Form 1120b-Me - Maine Franchise Tax Return For Financial Institutions - 2012 Page 7
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92012 Form 1120B-ME, Page 2
99
Federal Employer ID Number:
*1208411*
BALANCE DUE, PENALTY, PAYMENT DUE WITH RETURN:
5.
.00
a.
If line 3c is greater than line 4f, enter line 3c minus line 4f ..................................... 5a
.00
b.
Enter PENALTY for Underpayment of Estimated Tax (attach Form 2220ME) ........ 5b
c.
PAYMENT DUE with return (add lines 5a and 5b)
.00
Pay in full with return ( make check payable to Treasurer, State of Maine) ...................... 5c
6. OVERPAYMENT:
If line 4f is greater than line 3c plus line 5b, enter line 4f minus lines 3c and 5b ........
.00
6
7. AMOUNT ON LINE 6 TO BE:
.00
a. CREDITED to next year’s estimated tax .................................................
7a
.00
b. REFUNDED ............................................................................................
7b
AFFIDAVIT AND SIGNATURE
Under penalties of perjury, I declare that I have examined this return and accompanying schedules and statements and to the best of my knowledge and
belief they are true, correct and complete. Declaration of preparer (other than taxpayer) is based on information of which preparer has any knowledge.
Date
Signature of Offi cer
Offi cer’s Social Security Number
Title
Date
Individual or Firm Signature of Preparer
Preparer’s Federal ID Number
PAYMENT AND SUBMISSION
If enclosing a check, make check payable to:
If not enclosing a check,
Treasurer, State of Maine
MAIL RETURN TO:
and MAIL WITH RETURN TO:
MAINE REVENUE SERVICES
MAINE REVENUE SERVICES
P.O. BOX 1065
P.O. BOX 1064
AUGUSTA, ME 04332-1065
AUGUSTA, ME 04332-1064
SCHEDULE A - APPORTIONMENT OF INCOME & ASSETS
Do not complete this schedule if 100% of your business activity is conducted in Maine.
All others must complete this schedule and enter amount in columns A and B, even if those amounts are zero.
See instructions on page 4.
If this schedule is left blank or excluded, your Maine apportionment factor will be set at 100%.
(A)
(B)
(C)
Maine Factors
Col. (A) divided by Col. (B)
Within
x Statutory Weighting
Maine
Everywhere in U.S.
Rounded to 6 Decimals
.
.00
.00
8. Total Receipts:
X .50 =
÷
.
.00
9. Total Payroll:
÷
.00
X .25 =
.00
.00
.
10. Total Property:
÷
X .25 =
.
11. Maine Apportionment Factor (add column (C) lines 8 through 10) .......................................................................11.
.00
12. Net Income per books (from line 1a.) ................................................12.
13. Income Apportioned to Maine (line 12 multiplied
.00
by line 11). Enter here and on line 1b ..............................................13.
.00
14. Total end-of-year assets (from line 2a) .............................................14.
15. Assets Apportioned to Maine (line 14 multiplied
.00
by line 11). Enter here and on line 2b ..............................................15.
Rev. 9/12
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