Form 1975 - South Dakota Franchise Tax On Financial Institutions

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SD EForm -
1975
V3
HELP
South Dakota Franchise Tax on Financial Institutions
M
L
, M
L
,
M
B
FOR
ONEY
ENDERS
ORTGAGE
ENDERS
AND
ORTGAGE
ROKERS
For the year beginning______________20_____ and ending________________20_____
Name: __________________________________________
Phone No.:____________________
Examined
Address:_________________________________________
County:_______________________
City:________________________________
State:______
Zip code +4:____________________
Contact Person:___________________________________
1. Net Income . . . . . . . . . . . . . . . . . . . . . . . . . . . $
A. Money Lender License Number_______________________
___________________________________________________
2. Total Tax 6% . . . . . . . . . . . . . . . . . . . . . . . . . . $
B. Mortgage Broker License Number______________________
if line 1 exceeds $400,000,000 use rate table page 5.
___________________________________________________
Minimum tax - Page 3 (E) $200.00
C. Mortgage Lender License Number______________________
3. Interest 1.25% per Month $5 minimum.. . . .$
___________________________________________________
4. Penalty 10% of unpaid tax . . . . . . . . . . . . . . $
D. Federsal Employer ID Number_________________________
*Include all licenses to which this return applies
5. Tax Due
$0.00
(Lines 2 + 3 + 4). . . . . . . . . . . . . . . . . . . . . . . $
E. Date business was licensed in South Dakota______________
F. Accounting method ________________________________
6. Credits Due to Overpayments . . . . . . . . . . . $
Y
N
G. Is business carried on entirely in S.D?_________________
H. Name, address and phone number of persons who assisted in
7. Estimated Payments. . . . . . . . . . . . . .. . . . . . .$
preparing return
8. Payments
____________________________________________________
$0.00
(Lines 6 + 7).. . . . . . . . . . . . . . . . . . . . . . . . . .. $
____________________________________________________
9. Tax Due or Credit . . . . . . . . . . . . . . . . . . . . . .$
$0.00
____________________________________________________
(Line 5 minus Line 8)
____________________________________________________
Signature of Preparer:
Overpayment Reconciliation :
_____________________________________________________
Refund of overpayment
I. Is this a final return? _________ if yes, date canceled _______
Y
N
J. Has the federal government redetermined your income tax
Waive right to refund, credit as prepayment for following
liability for any prior years which has not been reported? _______
Y
N
year
If yes, attach a copy of the agent’s report.
Attach a copy of the Federal Income Tax Form 1120,
K. City and County of each license number in South Dakota.
1120-S, 990, 1040, or 1065 along with schedules.
City
County
_____________________________________________________
For Department use Only
_____________________________________________________
County Share
$___________________
_____________________________________________________
_____________________________________________________
State Share
$___________________
I have not conducted any business in South Dakota during
Attach remittance payable to the State Treasurer, and
this fiscal year.
mail to the Department of Revenue, 445 E. Capitol
Avenue, Pierre, SD 57501. See instructions for due date.
I, the undersigned, president , owner or pincipal officer of the business for which this return is made, being severally duly sworn, each
for himself deposes and says that this return, including the accompanying schedules and statements, has been examined by him, and is
to the best of his knowledge and belief a true and complete return, made in good faith, for the taxable year stated pursuant to SDCL 10-
43, and the rules and regulations thereunder
this _________day of ___________________20____
Print Signature of President or Owner: _____________________________________________________
Signature of President or Owner: __________________________________________________________
SPT 600B 04/10
1

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