Form Ia 1139-Nol - Application For Refund Due To The Carryback Of Net Operating Losses And Alternative Minimum Tax Losses
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2Iowa Department of Revenue
IA 1139-NOL
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Application for Refund Due to the Carryback of Net Operating
Losses and Alternative Minimum Tax Losses for Years
beginning prior to January 1, 2009 ONLY
Corporation Name and Address
FEIN:
Do not attach to Iowa
return; mail in separate
Type of Tax
envelope.
Corporation
Franchise
Loss Return for the period ended ____/____/____
Remaining to be carried forward
Net Operating $ ____________________
$ ______________________
Check box if name, address, or FEIN
Altr. Min. Tax $ ____________________
$ ______________________
has changed.
Federal Audit Involved
YES
NO
Phone No. (_____)______-____________
Disaster Area
NOTE: The 3rd preceding
2nd preceding
1st preceding
3rd preceding
year is used for losses in a
tax period____/____/____
tax period____/____/____
tax period____/____/____
Presidentially Declared
after carryback
as last reported
after carryback
as last reported
after carryback
as last reported
Disaster Area.
on ________
on ________
on ________
1. Net Income ............................................ 1. _____________________________________________________________________________________________________________________
2. Nonbusiness Income ............................. 2. _____________________________________________________________________________________________________________________
3. Income Subject To Apportionment ........ 3. _____________________________________________________________________________________________________________________
4. Iowa Percentage .................................... 4. _____________________________________________________________________________________________________________________
5. Income Apportioned To Iowa ................ 5. _____________________________________________________________________________________________________________________
6. Iowa Nonbusiness Income .................... 6. _____________________________________________________________________________________________________________________
7. Income Before Net Operating Losses ... 7. _____________________________________________________________________________________________________________________
8. Iowa Net Operating Loss Carryforward
8. _____________________________________________________________________________________________________________________
9. Iowa Net Operating Loss Carryback ..... 9. _____________________________________________________________________________________________________________________
10. Income Subject To Tax ........................... 10. _____________________________________________________________________________________________________________________
11. Computed Tax ........................................ 11. _____________________________________________________________________________________________________________________
12. Alternative Minimum Tax. Attach forms. 12. _____________________________________________________________________________________________________________________
13. Total Tax Liability .................................... 13. _____________________________________________________________________________________________________________________
14. Recomputed Tax Liability from line 13. .. 14. _____________________________________________________________________________________________________________________
15. Decrease In Tax.
Subtract line 14 from line 13. ................. 15. _____________________________________________________________________________________________________________________
Under penalties of perjury, I declare that I have examined this return and attached schedules/statements, and, to the best of
my knowledge, believe it to be true, correct, and complete. If prepared by a person other than the taxpayer, the declaration
is based on all information of which there is any knowledge.
Officer’s Signature: _______________________________________ Date: ________
Title: __________________________________
Preparer’s Signature: _____________________________________ Date: ________
Preparer’s Phone: _______________________
Preparer’s ID No.: ______________________
IA 1139-NOL Instructions
All amounts should be in whole dollars.
Tax Periods Beginning on or after January 1, 2009
Attach Forms
For tax periods beginning on or after January 1, 2009, both the
You must attach a copy of page 1 of the company’s Iowa
Iowa net operating loss (NOL) and alternative minimum tax
returns as filed and any federal forms 1120X or 1139 filed for
net operating loss (AMT NOL) can only be carried forward 20
all periods involved with this claim.
taxable periods.
Interest
Tax Periods Beginning prior to January 1, 2009
Interest on this claim will accrue starting on the date all
For tax periods beginning prior to January 1, 2009, an Iowa
required information is received by the Department.
net operating loss or an Iowa alternative minimum tax net
42-026a
(06/24/11)
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