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Fillable Printable 2011 Form 4H - Wisconsin Department Of Revenue

Fillable Printable 2011 Form 4H - Wisconsin Department Of Revenue

2011 Form 4H - Wisconsin Department Of Revenue

2011 Form 4H - Wisconsin Department Of Revenue

Corporation Balance Sheets
2011
4H
Wisconsin Corporation
Declaration of Inactivity
Form
1 Cash .......................................... 1
2 Net trade notes and accounts receivable ............... 2
3 Inventories ...................................... 3
4 Government obligations ............................ 4
5 Other current assets (attach schedule) ................ 5
6 Loans to stockholders ............................. 6
7 Mortgage and real estate loans ...................... 7
8 Other investments (attach schedule) .................. 8
9 Netbuildingsandotherxeddepreciableassets ......... 9
10 Netdepletableassets ............................. 10
11 Land (net of any amortization) ....................... 11
12 Intangible assets (amortizable only). . . . . . . . . . . . . . . . . . . 12
13 Other assets (attach schedule) ...................... 13
14 Total assets .................................... 14
15 Accountspayable ................................ 15
16 Mortgages,notes,bondspayableinlessthan1year ..... 16
17 Other current liabilities (attach schedule) ............... 17
18 Loans from stockholders ........................... 18
19 Mortgages,notes,bondspayablein1yearormore ...... 19
20 Other liabilities (attach schedule) ..................... 20
21 Capitalstock:
a Preferred stock ................................ 21a
b Common stock ................................ 21b
22 Paid-inorcapitalsurplus ........................... 22
23 Retainedearnings—Appropriated ................... 23
24 Retainedearnings—Unappropriated ................. 24
25 Adjustments to shareholders’ equity .................. 25
26 Less:Costoftreasurystock ......................... 26
27 Total liabilities and stockholders’ equity ............. 27
(a)
Beginning of
Taxable Year
(b)
End of
Taxable Year
IC-046i
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DO NOT STAPLE OR BIND
NO COMMAS; NO CENTS
ENTER NEGATIVE NUMBERS LIKE THIS
–1000
NOT LIKE THIS (1000)
For2011ortaxableyearbeginning andending
M Y Y C C M Y Y C C
.
M D D M D D
Complete form using BLACK INK.
CorporationName
Number and Street
City State
Due Date: 15thdayof3rdmonthfollowingcloseoftaxableyear.
BStateofIncorporation and Year
A Identifying Number
C Enter ifyouhaveanextensionoftimetole.Enterextendedduedate .
M D M D Y C C Y
Enter abbrevia-
tion of state in
box,orifa
foreign country,
enterbelow.
ZIP(+4digitsufxifknown)
Y C C Y
Suite Number
Instructions
Tab to navigate within form. Use mouse to check
applicable boxes, press spacebar or press Enter.
Save
Print
Clear
Go to Page 2
28 Persontocontactconcerningthisreturn: Name
Telephonenumber() Faxnumber()
General Instructions
Purpose of Form 4H
Acorporationthathasbeencompletelyinactiveboth
in and outside Wisconsin
for an entire taxable
year may le Form 4H instead of ling a corporate
franchiseorincometaxreturn.Ifthecorporationisa
combinedgroupmember,itmayleForm4Hinstead
of being included in the combined return. Thereafter,
thecorporationneednotleacorporatefranchiseor
incometaxreturn,beincludedinacombinedreturn,or
leForm4Hforanysubsequentyearunlessrequested
to do so by the Department of Revenue or unless,
inasubsequentyear,thecorporationisactivatedor
reactivated.
Note:BylingForm4H,acorporationisrelievedofthe
requirementtoleanannualfranchiseorincometax
returnwiththeDepartmentofRevenue.Thisexemption
does not extendtoreportsrequiredbyotheragencies.
Inorderforthecorporationtocontinueingoodstanding,
itmustcontinuetoleaWisconsinCorporationAnnual
Report each year with the Corporations Bureau,
Division of Corporate and Consumer Services,
WisconsinDepartmentofFinancialInstitutions.Failure
tolethisreportwithinaspeciedperiodoftimemay
subjectthecorporationtoadministrativedissolution.
Who May Not File Form 4H
Acorporationmustleacorporatefranchiseorincome
taxreturninsteadofForm4Hineitherofthefollowing
cases:
• Thecorporation’sbalancesheetfortheendofthe
taxableyeardiffersfromitsbalancesheetforthe
beginningofthetaxableyear.
• Thecorporationliquidatesduringthetaxableyear.
Instructions for 2011 Form 4H
When to File
FileForm4Honorbeforethe15thdayofthethirdmonth
followingthecloseofthetaxableyear.Anyextensionof
timeallowedbyeithertheInternalRevenueServiceor
theDepartmentofRevenuetoleyourreturnextends
theduedateforlingForm4H,providedyoucheckline
C,entertheextendedduedate,andattachacopyof
yourextensiontoForm4H.IfForm4Hisnotledon
orbeforetheduedateorextendedduedate,a$150
latelingfeeapplies.
Specic Instructions
Identifying Number
Enter either of the following: federal employer
identicationnumber(EIN)or Wisconsin tax number
(WTN).AfederalEINisnotrequiredtolethisformif
youhaveaWTN.
Balance Sheets
Completethebalancesheetsfortherstdayandlast
dayofthetaxableyearindicatedatthetopofForm4H.
Ifthecorporationhadnoassetsorliabilitiesandcapital
oneithertherstdayorthelastdayofthetaxableyear,
enterzero(0)online14andonline27.
Signature on Form 4H
The corporation president must sign Form 4H if the
presidentisaresidentofWisconsin.Otherwise,another
ofcerwhoisaWisconsinresidentshouldsignForm
4H.IfnoneoftheofcersareresidentsofWisconsin,
Form4Hmaybesignedbyanydulyauthorizedofcer.
I,theundersignedauthorizedofcer,declarethattheabovenamedcorporationhashadnoincomeorexpenseandhasbeencompletely
inactivefortheentiretaxableyearshownabove.Ialsodeclarethattheabovecorporationbalancesheetsaretrueandcorrect.
Mail to:WisconsinDepartmentofRevenue,POBox8908,Madison,WI53708-8908.
SignatureofOfcer
Title
Date
OfcersStateofResidence
Page 2 of 2
2011Form4H
Return to Page 1
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