(Can be up to 17 characters Omit hyphens spaces and special symbols Enter from left to right and leave any unused boxes blank )
(check only one):
(Enter 9 digits first two digits must be 01 through 12 or 21 through 32;
1 A Nebraska Corporation Net Operating Loss Worksheet;
1 Adjusted FTI (line 5 Form 1120XN) 1
1 Failure to pay tax when due;
1 Federal gross sales or receipts less returns and allowances 1 1
1 Federal net operating or capital loss carryover or carryback allowed on the federal return;
1 Interest or dividend income from U S government obligations included in federal taxable income Attach a schedule
10 Net Nebraska taxable income (line 8 minus line 9) 10 10
11 Nebraska tax 11 11
12 Premium tax credit 12 12
13 Community Development Assistance Act credit 13 13
15 Total nonrefundable credits (total of lines 12 through 14) 15 15
16 Nebraska tax after nonrefundable credits Subtract line 15
17 Form 3800N refundable credit (attach Form 3800N) 17 17
18 Beginning Farmer credit 18 18
19 Nebraska income tax withheld 19 19
1987 through 2013
2 A Nebraska Incentives Credit Computation Form 3800N;
2 Failure to file an amended return when required;
2 Federal taxable income (FTI) 2 2
2 Foreign dividends foreign dividend gross up or special foreign tax credit deduction;
2 Interest income from non Nebraska state and local bonds exempt from federal taxation;
2 Nebraska apportionment factor (line 5 below) 2 % %
20 tax years
2014 5 58% of first $100 000 7 81% of excess
2014 and after
21 Estimated payments (minus any Form 4466N adjustments) 21 21
22 Tax paid with original return plus additional payments made after it was filed 22
23 Total payments (add lines 17 through 22) 23
24 Overpayment allowed on original return plus additional overpayments allowed after it was filed 24
25 Line 23 minus line 24 25
26 Nebraska income tax due (line 16 minus line 25) 26
27 Penalty for underpayment of estimated tax (see instructions) 27
3 A copy of the related amended corporation income tax return filed with the IRS or another state; or
3 Adjustments increasing FTI 3 3
3 Allocable nonapportionable income less related expenses Allocable nonapportionable income is income which is
3 Allocable nonapportionable losses plus related expenses; and
3 Preparing or filing a fraudulent income tax return;
3 Taxable income apportioned to Nebraska (line 1 multiplied by line 2) Enter here and
30 Interest due 30
301 Centennial Mall South 1313 Farnam Street
31 Balance Due (total of lines 28 through 30) Check this box if payment is being made electronically 31
32 Refund (line 25 minus line 16) Complete the direct deposit information on the reverse side to receive your
4 A signed and dated copy of a final determination issued by the IRS another state or other competent authority
4 Adjustments decreasing FTI 4 4
4 Any other adjustments Attach a detailed explanation of the basis for each adjustment and any necessary schedules
4 Nebraska College Savings Program contributions The maximum annual exempt contribution per return is $10 000; and
4 Sales or gross receipts 4
4 Understatement of income on an income tax return; or
5 Adjusted FTI (enter line 2 plus line 3 minus line 4) 5 5
5 Any other adjustments Attach a detailed explanation of the basis for each adjustment and any necessary schedules
5 Nebraska apportionment factor Divide line 4 column (D) by line 4 column (A) and round
5 tax years
5 tax years
5 Underpayment of estimated tax
6 Allocable nonapportionable income (attach affidavit see instr ) 6
6 Nebraska taxable income before Nebraska carryovers 6 6
7 Allocable nonapportionable loss (attach affidavit see instr ) 7
7 Nebraska capital loss carryover (attach worksheet) 7 7
8 Nebraska taxable income after Nebraska capital loss
9 Nebr net operating loss carryover (see instr attach worksheet) 9 9
Account Number
affiliated corporations and federal ID numbers
Answer questions F G and H
Attach additional sheets or schedules if necessary
carryover (line 6 minus line 7) 8 8
changed or corrected by the IRS?
Check this box if this refund will go to a bank account outside the United States (see instructions)
City State Zip Code
Complete the information below to have your refund directly deposited into your bank account
corporation; or is it owned at least 50% by another
corporation?
E Does this corporation own at least 50% of another
F Is one single Nebraska return being filed for the
Federal ID Number Nebraska ID Number
Form 1120X
from line 11 (if less than zero enter 0 ) 16 16
G Are you filing as a unitary group in any other state?
