1 Estimated corporation income tax before nonrefundable credits 1
1 The amount of the adjustment previously allowed by the Department; or
10 OVERPAYMENT of estimated tax claimed (line 9 minus line 8) If this amount is at least 10% of line 8 and
2 Estimated premium tax paid 2
2 The corporation s income tax liability shown on its Nebraska Corporation Income Tax Return Form 1120N minus the sum of the estimated payments reduced by the previously allowed adjustment
3 Estimated other nonrefundable credits CDAA credit and Form 3800N credit 3
4 Estimated total nonrefundable credits (total of lines 2 and 3) 4
5 Estimated income tax liability (line 1 minus line 4 If less than zero enter 0 ) 5
6 Estimated Form 3800N refundable credit 6
7 Beginning Farmer credit 7
8 Estimated income tax liability (line 5 minus lines 6 and 7) 8
9 2012 estimated tax payments (include 2011 overpayment credited to 2012 estimated tax) 9
at least $500 the corporation may request this adjustment Lines 11a 11b and 11c must be completed 10
City State Zip Code
Corporation Name Doing Business As
Email Address
Legal Name
Lincoln NE 68509 4818
Nebraska Department of Revenue
Nebraska ID Number Federal ID Number
PO Box 94818
Signature of Officer Title Date Phone Number
Street or Other Mailing Address
Under penalties of perjury I declare that I have examined this application including any accompanying schedules and statements and to the best of my knowledge and belief it is correct and complete
1 At least 10% more than the expected tax liability calculated on line 8 of this form; and
11a Routing Number 11b Type of Account 1 = Checking 2 = Savings
11c Account Number
11d Check this box if this refund will go to a bank account outside the United States
2 At least $500
8 390 2012
An excessive adjustment is the smaller of:
beginning 2012 and ending
Corporation Application for Adjustment
DIRECT DEPOSIT OF YOUR OVERPAYMENT The Department will only issue refunds by Electronic Funds Transfer (EFT) To have your refund deposited directly to your checking or savings account it is necessary to enter the routing and account numbers found on the bottom of the checks used with the account The routing number is listed first and must be nine digits The account number is listed to the right of the routing number and can be up to 17 digits Enter these numbers in the boxes found on lines 11a and 11c and complete line 11b Type of Account Line 11d must be completed to comply with banking rules regarding International ACH Transactions (IATs) The box must be checked whenever a refund will go to a bank account outside the United States These refunds cannot be processed as direct deposits and will be mailed
DISALLOWANCE OF THE APPLICATION The Department may disallow without further action or appeal any application containing material omissions or errors that cannot be corrected within the 45 day review period Form 4466N does not constitute a claim for credit or refund
EXCESSIVE ADJUSTMENT If any adjustment made by the Department is later found to be excessive interest at the statutory rate will be due on the amount of the excessive adjustment calculated from the date the adjustment was made until the original due date of the corporation s return
for the taxable year January 1 2012 through December 31 2012 or other taxable year
FORM 4466N
If members of a unitary group paid their estimated income tax on a combined basis the common parent corporation must file the Form 4466N If members of the group paid estimated tax separately each member who claims an overpayment must file Form 4466N separately
If No see instructions
INSTRUCTIONS
Is this application being filed by the 15th day of the third month following the end of the tax year?
Mail the Form 4466N to:
Mail this application to: NEBRASKA DEPARTMENT OF REVENUE PO BOX 94818 LINCOLN NE 68509 4818
of Overpayment of Estimated Income Tax
OVERPAYMENT CREDITED AND REFUNDED The Nebraska Department of Revenue (Department) will act on this application within 45 days from the date it is filed and may credit the overpayment against any existing tax liability of the corporation and refund any balance
PLEASE DO NOT WRITE IN THIS SPACE
Please Type or Print
SIGNATURE This application must be signed by a corporate officer If the taxpayer authorizes another person to sign this application there must be a Power of Attorney Form 33 on file with the Department
The overpayment is the amount of the estimated tax the corporation paid during the tax year in excess of the estimated final 2012 income tax liability computed at the time this application is filed
WHEN AND WHERE TO FILE Form 4466N must be filed by the 15th day of the third month after the end of the tax year and before the corporation files its corporation income tax return A Form 4466N filed after this date will not be considered An extension of time to file the corporation income tax return will not extend the time for filing Form 4466N
WHO MAY FILE Corporations that overpaid estimated income tax for the tax year stated above must use this form to apply for an adjustment of the overpayment when the overpayment is:
www revenue ne gov 800 742 7474 (NE and IA) 402 471 5729