Form Ia Fran Es - Installment/franchise Estimated Worksheet - 2013 Page 2

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Iowa Department of Revenue
Franchise Estimated Worksheet
(Do not mail this form. Retain with your records.)
AMENDED
COMPUTATION
ORIGINAL
ONLY
COMPUTATION
$
$
1. Taxable income from federal 1120 .......................................................................................................................... 1.
2. Interest and dividends exempt from federal income tax ......................................................................................... 2.
3. Iowa franchise tax deduction on federal 1120 ......................................................................................................... 3.
4. Other additions .......................................................................................................................................................... 4.
5. Total Iowa income. Add lines 1 through 4. .............................................................................................................. 5.
6. Other deductions ....................................................................................................................................................... 6.
7. Iowa net operating loss ............................................................................................................................................. 7.
8. Total deductions. Add lines 6 and 7. ........................................................................................................................ 8.
9. IOWA NET INCOME SUBJECT TO FRANCHISE TAX. Subtract line 8 from line 5. ............................................ 9.
10. Computed tax. Multiply line 9 by 5% (.05). .............................................................................................................. 10.
11. Minimum tax .............................................................................................................................................................. 11.
12. Total tax. Add lines 10 and 11. ................................................................................................................................ 12.
13. Minimum tax carryforward credit and other credits ................................................................................................. 13.
14. Tax after credits. Subtract line 13 from line 12. ...................................................................................................... 14.
(
)
15. Payments previously made for current period estimated tax ................................................................ Use these two lines
15.
16. Unpaid balance ........................................................................................................................................
only if amending
16.
17. Computation of installment ....................................................................................................................................... 17.
(
) last day of the 4th month, enter 1/4 of line 14 .............................................................
if first installment (
) last day of the 6th month, enter 1/3 of line 14 (line 16 if amending) ..........................
is to be filed on (
) last day of the 9th month, enter 1/2 of line 14 (line 16 if amending) ..........................
(
) last day of the 12th month, enter all of line 14 (line 16 if amending) .........................
Estimated Tax Payment Schedule
Computed
Prior period
Amount to be paid
Date
Installment (line 17)
Overpayment
(column b minus
(a)
(b)
(c)
column c)
(d)
1
2
3
4
Total
When you pay by check, you authorize the Department of Revenue to convert your check to a one-time
electronic banking transaction.
Iowa Department of Revenue
2013 IA FRAN ES
INSTALLMENT
4
F
Iowa Tax Payments for Financial Institutions
For Department of Revenue Use
FOR CALENDAR YEAR 2013 OR FISCAL YEAR ENDING ____________ , _____
Address Change
FEIN
PERIOD ______________________________________________ L
L
CODE:
07 ____________________________________________ L
DAYTIME TELEPHONE #
AMOUNT OF PAYMENT $ _____________________________________ L
please use whole dollars
Mail to:
DATE PAYMENT MAILED: ___________________________________________________
Franchise Tax Processing
Iowa Department of Revenue
PO Box 10413
Make check payable to "Treasurer - State of Iowa"
43-006 (09/13/12)
Des Moines, IA 50306-0413

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