(: NonresTrust) Unchecked
(: ResTrust) Unchecked
(checkbox) Unchecked
(checkbox) Unchecked
(Distributive share of Louisiana income to beneficiary %)
(Distributive share of Louisiana income to beneficiary %)
(Distributive share of Louisiana income to beneficiary %)
(Distributive share of Louisiana income to beneficiary 100%)
(mmddyyyy)
(mmddyyyy) (mmddyyyy)
(Name address city state ZIP a )
(Name address city state ZIP b )
(Name address city state ZIP c )
(Name address city state ZIP d )
(Name address city state ZIP e )
(Name address city state ZIP f )
(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)
(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)
1 Federal taxable income before income distribution deduction 1
1 First quarter estimated payment
1 Louisiana income before federal income tax deduction 1
1 Net sales of merchandise and/or charges for services
1 plus Line 2C less Line 3D OR enter the amount from Form IT 541 Schedule A Line 12
1 Total amount per
10 Ratio Louisiana Special/Federal Special Divide Line 4 by Line 7 10
10 Total Income Tax Credits: Add Lines 1 through 9 Enter the result here and on IT 541 Line 11 10
1041 When using Louisiana Schedule A (Computation of Louisiana taxable income before
11 Federal income tax liability 11
11 Less federal itemized deductions attributable to Louisiana See instructions 11
11 Other nonrefundable income tax credits From Schedule NRC Line 10 11
12 Less federal special rates tax 12
12 Total income tax after nonrefundable credits Subtract Lines 10 and 11 from Line 9 12
13 Less alternative minimum tax 13
13 Louisiana Citizens Insurance Credit See instructions 13
14 Federal ordinary tax Subtract Lines 12 and 13 from Line 11 14
14 Other refundable credits From Schedule RC Line 6 14
15 Amount of credit carried forward from 2013 15
15 Federal income tax attributable to Louisiana ordinary income Multiply Line 14 by Line 9 15
16 Federal income tax on Louisiana income taxed at special rates Multiply Line 12 by Line 10 16
17 Amount of Louisiana Tax Withheld For 2014 Attach Forms W 2 and 1099 17
17 Federal income tax disaster relief credits 17
19 Total Refundable Tax Credits and Payments Add Lines 13 through 18 19
2 by Column 1 and enter the ratio in Column 3
2 Net Adjustment 2
2 Net income taxes paid to any state or political or municipal subdivision 2
2 Second quarter estimated payment
2 Total Louisiana
2 Wages salaries and other personal service compensation paid during the
21 Amount of Line 20 to be credited to 2015 Income tax 21
22 Amount to be refunded Subtract Line 21 from Line 20 22
23 Amount owed If Line 12 is greater than Line 19 subtract Line 19 from Line 12 23
24 Interest From the Interest Calculation Worksheet page 15 Line 5 24
27 Total amount due (Add Lines 23 through 26 ) PAY THIS AMOUNT 27
2A Net income tax paid to any state or political or municipal subdivision 2A
2B Interest income from other states and their political or municipal subdivisions 2B
2C Total Add Lines 2A and 2B 2C
3 Factor ratios (%)
3 Income tax property ratio Enter amounts in Column 1 and 2 Divide Column
3 Louisiana income on a federal basis Subtract Line 2 from Line 1 3
3 Third quarter estimated payment
3A Interest on U S government obligations 3A
3B Depletion allowed under Louisiana law in excess of federal depletion 3B
3B Depletion in excess of federal depletion 3B
3C S Bank exclusion 3C
3C S Bank Exclusion See instructions 3C
3D Total Add Lines 3A through 3C 3D
4 Fourth quarter estimated payment
4 Less Louisiana income taxed at special rates 4
4 Loans made during the year Enter amounts in Columns 1 and 2 Divide
4 Total subtractions Add Lines 3A through 3C 4
5 Less Louisiana income distribution deduction from Schedule C 5
5 Louisiana ordinary income on a federal basis Subtract Line 4 from Line 3 5
5 Modified federal taxable income Add Lines 1 and 2 subtract Line 4 and enter the result 5
5 Payment made with extension request