H Check the method used to determine Nebraska income
If Yes attach a complete copy of Federal
If Yes attach a copy of the Form 872 or 872 A
If Yes attach Federal Form 851 or a schedule of
If Yes identify office:
Legal Name
Lincoln NE 68509 4818
Lincoln Omaha
Name and Address Used on Original Return (if same as above write same )
Name Doing Business As (dba)
Name on Form 1120XN Nebraska ID Number
Nebraska Schedule I Apportionment for Multistate Business
Nebraska Schedule II Explanation of Changes
Nebraska State Office Building Nebraska State Office Building
on line 6 Form 1120XN 3
Other
PO Box 94818 Omaha NE 68102 1871
Previous Penalty: Previous Interest Other
Previous Underpayment
Reference net change (Column C) and line number
refund electronically 32
Routing Number Type of Account Checking Savings
Street or Other Mailing Address
Taxable year beginning and ending
to six decimal places Enter as a percent here and on line 2 of Schedule I above 5 %
use an actual check or savings account number not a deposit slip)
Year Nebraska Rate
YES NO
YES NO
YES NO
YES NO
(A) As Originally Reported
(B) Net Change (Explain
(C) Correct Amount
(explain below)
1120XN
14 Form 3800N nonrefundable credit (attach Form 3800N) 14 14
20 Tax deposited with Form 7004N 20 20
26 by 5% per month or fraction of a month not to exceed a total of 25% from the due date as extended until the original
28 Total tax and penalty for underpayment of estimated tax (total of lines 26 and 27) 28
29 Penalty (see instructions) 29
8 745 2014
A Is an amended federal return being filed?
a Nebraska capital loss consists of the loss on property which was used by the unitary business that did business in Nebraska
activities generating the nonapportionable income to the total investment
Allocable Nonapportionable Income Allocation means the process of determining the amount of nonapportionable
Allocable Nonapportionable Income or Loss
Alternate method (attach Department of Revenue approval)
Amended Nebraska Corporation Income Tax Return
amended return is being filed Attach a schedule listing the date of payment amount of payment and the payee
Amount
amount allowable is based on the loss previously reported to Nebraska and is not based on a percentage of the federal
and 7 of Nebraska Schedule I Income that could be allocable to Nebraska under federal law must be apportioned under the
and Federal Form 1120 for the year you are amending Complete the appropriate forms and schedules Assistance may be
and line 26 shows a tax due it will be necessary to compute a penalty for failure to timely file Multiply the amount on line
Any corporation filing an amended return with the IRS which will not result in a credit or refund or filing an amended return
Any corporation filing an amended return with the IRS which will result in a credit or refund must report the change or
Any person who is paid for preparing a taxpayer s return must also sign the return as preparer The preparer must also enter
apportionment factors The entire amount of federal taxable income is presumed to be apportionable income
Apportionment for Multistate Business
apportionment in another state with substantially the same law as Nebraska
Apportionment refers to the division of business income between states by the use of a formula containing one or more
are not limited to:
As Amended
B Has the original federal return been
by another state with substantially the same law as Nebraska;
by filing Form 1120XN A Form 1120XN must also be filed within 60 days after another state's changes in the corporation s
C Has a Federal Form 872 or 872 A been filed for
Capital Loss
carryover A net operating loss can only be carried forward See the Net Operating Losses and Capital Losses section on
change (but not more than ten years from the due date of the original return in the case of a change made by another state)
change Attach a copy of any federal document relating to the federal change establishing the timeliness of the refund claim
Change in Net Allocable
claim a refund resulting from a federal or state change within two years and 60 days following the final determination of the
claimed amount together with evidence that the income is not part of a unitary business Also attach an affidavit from a
Column (A) Enter the amounts shown on your original return or as later adjusted
Column (B) Enter the net changes to the amounts entered in column (A) All entries in column (B) must be explained in
Column (B) Enter the total Nebraska amounts shown on your original return or as later adjusted
Column (C) Enter the corrected totals after the increases or decreases shown in column (B) If there are no changes enter
Combined report of a controlled group of corporations
Complete Reverse Side
Computation of Tax
confidential information
Consent to Extend the Time to Assess Tax; Form 872 A Special Consent to Extend the Time to Assess Tax; or any other
considered in preparing your Form 1120XN since any amount claimed for refund on your original return will be refunded
corporate officer that the corporate taxpayer has not claimed the same income to be a part of a unitary business subject to
corporate stock or other assets the income from which was not previously treated as income apportionable to Nebraska the
Corporation Filing Status Answer questions E through H as applicable
corporations (attach supporting documentation)
Corporations reporting for a fiscal year or filing a short period tax return must use the Nebraska rate that was in effect on the
Correct Amount
correction within 60 days after receiving proof that the IRS accepted the federal return
Credits and Payments If you are correcting the amount of a credit or other payment refer to the instructions for Form 1120N
D Has the corporation been advised
date of the original return to the date of payment
deductions adjustments or credits etc refer to the instructions for Form 1120N and U S Corporation Income Tax Return
detail on Explanation of Changes Nebraska Schedule II Form 1120XN with supporting schedules attached
each change Also attach any schedules or forms necessary to support the change These schedules and forms include but
Enter the line number from Form 1120XN and Nebraska Schedule I for the items you are changing and give a reason for
Enter the Overpayment from your original return or as later corrected or adjusted The amount of overpayment must be
entire group?
