2013
Massachusetts
Schedule DRE
Department of
Disclosure of Disregarded Entity
Revenue
For calendar year 2013 or taxable period beginning
2013 and ending
Name of taxpayer
Taxpayer Identification number
3
3
Type of return filed by taxpayer
Is disregarded entity a QSUB?
355
355S
355U
63 FI
PS-1
Other
Yes
No
Name of disregarded entity
Taxpayer Identification number, if applicable
3
3
Address of disregarded entity
Date of organization
Effective date as disregarded entity
Notice to Combined Report (355U) Filers
This schedule is only required if the owner of the disregarded entity is a taxable member of the group.