5 Taxpayers primarily in the business of manufacturing and merchandising
6 Add percentages under Column 3 Lines 1D 2 3 4 and 5 and enter result %
6 Federal taxable income 6
6 Louisiana taxable income before federal income tax deduction Subtract Line 5 from Line 4 6
6 Total Add Lines 1 through 5
6 Total: Add lines 1 through 5 Print the result here and on IT 541 Line 14 6
6A Net rents and royalties from immovable or corporeal movable property 6A
6B Royalties from the use of patents trademarks etc 6B
6C Income from estates trusts and partnerships 6C
6D Income from construction repair etc 6D
6E Other allocable income See instructions page 6 6E
6F Total allocable income from all sources 6F
7 Average of percents Line 6 divided by the number of factors used Multiply
7 Less federal income taxed at special rates 7
7 Net income subject to apportionment Subtract Line 6F from Line 5 7
7A Less federal income tax deduction Enter the amount from Schedule D Line 19 7A
7B Federal Disaster Relief Credits See Instructions 7B
8 Federal net income Ordinary Subtract Line 7 from Line 6 8
8 Louisiana taxable income Subtract Line 7A from Line 6 8
9 Ratio Louisiana Ordinary/Federal Ordinary Divide Line 5 by Line 8 9
9 Total tax See Worksheet 1 Calculation of Income Tax 9
9A Net rents and royalties from immovable or corporeal movable property 9A
9B Royalties from the use of patents trademarks etc 9B
9C Income from estates trusts and partnerships 9C
9D Income from construction repair etc 9D
9E Other allocable income See instructions 9E
9F and enter the result
9F Total allocable income from Louisiana sources 9F
A Sales where goods merchandise or property is received in
Ad Valorem Natural Gas
Ad Valorem Offshore Vessels
Add Lines 1A 1B and 1C Enter the result in Column 2 Divide Column 2
Additions
Address
Address
Adjustment to convert Louisiana net income to a federal basis:
Advisors Instructors 175
Allocable income from all sources See instructions page 6 Attach schedule supporting
Allocable income from Louisiana sources See instructions page 6 Attach schedule
Alternative Fuel
Amended Return
Amount
Amount of Estimated Payments for 2014 and Amount Paid with Extension Request From
Angel Investor
Angel Investor 262
Any income that is exempt from taxation under the laws of Louisiana or that Louisiana is
Apprenticeship 236
Atchafalaya Trace 200
attached:
B Charges for services performed in Louisiana
Basic Skills Training 212
Baton Rouge LA 70821 3440
begun
Beneficial Interest
beneficiary
Biomed/University Research 300
Bone Marrow 120
Brownfields Investor 260
by Column 1 and enter the ratio in Column 3
C Other gross apportionable income attributable to Louisiana
Cane River Heritage Area 232
Capital Company 257
Check Number Date Amount
Cit y
Cit y
Code Amount of Credit Claimed
Column 2 by Column 1 and enter the ratio in Column 3
Computation of Income
Contributions to Educational
Conversion of Vehicle to
D Total In Column 1 enter total net sales and charges for services
Date (mm/dd/yyyy)
Date entity was created:
Debt Issuance 155
Delinquent filing penalty From the Delinquent Filing Penalty Calculation Worksheet
Delinquent payment penalty From the Delinquent Payment Penalty Calculation Worksheet
Description
Description
Description
Description Code
Description Code
Description Code Amount of Credit Claimed
Description of items used as factors
Digital Interactive Media 254
Digital Interactive Media and
distribution deduction) leave Lines 1 2 and 3 blank and begin with Line 4
Distributive Share of
Donations of Materials Equipment
Donations to Public Schools 170
each amount
Eligible Re entrants 228
ended
Enter name of partnership
enter ratio from Column 3 Line 1D
enter the ratio in Column 3
Enterprise Zone 315
Export Cargo 240
Federal Identification Number:
Federal income tax deduction Add Lines 15 16 and 18 Enter the result here and on
Federal income tax disaster relief credits attributable to Louisiana Louisiana Multiply
