Form K-120 Corporation Income Tax

(1) Compensationofofficers (1) Valueofownedrealandtangiblepersonal propertyusedinthebusinessatoriginalcost Beginning ofYear End ofYear Beginning ofYear End ofYear (15 U S C 381)? (2) Wages salariesandcommissions (3) Payrollexpenseincludedincostofgoodssold (4) Payrollexpenseincludedinrepairs (5) Otherwagesandsalaries (Enclose a separate sheet for additional corporations) (Include the interest from line 5 of the federal return) (Include those taxes deducted on line 17 of the federal return See instructions ) (Rev 7/12) 1 Does the Kansas sales figure in Part VI include (1) all sales delivered b Has any state determined that this corporation conducts or has from Kansas where purchaser is the U S Government and (2) all conducted a unitary business with any other corporation? sales delivered from Kansas to states in which this corporation is Yes No If yes specify which state(s) and enclose a 1 Taxes on or measured by income or fees or payments in lieu of income taxes (include federal environmental tax; itemize) 1 U S interest income (describe type): 150012 150112 2 If you claim that part of your net income is assignable to business done outside Kansas: 2) Netannualrentedproperty Multipliedby8 20 12 3 Describe briefly the nature and location(s) of your Kansas business 4 Are the amounts in the total company column the same as those reported in returns or reports to other states under the Uniform Division of Income for Tax Purposes Act? Yes No If no please explain 8 If you are registered with the Kansas Department of Revenue under any other Kansas tax act enter all registration or license numbers on the applicable line a Enclose a list of all states in which this corporation is doing business A Property WITHINKANSAS TOTALCOMPANY PERCENT WITHIN KANSAS activities Address Agritourism Liability Insurance Credit (Enclose Schedule K 33; see instructions) Alternative Fuel Motor Vehicle Property Credit (Enclose Schedule K 62; see instructions) Amended Return and filing state corporation income or franchise tax returns Assistive Technology Contribution Credit (Enclose Schedule K 42; see instructions) Averageownedproperty(Beg +End 2) B Payroll(Thosecorporationsqualifiedandutilizingtheelectivetwo factorformulamustcomplete thisareaonlyduringthefirstyearofqualifying) WithinKansas TotalCompany BioMass to Energy Credit for carry forward use only (Enclose Schedule K 79; see instructions) Business and Job Development Credit for carry forward use only (Enclose Schedule K 34; see instructions) C Sales(Grossreceipts lessreturnsandallowances) (1) SalesdeliveredorshippedtopurchasersinKansas: (a) ShippedfromoutsideKansas (b) ShippedfromwithinKansas (2) SalesshippedfromKansasto: (a) TheUnitedStatesGovernment (b) Purchasersinastatewherethetaxpayerwouldnotbetaxable(e g underfederal PublicLaw86 272) (3) Dividends Interest Rents Royalties Gains/lossesfromintangibleassetsales Grossproceedsfromtangibleassetsales Otherincome(Encloseschedule) TOTALSALES(Enteronline14C page1) Center for Entrepreneurship Credit (Enclose Schedule K 31; see instructions) Check if included: In Total Company Child Day Care Assistance Credit (Enclose Schedule K 56; see instructions) Community Service Contribution Credit (Enclose Schedule K 60; see instructions) Compensating Use Tax Corporation Apportionment Schedule D(1) Totalpercent(SumoflinesA B&Cifqualifiedandutilizingthree factorformula) D(2) Totalpercent(SumoflinesA&Cifqualifiedandutilizingtwo factorformula) E AveragepercentofeitherD(1)orD(2) whicheverisapplicable(Enteronline14 page1) D(1) D(2) % % Date Amount Date Amount Declared Disaster Capital Investment Credit for carry forward use only (Enclose Schedule K 87; see instr ) Declared Disaster CapitalInvestment Credit (Enclose Schedule K 87; see instructions) Depreciableassets Did the corporation file a Kansas Income Tax return under the same name for the preceding year? Yes No If "no" enter previous name and EIN Disabled Access Credit (Enclose Schedule K 37; see instructions) DO NOT STAPLE Electric Cogeneration Facility Credit for carry forward use only (Enclose Schedule K 83; see instructions) EmployerIdentificationNumber(EIN) Enter the address of the corporation's principal location in Kansas Environmental Compliance Credit (Enclose Schedule K 81; see instructions) Factors Factors Farm Net Operating Loss (Enclose Schedule K 139F; see