Form 1120b-Me - Maine Franchise Tax Return For Financial Institutions - 2004

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FORM 1120B-ME
MAINE FRANCHISE TAX RETURN
00
FOR FINANCIAL INSTITUTIONS
*0408410*
/
/
/
/
0 4
For tax period 01/01/04 to 12/31/04 or
to
Check here if part of
an amended return:
CHECK APPLICABLE BOXES:
(1)
Initial return
(2)
Final return
(3)
Change of name/address
Name
Federal Employer ID Number
Address
Business Code
State of
Incorporation
City
State
ZIP Code
-
-
Contact Person First Name
Contact Person Last Name
Telephone Number
Check Here if this is a Combined
Return and Enclose Form CRB
Parent Company Federal Employer ID Number
Principal Place of Activity in Maine
City where Records are Maintained
State
1.
MAINE NET INCOME:
,
,
,
.00
a. NET INCOME PER BOOKS (From federal Form 1120, 1120S or 1065) ............................................. 1a
,
,
,
.00
b. MAINE NET INCOME (From line 1a above or page 2, Schedule A, line 13) ....................................... 1b
2.
ASSETS:
,
,
,
.00
a. TOTAL END-OF-YEAR ASSETS (From federal Form 1120, 1120S or 1065) .............................................. 2a
,
,
,
.00
b. MAINE ASSETS (From line 2a above or page 2, Schedule A, line 15) ........................................................ 2b
3.
TAX:
,
,
,
.00
a. TAX ON MAINE NET INCOME (Not less than zero) line 1b x 0.01 ............................................................. 3a
,
,
,
.00
b. TAX ON ASSETS - line 2b x 0.00008 ....................................................................................................... 3b
,
,
,
.00
c. TOTAL TAX (Add lines 3a and 3b) ........................................................................................................... 3c
4.
CREDITS:
,
,
,
.00
a. ESTIMATED TAX PAID .......................................................................................................................... 4a
,
,
,
.00
b. DEPOSIT WITH EXTENSION VOUCHER ......................................................................................... 4b
,
,
,
.00
c. PAID WITH ORIGINAL RETURN ......................................................................................................... 4c
,
,
,
.00
d. NET OPERATING LOSS CREDIT (See instructions) ......................................................................... 4d
,
,
,
.00
e. OTHER CREDITS (See instructions) ................................................................................................. 4e
,
,
,
.00
f. TOTAL CREDITS (Add lines 4a through 4e) ......................................................................................... 4f
,
,
,
.00
5. a. IF LINE 3c IS GREATER THAN LINE 4f, ENTER TAX BALANCE DUE ............................................ 5a
,
,
,
.00
b. ENTER PENALTY for Underpayment of Estimated Tax (Attach Form 2220ME) ................................. 5b
,
,
,
.00
c. TOTAL AMOUNT DUE (Add lines 5a and 5b). PAY IN FULL WITH RETURN .................................... 5c
(Make check payable to Treasurer, State of Maine)
Office use only
Return continued on page 2

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