Protective Claim in the box Reason For Amendment
Schedule of Changes on page 2 must be completed and copies
$100 000 to $250 000: 10% minus $2 500
$25 000 to $100 000: 8% minus $500
(: 2) Checked
(: accrual) Unchecked
(: cash) Checked
(: ln1) Unchecked
(: ln2) Unchecked
(: ln3) Unchecked
(: ln4) Unchecked
(11a) and (11b): These lines must always be completed If
(12) Percentage: Divide line 11a by line 11b and enter the result
(15) Income Before Net Operating Loss: If the corporation s
(18) Computed Tax: Multiply line 17 by the following if it is:
(19) Alternative Minimum Tax: Attach a copy of the
(21) Credits: Enclose IA 148 Tax Credits Schedule
(22) Payments: Include tax amount only; for example estimates
(26a) IA 2220 Penalty: Enter only if different from amount on
(26b) Failure to Timely File a Return: A penalty of 10% will
(27) Interest: Interest accrues on any unpaid tax from the original
(30) Credit to Next Period s Estimated Tax: Can only be
(a) As last reported
(b) Net Change
(c) Corrected amount
(Change must be requested by the last day of the subsequent tax period )
(checkbox) Checked
(text)
(text)
(text)
(text)
(text)
(text)
(text)
(text)
(text)
(text)
(text)
(text)
(text)
(text)
(text)
(text)
(text)
(text)
(text)
(text)
(text)
(text)
(text)
(text)
(text)
(text)
(text)
(text)
(text)
(text)
(text)
(text)
(text)
(text)
(text)
(text)
(text)
(text)
(text)
(text)
(text)
(text)
(text)
(text)
(text)
(text)
(text)
(text)
(text)
(text)
(text)
(text)
10 Income Subject to Apportionment Subtract line 9 from line 8
11a Iowa Receipts
11b Receipts Everywhere
12 Percentage Divide line 11a by line 11b
13 Income Apportioned to Iowa Multiply line 10 by line 12
14 Iowa Nonbusiness Income
15 Income Before Net Operating Loss Add lines 13 and 14
16 Net Operating Loss
17 Income Subject to Tax Subtract line 16 from line 15
18 Computed Tax
19 Minimum Tax Attach IA 4626
2 50% Federal Tax Refund
20 Total Tax Add lines 18 and 19
21 Credits (only credits does not include estimates from last period)
22 Payments See instructions
23a Total Credits and Payments: Add lines 21 and 22
23b Tax Amounts Previously Refunded and/or Credited to Next Period
24 Net Amount Subtract line 23a from line 20 and add line 23b
25 If line 24 is greater than $0 00 enter Tax Due on line 25
26a IA 2220 Penalty See instructions
26b Late Penalty
27 Interest
28 TOTAL AMOUNT DUE Add lines 25 through 27
29 If line 24 is less than $0 00 enter Overpayment on line 29
3 Other Additions to Income from IA 1120
30 Credit Carryforward to Next Period s Estimated Tax
4 Total Additions Add lines 1 through 3
42 024b (07/18/13)
5 50% Federal Tax Accrued or Paid
7 Total Reductions Add lines 5 and 6
8 Net Income Subtract line 7 from line 4
9 Nonbusiness Income
a change and give the reason for each change Attach applicable
A penalty of 5% will be added to tax due if the return is filed by
Accrual basis
All amounts should be in whole dollars
applicable only the 10% penalty will be charged Penalties can
audit is in progress and an amended return is filed within 60 days
be added to the tax due for failure to timely file a return if the
be attached
business is entirely within Iowa enter the amount of line 8
business ratio is 100% skip lines 9 10 13 and 14
carried to six places
Cash basis
changed after the due date if the change is requested by the last
changes and column (c) represents the results of adding or
Check this box if Name Address or FEIN has changed
Computation of Changes
Computation of Changes: Use Whole Dollars
Contact Person:
Copies of all federal documents must be attached
Corporation Name and Address
corporation s original IA 4626 revised IA 4626 and the federal
Corporation Tax Return Processing
date if the original return was filed under extension or within one
day of the subsequent tax year
Des Moines IA 50306 0468
different from present name or FEIN
Do NOT attach multiple years together
Do NOT use for loss carrybacks
due being paid by the due date However if an amended return is
due date of the return If due on the original return the penalty
due date of the return Interest will be computed by the Department
E mail: idr@iowa gov
Enter the line reference from page 1 for which you are reporting
Failure to Timely Pay the Tax Due or
Federal 1120X
Federal Audit
Federal Net Income
FEIN:
filed prior to contact by the Department and tax and interest paid
Filing an amended return may result in less than 90% of the tax
Filing Status
filing status and return type
Filing Status/Type of Return: Enter the appropriate numbers for
for any overpayment of tax
form IA 1120 or 1120A unless the change was due only to
Form IA 1120X is to be filed to make any changes to a previouslyfiled
From / / to / /
General Instructions
IA 1120X Amended Corporation Instructions
If the form is filed requesting a refund it must be filed within
If the refund claim is a result of a federal audit and the above
If the refund claim is a result of a protective claim check
In order to expedite processing this form please enclose a copy of page 1 of
Iowa Amended Corporation Income Tax Return
Iowa Department of Revenue
Item Description Amount
least 90% of the correct amount of tax is not paid by the original
Make checks payable to TREASURER STATE OF IOWA
Name and FEIN Used on Original Return: Check the box if
no penalty will be assessed Also no penalty will be assessed if
of any federal forms supporting the changes must be attached
of final disposition of the federal audit
of the federal audit including the final determination date must
OFFICE USE ONLY
Officer s Signature: Title: Date:
only be waived under limited circumstances
only) or 515 281 3114 (Des Moines out of state)
original return
Other
Other Reductions to Income from IA 1120
Otherwise add lines 13 and 14 and enter the sum
Over $250 000: 12% minus $7 500
Penalty for Audit Deficiency
Phone No :
PO Box 10468
Postmark
Preparer s ID Number: Enter the preparer s FEIN or
Preparer s Signature: Preparer s ID No : Date:
previously reported or as last computed column (b) represents
Protective Claim
Questions?: 1 800 367 3388 (Iowa Omaha Rock Island Moline
Reason for Amendment:
REFUND REQUESTED on Amended Return Subtract line 30 from line 29
return is filed after the original due date of the return and if at
Schedule of Changes to Income Deductions and Credits
schedules
Specific Instructions
statute has expired it must be filed within six months of the date
subtracting column (b) from column (a)
tax due is not paid by the original due date of the return
tax paid with return tax paid on billing (exclude penalty and interest)
the audit was finalized by the Internal Revenue Service A copy
the carryback of a capital loss that uses form IA 1139 CAP
the company s Iowa return as filed and any federal forms detailing the changes 42 024a (08/27/13)
the original due date and at least 90% of the correct amount of
three years of the due date of the original return or extended due
true correct and complete If prepared by a person other than the taxpayer the declaration is based on all information of which there is any knowledge
Type of Return
Under $25 000: 6%
Under penalties of perjury I declare that I have examined this return and attached schedules/statements and to the best of my knowledge believe it to be
Unless specified below column (a) represents amounts as
When the failure to file penalty and the failure to pay penalty are
Where to File:
will be applied to the recomputed tax
written notification is provided to the Department while a federal
www iowa gov/tax IA 1120X
year of payment