Form 41a750 - Business Development Corporation Tax Return

__ __ __ __ __ __

750

*1600010302*

Kentucky Corporation/LLET Account Number

41A750 (9-16)

2016

Commonwealth of Kentucky

DEPARTMENT OF REVENUE

BUSINESS DEVELOPMENT CORPORATION TAX RETURN

➤ See instructions.

Form 41A750 is used by Business Development Corporations organized under the provisions of KRS 155.020.

Name of Corporation

Federal Identification Number

—

Number and Street

Date of Incorporation

State

ZIP Code

City

GROSS INCOME

1 Gross receipts or sales $_________ Less: Returns and allowances $_________ ..

2 Less: Cost of goods sold and/or cost of operations (From Schedule A or

Schedule B) ................................................................................................................

3 Gross profit (line 1 less line 2) .................................................................................

4 Dividends (From Schedule C) ..................................................................................

5 Interest on loans, notes, mortgages, bonds, bank deposits, etc. ..........................

6 Interest on corporation bonds, etc. .........................................................................

7 Interest on governmental obligations subject to tax .............................................

8 Rents ..........................................................................................................................

9 Royalties ....................................................................................................................

10 Gains and losses (From Schedule D):

(a) Net short-term capital gain reduced by any net long-term capital loss ........ 10(a)

(b) Net long-term capital gain reduced by any net short-term capital loss ........ 10(b)

11 Other income (Attach schedule. Include Federal income tax refunds) .................

12 Total income on lines 3, and 4 through 11 ...................................................................................................................

DEDUCTIONS

13 Compensation of officers (From Schedule E) .........................................................

14 Salaries and wages (Not deducted elsewhere) ......................................................

15 Rent ............................................................................................................................

16 Repairs (Do not include cost of improvements or capital expenditures) .............

17 Bad debts (From Schedule F) ...................................................................................

18 Interest .......................................................................................................................

19 Taxes (From Schedule G) ..........................................................................................

20 Contributions or gifts paid (From Schedule H) .......................................................

21 Losses by fire, storm, shipwreck or other casualty, or theft (Submit schedule) .....

22 Depreciation and amortization (From Schedule I) ..................................................

23 Depletion of mines, oil and gas wells, timber, etc. (Submit schedule).................

24 Advertising ................................................................................................................

25 Amounts contributed under:

(a) A pension, annuity, stock bonus or profit-sharing plan .................................. 25(a)

(b) Other employee benefit plans ........................................................................... 25(b)

26 Other deductions authorized by law (From Schedule J) .......................................

27 Total deductions on lines 13 through 26 ......................................................................................................................

28 Net income (line 12 less line 27) ...................................................................................................................................

29 Federal income tax ........................................................................................................................................................

30 Taxable net income (line 28 less line 29) .....................................................................................................................

31 Tax Rate ..........................................................................................................................................................................

4.5%

32 TOTAL TAX (line 30 multiplied by line 31 or $10, whichever is greater) ....................................................................

Has the Internal Revenue Service made any changes in taxable income? Yes o No o If “yes, ” attach copy of changes to this return.

I, the undersigned, declare under the penalties of perjury, that I have examined this return, including all accompanying schedules and statements,

and to the best of my knowledge and belief, it is true, correct and complete.

✍

Signature of principal officer or chief accounting officer

Date

Printed name of principal officer or chief accounting officer

Name of person or firm preparing return

SSN, PTIN or FEIN