Form 527 - Small Business Capital Company Information Report
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1
2
3State of Oklahoma
Small Business Capital Company
527
Information Report
Revised 2011
For the Calendar Year Ending:
See Tax Credit Moratorium on page 2.
Federal Employer Identification Number
Corporation
Partnership
LLC
Name of Small Business Capital Company
Address
Phone Number
City
State
Zip
Complete the applicable sections for investments made during this calendar year. Attach additional schedules if
necessary. Enclose a copy of the capital company’s annual financial statements, including documentation to indi-
cate the methods of operation and conduct of the business of the capital company. (*See note on Page 2)
A:
Entities Investing in the Small Business Capital Company
Date of
Type of
Amount
Investor’s Name
Address
FEIN/SSN
Investment
Investment
Invested
1)
2)
3)
4)
B:
Entities Investing in Oklahoma Small Business Ventures in Conjunction
with the Small Business Capital Company
Business
Date of
Type of
Amount
Investor’s Name
FEIN/SSN
Invested In
FEIN
Investment
Investment
Invested
1)
2)
3)
C:
Oklahoma Small Business Ventures in which Investments Were Made
by the Small Business Capital Company
Name of Business
Date of
Type of
Amount
Invested In
FEIN
Type of Business
Investment
Investment
Invested
1)
2)
3)
This information return, including enclosures, must be filed by April 30th.
Under penalties of perjury, I declare I have examined this return, including accompanying statements, and to the best of my
knowledge and belief it is true, correct and complete.
Officer, General Partner or Member
Date
The Oklahoma Tax Commission is not required to give actual notice to taxpayer of changes in any state tax law.
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