Form Ia 1139 Farm - Application For Refund Due To The Carryback Of Corporate Farming Losses
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1Corporation Name and Address
Federal T.I.N.
IA 1139
Iowa Department
Farm
Type of Tax: Corporation Income Only
of Revenue
Loss Return for the period ended ____/____/____
Remaining to be carried forward
Application for Refund
Due to the Carryback of
Net Operating $ ______________________
$ ________________________
Corporate Farming Losses
Capital
$ ______________________
$ ________________________
Do not attach to Iowa return;
Check box if name, address, or Federal
Altr. Min. Tax $ ______________________
$ ________________________
mail in separate envelope.
TIN has changed.
Phone No. (_____)______-____________
Federal Audit Involved
YES
NO
5th preceding
4th preceding
3rd preceding
2nd preceding
1st preceding
NOTE: At this time, the five year
tax period____/____/____
tax period____/____/____
tax period____/____/____
tax period____/____/____
tax period____/____/____
carryback applies to farming
as last reported
after carryback
as last reported
after carryback
as last reported
after carryback
as last reported
after carryback
as last reported
after carryback
losses only.
on _________
on _________
on _________
on _________
on _________
____________________________________________________________________________________________________________________________________________________
1. Net Income ............................................
____________________________________________________________________________________________________________________________________________________
2. Iowa Capital Loss ..................................
____________________________________________________________________________________________________________________________________________________
____________________________________________________________________________________________________________________________________________________
3. Capital Loss Subtotal (line 1 minus 2) ..
4. 50% Federal Refund From Capital Loss .
____________________________________________________________________________________________________________________________________________________
5. Subtotal (Add lines 3 and 4) ..................
____________________________________________________________________________________________________________________________________________________
____________________________________________________________________________________________________________________________________________________
6. Nonbusiness Income .............................
7. Income Subject To Apportionment .......
____________________________________________________________________________________________________________________________________________________
8. Iowa Percentage ....................................
____________________________________________________________________________________________________________________________________________________
____________________________________________________________________________________________________________________________________________________
9. Income Apportioned To Iowa ................
10. Iowa Nonbusiness Income ...................
____________________________________________________________________________________________________________________________________________________
11. Income Before Net Operating Losses ..
____________________________________________________________________________________________________________________________________________________
____________________________________________________________________________________________________________________________________________________
12. Iowa Net Operating Loss Carryforward
13. Iowa Net Operating Loss Carryback ....
____________________________________________________________________________________________________________________________________________________
14. Income Subject To Tax .........................
____________________________________________________________________________________________________________________________________________________
____________________________________________________________________________________________________________________________________________________
15. Computed Tax ......................................
16. Minimum Tax (attach forms) ................
____________________________________________________________________________________________________________________________________________________
17. Total Tax Liability ..................................
____________________________________________________________________________________________________________________________________________________
____________________________________________________________________________________________________________________________________________________
18. Recomputed Tax Liability (line 17) ......
19. Decrease In Tax (line 17 minus 18) .....
____________________________________________________________________________________________________________________________________________________
Under penalties of perjury, I declare that I have examined this return, and attached schedules/statements, and, to the best of my
You must attach a copy of page one of
knowledge, believe it to be true, correct and complete. If prepared by a person other than the taxpayer, the declaration is based
the company’s Iowa returns as filed
on all information of which there is any knowledge.
and any federal forms 1120X or 1139
Officer’s Signature _______________________________________ Date _________
Title __________________________________
filed for all periods involved with this
claim.
Preparer’s Signature ______________________________________ Date _________
Preparer’s Phone _______________________
Interest on claim will accrue starting on the
Preparer’s ID No. _______________________
date all required information is received by
the Department.
Reset Form
42-027a
(8/20/08)
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