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Allocation Factor Interrogatories BCA-1.35 - Illinois
| Allocation Factor Interrogatories Form. This is a Illinois form and can be used in Corporation Secretary Of State . |
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FORM BCA 1.35 (rev. March 2011) ALLOCATION FACTOR INTERROGATORIES Business Corporation Act Secretary of State Department of Business Services 501 S. Second St., Rm. 350 Springfield, IL 62756 217-782-6961 www.cyberdriveillinois.com This form acts as a supplement to form BCA 1.15, Statement of Correction. __________________________ File #___________________________ Date Reviewed:__________________ Approved: ________ ________ Submit in duplicate ________ Type or Print clearly in black ink ________ Do not write above this line ________ In accordance with the provisions of the Business Corporation Act of 1983, as amended, the Secretary of State herewith propounds the following interrogatories verifying property owned and business transacted as of the applicable date. PART I: COMPUTATION OF PROPERTY (Gross Assets -- See Notes on Page 3) The information below is given as of ____________________ , _______ Month & Day Year Line reference to Schedule L of IRS Forms 1120 & 1120S (a) Property wherever located (b) Property located in Illinois Cash Trade notes and accounts receivable Inventories U.S. Government obligations Tax-exempt securities Other current assets Loans to stockholders Mortgage and real estate loans Other investments Buildings and other depreciable assets Depletable assets Land Intangible assets Other assets 1 2a 3 4 5 6 7 8 9 10a 11a 12 13a 14 $ ________________ $ ________________ $ ________________ $ ________________ $ ________________ $ ________________ $ ________________ $ ________________ $ ________________ $ ________________ $ ________________ $ ________________ $ ________________ $ ________________ $ ________________ $ ________________ $ ________________ $ ________________ $ ________________ $ ________________ $ ________________ $ ________________ $ ________________ $ ________________ $ ________________ $ ________________ $ ________________ $ ________________ TOTAL PROPERTY (Gross Assets) Page 1 $ ________________ $ ________________ Printed on recycled paper. Printed by authority of the State of Illinois. April 2011 -- 500 -- C 287.6 American LegalNet, Inc. www.FormsWorkFlow.com PART II: COMPUTATION OF BUSINESS TRANSACTED (Gross receipts -- see notes on page 4) The information below is given as of ____________________ , _______ Month & Day Year Line reference to IRS Form 1120 Line reference to IRS Form 1120S (c) Gross amount of business transacted everywhere (d) Gross amount of business transacted at or from Illinois Gross receipts, less returns Dividends Interests Gross rents 1c 4 5 6 1c 4b (Sch. K) 4a (Sch. K) 3A (Sch. K) and Line 2 (form 8825) 4c(Sch. K) Sch. D [Line 1 col. (d)] Form 4797 [Line 2 col. (d) and Line 20] 5 Sch. M-1 Line 5a $ _______________ $ _______________ $ _______________ $ _______________ $ _______________ $ _______________ $ _______________ $ _______________ $ _______________ $ _______________ Gross royalties Capital gains -- gross sales price Sales of business property -- gross sales price Other income Non-taxable receipts: Tax-exempt interest or dividends Other 7 Sch. D [Line 1 col. (d)] Form 4797 [Line 2 col (d) and Line 20] 10 Sch. M-1 Line 7 $ _______________ $ _______________ $ _______________ $ _______________ $ _______________ $ _______________ $ _______________ $ _______________ $ _______________ $ _______________ TOTAL GROSS RECEIPTS (Gross Amount of Business Transacted) $ _______________ $ _______________ IMPORTANT--These interrogatories must be accompanied by a photocopy of the appropriate pages of the IRS Form 1120 or 1120S containing the line references for all lines completed above. If the corporation is included in a consolidated return, the appropriate schedules also must be provided. The undersigned corporation has caused this statement to be signed by a duly authorized officer who affirms, under penalties of perjury, that the facts stated herein are true and correct. All signatures must be in BLACK INK. Dated _______________________________ , _____ Month & Day Year ________________________________________________ Exact Name of Corporation ______________________________________ Any Authorized Officers Signature ______________________________________ Name and Title (type or print) Page 2 Printed on recycled paper. Printed by authority of the State of Illinois. April 2011 -- 500 -- C 287.6 American LegalNet, Inc. www.FormsWorkFlow.com NOTES TO COMPUTATION OF PROPERTY (Part I) Total property means gross assets, including all real, personal, tangible and intangible property, without qualification. The value of gross assets is original cost without reduction for allowances, reserves, depreciation, etc. Total Property for this interrogatory should not equal "total assets" on Line 15 of Federal Schedule L (IRS Forms 1120 and 1120S). 1. Real and personal tangible property, including inventories, buildings, and other depreciable assets, depletable assets, land, and uninvested cash are located in Illinois if they are physically located in Illinois. 2. Trade notes and accounts receivable are located in Illinois if arising from Illinois sales. (See Notes (1) and (2) of Computation of Business Transacted.) 3. Invested cash, securities, loans to stockholders, mortgage and real estate loans, U.S. Government obligations, and other investments are located in Illinois if they are administered, managed, or controlled in Illinois. 4. Goodwill is located in Illinois if arising from the acquisition of a business located in Illinois. 5. All property not listed above, including other intangible assets, patents, trademarks, copyrights, prepaid expenses, and other miscellaneous assets, is located in Illinois to the extent the property was acquired or produced or is used in Illinois. 6. Do not show a negative amount on this form. If the entry on the federal return shows a negative amount, insert "0" on the appropriate line of this document. Page 3 Printed on recycled paper. Printed by authority of the State of Illinois. April 2011 -- 500 -- C 287.6 American LegalNet, Inc. www.FormsWorkFlow.com NOTES TO COMPUTATION OF BUSINESS TRANSACTED (Part II) Total gross receipts from whatever source derived must be allocated to Illinois based on the gross amount of business transacted by the corporation at or from places of business in Illinois. Gross receipts are not reduced by the cost of goods sold. Capital gains are not reduced by basis. Total Gross Receipts should not equal "total income" on Line 11 of IRS Form 1120 or Line 6 of IRS Form 1120S. 1. Sales of
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