Form 1120-SN-K-1N Fillable Shareholder's Share of Income, Deductions, Modifications, and Credits (1/2015)
(all forms fillable on Windows, Mac, Android tablets, and iPad using Adobe Reader XI)

% % Final Amended 1 Ordinary business income (loss) 1 10 Other income 10 11 Charitable contributions 11 12 Section 179 expense deduction 12 13 Other deductions and losses 13 14 Qualified U S government interest deduction 14 15 State and local government interest and dividend income 15 16 Income (loss) from non Nebraska sources 16 17 Community Development Assistance Act credit 17 18 Form 3800N credits (see instructions) 19 Contractor withholding (see instructions) 19 2 Net income (loss) from rental real estate activities 2 20 Nebraska income tax withheld (see instructions) 20 3 Net income (loss) from other rental activities 3 4 Interest income 4 5 Dividend income 5 6 Royalties 6 7 Net short term capital gain (loss) 7 8 Net long term capital gain (loss) 8 9 Net Section 1231 gain (loss) 9 a Employment and Investment Growth Act 18 a $ b Nebraska Advantage Act 18 b $ Beginning 20 and Ending 20 c Nebraska Advantage Rural Development Act 18 c $ Check One: d Nebraska Advantage Research and Development Act 18 d $ e New Markets Tax Credit 18 e $ Exempt Organization Resident Individual Nonresident Individual Estate or Trust S Corporation s Nebraska Apportionment Factor Shareholder s Ownership Percentage If applicable check the appropriate box: Taxable Year of Organization Total of 18a through 18e 18 8 687 2014 City State Zip Code City State Zip Code Corporation s Name and Mailing Address FORM 1120 SN Legal Name Name Doing Business As (dba) Name Nebraska ID Number Federal ID Number Social Security Number/Federal ID Number Spouse s Social Security Number Nebraska Schedule K 1N Part A Part B Part C revenue nebraska gov 800 742 7474 (NE and IA) 402 471 5729 Schedule K 1N Shareholder s Name and Mailing Address Shareholder s Share of Credits Shareholder s Share of Income and Deductions Shareholder s Share of Income Deductions Modifications and Credits Shareholder s Share of Modifications Street or Other Mailing Address Street or Other Mailing Address