Form Ct-60-Qsss - Qualified Subchapter S Subsidiary Information Schedule - 2011
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CT-60-QSSS
New York State Department of Taxation and Finance
Qualified Subchapter S Subsidiary
Information Schedule
(Attach to your franchise tax return, Form CT-3, CT-4,
CT-3-A, CT-3-S, CT-32, CT-32-S, or CT-32-A.)
For period ended
Employer identification number of parent corporation Legal name of parent corporation
Part 1 — QSSS required inclusion
Federal employer identification number or
Name of QSSS
Effective date of
TF number of QSSS
federal QSSS election
(see instructions on page 2)
(mm-dd-yy)
Part 2 — QSSS elective inclusion
Federal employer identification number or
Name of QSSS
Effective date of
TF number of QSSS
federal QSSS election
(see instructions on page 2)
(mm-dd-yy)
Attach additional sheets if necessary.
Certification: I certify that this document and any attachments are to the best of my knowledge and belief true, correct, and complete.
Printed name of authorized person
Signature of authorized person
Official title
Authorized
person
E-mail address of authorized person
Telephone number
Date
(
)
Firm’s name
Firm’s EIN
Preparer’s PTIN or SSN
Paid
(or yours if self-employed)
preparer
Signature of individual preparing this document
Address
City
State
ZIP code
use
only
E-mail address of individual preparing this document
Preparer’s NYTPRIN
Date
(see instr.)
47801110094
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