income Tax Return For S Corporations - 2012

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Iowa Department of Revenue
OFFICE USE ONLY
2012 IA 1120S
Reset Form
Iowa Income Tax Return for S Corporations
For Calendar Year 2012 or other fiscal year
Print Form
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From____/____/____to____/____/____
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Check all that apply:
Name/Address Change
Short Period
Amended Return
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Part I: Corporation Name and Address
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Name: _______________________________________
FEIN:
Business Code:
Street Address: ________________________________
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County No.:
Number of Shareholders:
_____________________________________________
Is this a first or final return? If yes, check the appropriate box.
City, State, ZIP: ________________________________
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First Return
New Business
Successor
Entering Iowa
Name of contact person: _______________________________
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Final Return
Reorganized
Merged
Dissolved
Phone No.: ( _____ ) _________ - ______________________
Withdrawn
Bankruptcy
Other__________
Part II: Corporation Information
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Type of Return:
1. S Corporation
2. IC Domestic International Sales Corporation
3. Foreign Sales Corporation
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Is this an inactive corporation? ................................................
Yes
No
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Was federal income or tax changed for any prior period(s)?..
Yes
No Periods: __________________________________
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Is the corporation’s business carried on entirely within Iowa?
Yes
No
Date of S corporation election: _____________
Part III: Modification of Corporation Income
USE WHOLE DOLLARS
1. Net income per federal Schedule K. (See instructions). ................................................................................. 1. ________________
2. Interest and dividends exempt from federal income tax. (See instructions). ........... 2. ________________
3. Other additions. Attach schedule. ............................................................................. 3. ________________
4. Total additions. Add lines 2 and 3. ....................................................................................................................... 4. ________________
5. 50% of federal income tax ......................................................................................... 5. ________________
6. Interest and dividends from f eder al securities. (See instructions). .......................... 6. ________________
7. Other reductions. Attach schedule. ........................................................................... 7. ________________
8. Total reductions. Add lines 5, 6, and 7. ................................................................................................................ 8. ________________
9. Net modifications. Subtract line 8 from line 4. ...................................................................................................... 9. ________________
10. Modified federal net income. Add line 1 and line 9. ............................................................................................. 10. ________________
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11. Tax on built-in gains or passive investment income. (See instructions). ............................................................ 11. _______________
Amount Owed: Make check payable to Treasurer-State of Iowa. If a refund is needed, see instructions.
Part IV: Business Activity Ratio (BAR) See instructions.
Enter Whole Dollar Amounts.
Types of Income
Column A Iowa Receipts
Column B Receipts Everywhere
1. Gross Receipts ................................................. 1. ___________________________________________________________________
2. Net Dividends. See instructions. ...................... 2. ___________________________________________________________________
3. Exempt Interest ................................................. 3. ___________________________________________________________________
4. Accounts Receivable Interest ........................... 4. ___________________________________________________________________
5. Other Interest .................................................... 5. ___________________________________________________________________
6. Rent ................................................................... 6. ___________________________________________________________________
7. Royalties ........................................................... 7. ___________________________________________________________________
8. Capital Gains / Loss ......................................... 8. ___________________________________________________________________
9. Ordinary Gains / Loss ....................................... 9. ___________________________________________________________________
10. Partnership Gross Receipts. Attach schedule. 10. ___________________________________________________________________
11. Other. Must attach schedule. ........................... 11. ___________________________________________________________________
12. TOTALS ............................................................. 12. ___________________________________________________________________
13. BAR to six decimal places. Divide line 12, column A, by line 12, column B.
%
Part V. Information from Prior Period Iowa Return:
Corporation Name: ___________________________________
Net Income/(Loss): $ ______________
FEIN: ______________________
File electronically. A complete copy of your federal return MUST be filed with this return, not including federal K-1s.
Under penalties of perjury, I declare that I have examined this return and any attached 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: ______________________________________________________
Date: _______ Title: _______________________
Preparer’s Signature: ____________________________________________________
Date: _______
Preparer’s Address:_______________________________________________________ Preparer’s ID No.: __________________________
Mail to: Corporate Tax Return Processing, Iowa Department of Revenue, P.O. Box 10468, Des Moines IA 50306-0468

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