Form Ia 1120f - Franchise Return For Financial Institutions - 2012

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Iowa Department of Revenue
2012 IA 1120F
Franchise Return For Financial Institutions
Period Ending ______ / _____ (mm/yy) L L L L L
OFFICIAL USE ONLY
Check all that apply:
This is a Short Period Return.
Mailing Address Change
The bank has opened, closed, or moved branch locations. Provide a schedule.
Contact Person
Phone No.: ( ______ ) ______-________
Name and Address
Please check the appropriate box
01 Pay Return
02 Amended Pay
03 No Pay Return
05 Amended No Pay
FEIN: _______________________________ L
If this is a first or final return, check the appropriate
boxes.
First Return:
New Business
Successor
Entering Iowa
Filing Status:
Separate Iowa/Federal S Corporation
Final Return:
Reorganized
Merged
Dissolved
Separate Iowa/Separate Federal
Separate Iowa/Consolidated Federal
Name of Consolidated Parent: ____________________________
Type of Return:
Parent’s FEIN: __________________________________________
100% Iowa
Not 100% Iowa
Was federal income or federal tax changed for any prior period(s)?
No Iowa banking locations
Inactive bank
Yes. Periods changed: __________________ Reason:
Federal audit
USE WHOLE DOLLARS ONLY
1120X
1139
No
1. NET INCOME from federal return before net operating loss ........................................................................ 1 . ____________________ .00 L
2. INTEREST and DIVIDENDS exempt from federal income tax ......................................................... 2. _____________________ .00 L
3. IOWA FRANCHISE TAX EXPENSED ON FEDERAL RETURN ........................................................ 3. _____________________ .00 L
4. OTHER ADDITIONS from Schedule A .................................................................................................. 4. _____________________ .00 L
5. TOTAL IOWA INCOME. Add lines 1 through 4. ................................................................................................. 5. ____________________ .00
6. OTHER REDUCTIONS from Schedule D ............................................................................................. 6. _____________________ .00
7. INCOME SUBJECT TO APPORTIONMENT. Subtract line 6 from line 5. ...................................... 7. _____________________ .00
8. IOWA PERCENTAGE from Schedule 59F, line 19 ............................................................................. 8. _____________________ %
9. DEDUCTION for APPORTIONED INCOME from Schedule 59F, line 22 ....................................... 9. _____________________ .00
10. NET OPERATING LOSS from Schedule F ........................................................................................ 10. _____________________ .00
11. TOTAL REDUCTIONS. Add lines 6, 9, and 10. ............................................................................................... 11. ____________________ .00 L
12. IOWA NET INCOME subject to franchise tax. Subtract line 11 from line 5. .............................................. 12. ____________________ .00 L
13. COMPUTED TAX. Multiply line 12 by 5% (.05). .............................................................................................. 13. ____________________ .00
14. MINIMUM TAX from IA 4626F ............................................................................................................................ 14. ____________________ .00 L
15. TOTAL TAX. Add lines 13 and 14. ..................................................................................................................... 15. ____________________ .00
16. MINIMUM TAX CREDIT from IA 8827F ............................................................................................. 16. _____________________ .00 L
17. OTHER CREDITS from IA 148 ............................................................................................................ 17. _____________________ .00
18. PAYMENTS from Schedule C, line 8 .................................................................................................. 18. _____________________ .00
19. TOTAL CREDITS and PAYMENTS. Add lines 16, 17, and 18. ..................................................................... 19. ____________________ .00
20. NET AMOUNT. Subtract line 19 from line 15. ................................................................................................. 20. ____________________ .00 L
21. PENALTY for underpayment of estimated tax: Attach IA 2220. .................................................... 21. _____________________ .00
22. PENALTY for failure to pay or failure to file ..................................................................................... 22. _____________________ .00
23. TOTAL PENALTIES. Add lines 21 and 22. ....................................................................................................... 23. ____________________ .00 L
24. INTEREST ............................................................................................................................................................. 24. ____________________ .00 L
25. TOTAL DUE. Add lines 20, 23, and 24. Make check payable to “Treasurer - State of Iowa” ................ 25. ____________________ .00 L
26. NET OVERPAYMENT. Subtract line 21 from line 20. ................................................................................... 26. ____________________ .00
27. CREDIT TO NEXT PERIOD'S ESTIMATED TAX ............................................................................. 27. _____________________ .00 L
28. REFUND REQUESTED. Subtract line 27 from line 26. ................................................................................. 28. ____________________ .00
29.
29. ____________________
FOR OFFICIAL USE ONLY
A complete copy of your federal return, as filed with the Internal Revenue Service, MUST be filed with this return. If no copy is attached, this
WILL NOT be considered a complete return.
Under penalties of perjury, I declare that I have examined this return, 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:
Phone:
Phone:
Preparer's Signature:
ID No.:
Date:
43-001a (07/20/12)

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