Except as otherwise noted a Form 1120XN used to claim a refund must be filed within three years from the time the original
Explanation of Changes
Federal Form 1120 for the year you are amending
federal form used to extend the time to assess income taxes If copies of these federal forms are not provided to the Department
Firm s Name (or yours if self employed) Address and Zip Code EIN Daytime Phone
first day or the day deemed to be the first day of the taxable year for which the amended return is being filed
for allowable deductions of income from U S government obligations;
For Nebraska Department of Revenue Use Only
for Tax Years After 2013
Form 1120N Attach a copy of the recalculated Form 2220N
FORM 1120XN
his or her Preparer Tax ID Number (PTIN) and Federal Employer ID Number (EIN)
I and II
If a hearing is desired the hearing must be requested at the time this amended return is filed
If any changes are made in the amount of allocable nonapportionable income or loss attach a detailed description of the
income derived from sources within one or more states Income or loss allocated to other states may be reported on lines 6
Income or Loss
Income or Loss As
income or tax credits become final
Information on Income Deductions If you have any questions regarding the taxability of an item the allowance of
Instructions for Amended Nebraska Corporation Income Tax Return
Instructions for Schedule I
Instructions for Schedule II
Interest on these refunds will cease to accrue after the 60th day if the amended return has not been filed within 60 days after the
knowledge and belief it is correct and complete
laws of Nebraska
Line 1 Federal Gross Sales or Receipts Less Returns and Allowances Enter the amount of total sales or gross
line 10 column (C) by the following rates
Line 11 Nebraska Tax The Nebraska income tax is computed by multiplying the amounts on line 10 column (A) and
Line 12 Premium Tax Credit Enter the amount of credit for premium tax paid (not accrued) if any for the year this
Line 24 Overpayment Allowed on Original Return Plus Additional Overpayments Allowed After It Was Filed
Line 27 Penalty for Underpayment of Estimated Tax Enter the amount of the difference between the underpayment
Line 29 Penalty If the original return was not filed by its due date or within the period for which an extension was granted
Line 3 Adjustments Increasing FTI Enter the total Nebraska adjustments increasing federal taxable income which include:
line 3 if income was apportioned
Line 30 Interest Due Enter the total interest due computed on the additional tax due at the statutory rate from the due
Line 4 Adjustments Decreasing FTI Enter the total adjustments decreasing federal taxable income which include:
Line 4 Sales or Gross Receipts Column (A) Enter the total amounts shown on your original return or as later adjusted
Line 6 Allocable Nonapportionable Income Enter the amount of allocable nonapportionable income minus all
Line 6 Nebraska Taxable Income Before Nebraska Carryovers Enter the amounts from line 5 on line 6 if all income
Line 7 Allocable Nonapportionable Loss Enter the amount of allocable nonapportionable loss plus related expenses
Line 7 Nebraska Capital Loss Carryover Enter the allowable Nebraska capital loss carryover For a multistate taxpayer
Line 9 Nebraska Net Operating Loss Carryover Enter the allowable Nebraska net operating loss carryover The
listing the type and amount of income derived from each obligation for which a deduction is claimed See the
loss cannot be treated as a Nebraska loss Capital loss carryovers are only allowable to the extent of capital gains in the year
loss may only be carried forward and only for a maximum period of five tax years
Loss Year
Mail this return and remit payment (electronically if required) to:
multiplied by the Nebraska apportionment factor for the year of the loss If the corporate taxpayer reported a capital loss on
Nebraska
Nebraska Amount As
Nebraska Correct
Nebraska Department of Revenue (Department) within 60 days of the filing of the amended federal or state return
Nebraska Department of Revenue PO Box 94818 Lincoln NE 68509 4818
Nebraska If the operations within Nebraska are dependent upon or contribute to the operations outside Nebraska the entire
Nebraska Net Change
Nebraska Schedule I Apportionment for Multistate Business
Nebraska Schedule I Form 1120XN is used if the operations of the corporation are carried on both within and without
