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Utah State Tax Commission
210 N 1950 W, Salt Lake City, UT 84134
Utah Corporation
TC-20
Franchise or Income Tax Return
Rev. 12/03
This return is for the calendar year ending Dec. 31, 2003, or fiscal year beginning
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Jan. 1, 2003
Dec. 31, 2003
and ending
.
Corporation name
Employer Identification Number
Check box(es) if this
is a new address:
Address
Utah Incorporation/Qualification Number
Physical
address
Telephone Number
(
)
Mailing
address
City
State
Zip code
NOTE: ATTACH ONLY THE FIRST FOUR PAGES OF YOUR FEDERAL RETURN.
Corporations included in combined filings must complete Schedule M.
Check box
1. Check if this corporation conducted any UTAH business activity during the taxable year ............................................
1.
2. Check if this corporation joined in a federal consolidated return ..................................................................................
2.
3. Check if this return constitutes (check no more than one box):
(see "Combined Reports" in the General Instructions)
(a) A "water's edge" combined report ....................................................................................................................
3
or (b) A "water's edge" election under UCA §59-7-402(2) ..........................................................................................
3
or (c) A "worldwide" combined report ........................................................................................................................
3(c)
4.
If an election has been made or considered to have been made on behalf of any member of the federal affiliated
group during the taxable year, check the appropriate box(es) and attach a schedule showing names of target
corporation(s) and details of such transaction(s). See "IRC Sections..." in the General Instructions.
(a) IRC Section 338 ...............................................................................................................................................
4
(b) IRC Section 338 (h)(10) ...................................................................................................................................
4
(c) IRC Section 336 (e) ..........................................................................................................................................
4
5.
Check if this return includes one or more financial institutions as defined by Tax Commission Rule R865-6F-32 .............
5.
6. What is the ultimate U.S. parent's name?
______________________________________________
7. What is the ultimate U.S. parent's EIN?
______________________________________________
8. Net Refund (from Schedule A, line 23) .................................................................................................
8
00
9. Net Tax Due (from Schedule A, line 24) ...............................................................................................
9
00
10. Total the penalties and interest listed below and enter on this line
......................................................
10
00
Late filing penalty
$
Interest
$
Late payment $
penalty
Penalty for underpayment
Extension
of required prepayment
$
penalty
$
11. Utah Use Tax, if $400 or less (see instructions) ..................................................................................
11
00
12. TOTAL REFUND (subtract lines 10 and 11 from line 8) .......................................................................
12
00
13. TOTAL TAX REMITTED (add lines 9, 10 and 11)
......
13
00
Make check payable to: UTAH STATE TAX COMMISSION
OFFICE USE ONLY
Check the box for each
Schedule A
Schedule B, C and D
Schedule H
schedule attached. Arrange
Schedule J
Schedule M
in order behind this form.
Under penalties of perjury, I declare that to the best of my knowledge and belief,
this return and accompanying schedules are true, correct and complete.
Signature of officer
Date
Title
Don't forget to sign & date this return before filing with the Utah State Tax Commission.
Preparer's signature
Date signed
Preparer's SSN/PTIN
Check if
self-employed
Paid
Firm's name (or yours, if self-employed)
Telephone
EIN
Preparer's
Section
Preparer's complete address
City
State
Zip code
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