Federal Return
Federal taxable income before Income Distribution Deduction found on Federal Form
Fiduciary Income
Field
Final Return
For calendar year 2014
FOR OFFICE USE ONLY
Form IT 541 Line 7A
go to Line 23
Grants to Resource and
Historic Structures 253
Initial Return
Institutions 160
Inventory Tax
IT 541 (1/15)
IT 541 (1/15)
IT 541 (1/15) LDR Account Number
it is true correct and complete If prepared by a person other than taxpayer his declaration is based on all information of which he has any knowledge
La Community Economic Dev 234
LCDFI Credit 258
LDR Account Number
LDR Account Number:
LDR Account Number:
Leased Solar Energy Systems
Line 10 Enter the result here and on Form IT 541 Line 4
Line 17 by Line 9
Line 7 See instructions
Louisiana by the purchaser
Louisiana Department of Revenue
Louisiana income to
Louisiana taxable income before income distribution deduction Enter either the amount of Line
Louisiana taxable income before income distribution deduction Subtract Line 11 from
Mail to:
Manufacturing Establishments 310
Mark all Applicable Boxes:
Mentor Prot g
Milk Producers
Modified federal taxable income allocated and apportioned to Louisiana Add Line 8 and
Modified Federal Taxable Income Allocated or Apportioned to Louisiana
Motion Picture Infrastructure 261
Motion Picture Investment 251
Motion Picture Resident 256
Musical & Theatrical Production
Name and Title of Fiduciar y
Name of Estate or Tr ust
Neighborhood Assistance 230
Net income apportioned to Louisiana Multiply Line 7 by the percentage from Schedule B
New Jobs Credit 224
New Markets 259
Non Leased
Nonresident only: Amount paid on your behalf by a Composite Partnership Filing
Nonresident Trust
Nonviolent Offenders 140
Number of
or other taxable year
Other 199
Other 299
Other 399
Other Refundable
other state s return must be submitted
Overpayment If Line 19 is greater than Line 12 subtract Line 12 from Line 19 Otherwise
P O Box 3440
page 15 Line 7
Percentage of
Ports of Louisiana Import
Ports of Louisiana Investor 238
Premium Tax 100
Previously Unemployed 208
Prison Industry Enhancement
prohibited from taxing by the Constitution or laws of the United States
Provider
Qualified Playgrounds 150
Recycling Credit 210
Referral Agencies
Refunds by Utilities 226
Research and Development
Research and Development 252
Resident Trust
Resident Trust credit for net income taxes paid to a state other than Louisiana A copy of the
Retention and Modernization
Schedule A Computation of Louisiana Taxable Income before Income Distribution Deduction
Schedule B Computation of Apportionment Percent
Schedule C Distributive Shares of Beneficiaries
Schedule D Computation of Federal Income Tax Deduction
Schedule E Line 6
Schedule E Summary of Estimated Tax Payments
Schedule NRC Nonrefundable Tax Credits and Exemptions (For further information about these credits please see instructions beginning on page 9 )
Schedule RC Refundable Tax Credits (For further information about these credits please see instructions beginning on page 12 )
Schedules K 1
School Readiness Business
School Readiness Child Care
School Readiness Fees and
Short Period Return
Signature of fiduciar y or officer representing fiduciar y Telephone
Signature of preparer other than fiduciar y Telephone
Social Security Number Name Address City State ZIP
Social Security Number Name and Address of each beneficiary as shown on their individual income tax return IT 540 or IT 540B
Software
Solar Energy Systems
State
State
Subtractions
Supported Child Care
supporting each amount
Tax Equalization 305
Tax Return
Technology Commercialization
Telephone Company Property
the result by the amount on Schedule A Line 7
Total 100%
Type of entity:
Under the penalties of perjury I declare that I have examined this return including all accompanying documents and to the best of my knowledge and belief
Urban Revitalization
year Enter amounts in Columns 1 and 2 Divide Column 2 by Column 1 and