Nebraska Schedule II Explanation of Changes
needs to contact you By including your email address you are agreeing that the Department may use it to transmit
Net Allocable
Net Operating Loss
Net Operating Losses and Capital Losses
Nonapportionable
Nonapportionable
nonapportionable income and a portion of the total interest expense of the corporate taxpayer The amount of interest related
not part of the unitary business and has not been claimed as part of the unitary business subject to apportionment
obtained by contacting the Department Checks written to the Department may be presented for payment electronically
of the deduction Attach a detailed schedule which shows the computation of the capital loss carryover A Nebraska capital
on Reverse Side)
operation is unitary An operation is also considered unitary when a business is conducted as a single economic unit by one
or As Adjusted
or more corporations with common ownership and includes all activities in different lines of business that contribute to the
page 3 for carryover periods
penalty reported on the Corporate Income Tax Return Form 1120N and the recalculated underpayment penalty The
PLEASE DO NOT WRITE IN THIS SPACE
Please Print or
power of attorney must be on file with the Department Include your phone number and email address in case the Department
preparer s
Preparer s Signature Date Preparer s PTIN
Purpose An Amended Nebraska Corporation Income Tax Return Form 1120XN is filed when the corporation s federal
Question C Corporate taxpayers are required to provide the Department with a copy of every executed Federal Form 872
receipts reported on the federal return less returns and allowances
related expenses Related expenses include all direct and indirect expenses attributable to the activities producing the allocable
Reminder: Some taxpayers are required to remit any corporate balance electronically
renegotiation of a contract with the United States must report the change or correction within 60 days of the determination
Reported or Adjusted
Reported or Adjusted
return is not correct An amended return reporting a change or correction must be mailed separately from the annual income
return or another state s tax return is amended or corrected or whenever the information on the previously filed Nebraska
return was filed Enter the result on line 29 Additional penalties may be imposed for:
return was filed or within two years from the time the tax was paid whichever occurs later Form 1120XN must be filed to
revenue nebraska gov 800 742 7474 (NE and IA) 402 471 5729
Sales or Gross Receipts Factor
Sales or Gross Receipts Factor Refer to the instructions provided with the Form 1120N as a guide for completion of
Schedules
Separate report by a member of a controlled group of
separately from any additional refund claimed on this amended return
Signature of Officer Date Email Address
Signatures This return must be signed by a corporate officer If the taxpayer authorizes another person to sign this return a
single economic unit
Specific Instructions
tax return of the corporation
Taxability of Interest and Dividend Income From State Local and U S Government Obligations Information Guide
Taxpayer Assistance Contact the Department by phone at 800 742 7474 (NE & IA) or 402 471 5729 or by mail at:
that the Form 1120N is being or
the amount from column (A)
the year you are amending?
these forms are provided to the Department
this section The sales or gross receipts factor must be rounded to six decimal places and entered as a percent
Title Phone Number
to the nonapportionable income is determined by multiplying the total interest expense by the ratio of the investment in the
Total
Under penalties of perjury I declare that as taxpayer or preparer I have examined this return including accompanying schedules and statements and to the best of my
underpayment penalty may only be recalculated if the amended return is filed by the due date (including extensions) of the
use only
was derived from within Nebraska Enter the amount from Apportionment for Multistate Business Nebraska Schedule I
When to File Any corporation whose reported income or deductions are changed or corrected by the IRS or through a
will be audited?
with another state involving a change or correction material to its Nebraska tax liability must file an amended return with the
within 30 days after they are executed the Department may issue a notice of deficiency determination within one year after