Form 1902(B) - Information Return Holding Company I Investment Company - 2012
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FORM 1902(b)
DELAWARE
Print Form
INFORMATION RETURN
HOLDING COMPANY I INVESTMENT COMPANY
Rev Code 042
FOR OFFICE USE ONLY
This return is for calendar year 2012.
If not for calendar year, insert ending date of fiscal year
20
Name of Corporation
Delaware Address
Zip Code
Mailing Address (if different from above)
Zip Code
Date and State of Incorporation
Employer Identification Number
PART- I GENERAL INFORMATION
1.
Name and social security number of compensated employees working in Delaware. (Do not include Directors.)
Name
Social Security Number
Full or Part Time
2.
Name and FEIN/SSN of owners (individual corporations) of more than 10% of the stock of the corporation whose Delaware individ ual
or corporate income tax liability exceeded $100,000 in any of the past three years.
Name
EI or SSN
PART II - QUESTIONS RELATING TO NON-EXEMPT ACTIVITIES
If the answer to any of the following is “YES”, it would be an indication that the corporation is NOT exempt from Delaware corporate tax
under Section 1902(b)(8), 30 DEL. C. (If yes, please provide a brief description.)
1. Did the corporation receive income from the following sources:
YES / NO
a. Rental income from real property located within Delaware.
b. Rental income from tangible personal property located within Delaware.
YES / NO
2.
Did the corporation provide in Delaware any of the services listed below for an unaffiliated entity or an affiliated entity o ther than as part
of the corporation’s maintenance and management of its intangible assets? (If yes, please provide a brief description.)
YES / NO
YES / NO
a.
Accounting and Bookkeeping
e.
Collections
b.
Legal
f.
Management
c.
Consultation
g.
Computer Services
d.
Investment Advice
*DF41212019999*
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