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Wisconsin Tax- Option ( S ) Corporation
Form
5S
2003
Franchise or Income Tax Return
For 2003 or taxable year beginning
, 2003, and ending
, 20
Due Date: 15th day of 3rd month following close of taxable year.
A Federal Employer ID Number
Place label here. Make necessary corrections. Otherwise, please print or type.
Check box if
name or
Corporation Name
B Seller’s Permit or Use Tax Number
address
differs from that
C Wis. Employer ID (Withholding)
Number and Street
Number
on last year’s
City
State
Zip Code
D Wisconsin Business Activity Code
return
F State and Year of Incorporation
E
Check
1
First return - new corporation
3
Short period - change in accounting period
applicable boxes:
2
Final return - corporation dissolved (attach explanation) 4
Short period - stock purchase or sale
G Check box
if this is an amended return, attach an explanation of the changes, and see instructions.
1 Federal, state, and municipal government interest
. . . . . . . . . . . .
1
(see instructions)
2 Percent to Wisconsin (from Form 4B, line 28 or 33) . . . . . . . . . . . . . . . . . . . . . . . . .
2
%
INCOME
3 Multiply amount on line 1 by percentage on line 2 . . . . . . . . . . . . . . . . . . . . . . . . . . .
3
4 Enter 7.9% of amount on line 3. This is gross tax . . . . . . . . . . . . . . . . . . . . . . . . . . .
4
5 Manufacturer’s sales tax credit (from Sch. Z, line 13) .
5
6 Community development finance credit . . . . . . . . . . . .
6
7 Add lines 5 and 6. This is total nonrefundable credits . . . . . . . . . . . . . . . . . . . . . . . .
7
8 Subtract line 7 from line 4. If line 7 is more than line 4, enter -0-. This is net tax . . .
8
9 Additional tax on tax-option (S) corporations (from Schedule Q, line 10) . . . . . . . . .
9
10 Recycling surcharge (from Schedule S, line 24, below for S corporations whose
gross receipts from all activities are $4 million or more) . . . . . . . . . . . . . . . . . . . . . .
110
TAX
11 Endangered resources donation (decreases refund or increases amount owed) . . . . .
11
12 Add lines 8 through 11 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
12
13 Estimated tax payments less refund from Form
4466W.12
If this is an amended return, see instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
13
14 Interest, penalty, and late fee due (from Form 4U, line 17 or 26) . . . . . . . . . . . . . . .
14
15 Tax Due. If the total of lines 12 and 14 is larger than line 13, enter amount owed .
15
16 Overpayment. If line 13 is larger than the total of lines 12 and 14, enter amount overpaid
16
15
17 Enter the amount of line 16 you want credited on 2004 estimated
tax1 17
18 Subtract line 17 from line 16. This is your refund . . . . . . . . . . . . . . . . . . . . . . . . . .
18
1818
18
19 Enter total company gross receipts from all activities (see instructions)
19
RECEIPTS/ASSETS
20 Enter total company assets from federal Form 1120S, item E . . . .
20
21 Enter net income (loss) (see instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
21
SCHEDULE
22 Percent to Wisconsin (from Form 4B, line 28 or 33) . . . . . . . . . . . . . . . . . . . . . . . . .
22
%
S
23 Multiply amount on line 21 by percentage on line 22 . . . . . . . . . . . . . . . . . . . . . . . . .
23
RECYCLING
SURCHARGE
24 Enter the greater of $25 or 0.2% (0.002) of the amount on line 23, but not more than
$9,800. This is the recycling surcharge to enter on line 10 above . . . . . . . . . . . . . .
24
25
Person to contact concerning this return: Name
Phone #
Fax #
26
Location of books and records for audit purposes: City
State
27
Attach a list of QSubs and LLCs of which you are the sole owner. Have you included the incomes of these entities in this return?
Yes
No
28
Did you purchase any taxable tangible personal property or taxable services for storage, use, or consumption in Wisconsin without payment
ADDITIONAL
of a state sales or use tax?
Yes
No
If yes, you owe Wisconsin use tax. See instructions, page 22, for how to report use tax.
INFORMATION
29
REQUIRED
Did any adjustments made by the Internal Revenue Service to your income for prior years become finalized during this year?
Yes
No
If yes, see General Instructions, page 4, and indicate years adjusted:
30
Enter the number of Wisconsin business locations at the end of the taxable year:
31
List the locations of your Wisconsin operations:
32
Are any manufacturing facilities located in Wisconsin?
Yes
No
Under penalties of law, I declare that I have personally examined this return, including any accompanying schedules and statements, and to the best of my
knowledge and belief, it is true, correct, and complete.
Signature of Officer
Title
Date
SIGNATURES
Preparer’s Signature
Preparer’s Federal Employer ID Number
Date
Attach a copy of your federal Form 1120S, even if no Wisconsin activity.
MAILING
Make your check payable to and mail your return to: Wisconsin Department of Revenue, P.O. Box 8908, Madison, WI 53708-8908.
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For Department Use Only
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