instructions) Film Production Credit (Enclose Schedule K 86; see instructions) For the taxable year beginning / / ; ending / / FOR USE BY CORPORATIONS APPORTIONING INCOME (Corporations using the combined income method must use Schedule K 121) Has your corporation been involved in any reorganization during the period covered by this return? Yes No If "yes" enclose a detailed explanation High Performance Incentive Program Credit (Enclose Schedule K 59; see instructions) Historic Preservation Credit (Enclose Schedule K 35; see instructions) Historic Site Contribution Credit (Enclose Schedule K 75; see instructions) I declare under the penalties of perjury that to the best of my knowledge this is a true correct and complete return I authorize the Director of Taxation or the Director's designee to discuss my K 120 and enclosures with my preparer If not please explain If this is a final return for Kansas state the reason If the corporation was liquidated or dissolved state the IRC section under which the corporation was liquidated If your federal taxable income has been redetermined for any prior years that have not previously been reported to Kansas check the applicable box(es) below and state the calendar fiscal or short period year ending date You are required to submit under separate cover the federal Forms 1139 1120X or Revenue Agent's Report along with the Kansas amended return immune from state income taxation under federal Public Law 86 272 complete list of the corporations conducting the unitary business s Individual Development Account Credit (Enclose Schedule K 68; see instructions) Inventory K 120 2012 K 120AS KANSAS KANSAS CORPORATION INCOME TAX Kansas National Guard and Reserve Employer Credit (Enclose Schedule K 74; see instructions) Law Enforcement Training Center Credit (Enclose Schedule K 72; see instructions) Less:Constructioninprogress List each estimated tax payment and credit forward amount claimed on this return Mail to: Kansas Corporate Tax Kansas Department of Revenue 915 SW Harrison Street Topeka KS 66699 4000 Name of Corporation Employer ID Number Name of Corporation Employer Identification # NameasshownonFormK 120 Oil and Gas Well Plugging Credit (Enclose Schedule K 39; see instructions) Other (specify) Othertangibleassets(Encloseschedule) PART I NONREFUNDABLE AND REFUNDABLE CREDITS PART II ADDITIONAL INFORMATION PART III AFFILIATED CORPORATIONS DOING BUSINESS IN KANSAS PART IV SCHEDULE OF TAXES PART V SCHEDULE OF INTEREST INCOME PART VI APPORTIONMENT FORMULA PART VII ADDITIONAL INFORMATION PART VIII AFFILIATED CORPORATIONS INCLUDED IN FORM K 120AS CORPORATION APPORTIONMENT SCHEDULE Petroleum Refinery Credit for carry forward use only (Enclose Schedule K 73; see instructions) Qualifying Pipeline Credit for carry forward use only (Enclose Schedule K 77; see instructions) Regional Foundation Contribution Credit (Enclose Schedule K 32; see instructions) Research and Development Credit (Enclose Schedule K 53; see instructions) Revenue Agent's Report Net Operating Loss Sales Tax Seed Capital Credit (Enclose Schedule K 55; see instructions) signhere Signature of officer Individual or firm signature of preparer Title Address and Phone Number Date Date Single City Port Authority Credit (Enclose Schedule K 76; see instructions) SmallEmployerHealthcare Credit(Enclose Schedule K 57; see instructions) Storage and Blending Equipment Credit for carry forward use only (Enclose Schedule K 82; see instructions) Swine FacilityImprovement Credit(Enclose Schedule K 38; see instructions) Tax preparer's EIN (Employer Identification Number) or SSN (Social Security Number) Telecommunications and Railroad Credit (Enclose Schedule K 36; see instructions) Telephone The corporation's books are in care of: Total (Enter on line 3 page 1) Total (Enter on line 7 page 1) Total interest income (Must equal line 5 of the federal return) Total nonrefundable credits (Enter on line 25 page 2) Total other interest income Total other taxes Total refundable credits (Enter on line 30 page 2) Total taxes (Must equal line 17 of the federal return) TOTALPAYROLL(Enteronline14B page1) (Ifqualifiedandutilizingtheelective two factorformula do not carrythispercentagetopage1) B % TOTALPROPERTY(Enteronline14A page1) A % Totalpropertytobeaveraged Venture Capital Credit(Enclose Schedule K 55; see instructions) Withholding Tax Within Kansas Years ended