Arizona Form 120s (Schedule K-1) - Resident And Part-Year Resident Shareholder'S Information Schedule - 2015

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Resident and Part-Year Resident
Arizona Form
2015
120S Schedule K-1
Shareholder’s Information Schedule
M M D D
2 0 1 5 and ending
M M D D
2 0
Y Y
For the
calendar year 2015 or
fiscal year beginning
.
CHECK ONE:
Original
Amended
Shareholder’s Identifying Number
S Corporation’s Employer Identification Number (EIN)
Shareholder’s Name
S Corporation’s Name
Shareholder’s Address – number and street or rural route
S Corporation’s Address – number and street or rural route
Shareholder’s City, Town or Post Office
State ZIP Code
S Corporation’s City, Town or Post Office
State ZIP Code
Shareholder’s percentage of stock ownership for the taxable year:
%
Part I
Net Capital Gain From Investment in a Qualified Small Business – Information Schedule
If the shareholder’s federal Schedule K-1 (Form 1120-S) does not include any net capital gain (loss) from investment in a qualified small
business, the S corporation is not required to complete Part I.
(a)
Pro Rata Share Items
Distributive Share Amount
1
Net capital gain (loss) from investment in a qualified
small business .........................................................
1
Part II
Net Long-Term Capital Gain Subtraction – Information Schedule
If the shareholder’s federal Schedule K-1 (Form 1120-S) includes net long-term capital gain (loss), complete line 2 and line 3 (if applicable).
If the shareholder’s federal Schedule K-1 (Form 1120-S) does not include any net long-term capital gain (loss), the S corporation is not
required to complete Part II.
(a)
(b)
(c)
Pro Rata Share Items
Distributive Share Amount
Net long-term capital gain
Net long-term capital gain
From Federal Form 1120-S, Schedule K-1
(loss) included in column (a)
(loss) included in column (a)
from assets acquired before
from assets acquired after
January 1, 2012
December 31, 2011
2
Net long-term capital gain (loss) ..............................
2
ADDITIONAL INFORMATION:
3
Net long-term capital gain (loss) from investment in
a qualified small business (amount already included
in line 2, column (c)) ................................................
3
ADOR 11191 (15)
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