Fillable Printable Form 1120C
Fillable Printable Form 1120C
Form 1120C
Form
1120-C
Department of the Treasury
Internal Revenue Service
U.S. Income Tax Return for Cooperative Associations
For calendar year 2012 or tax year beginning , 2012, ending
, 20
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Information about Form 1120-C and its separate instructions is at www.irs.gov/form1120c.
OMB No. 1545-2052
2012
Please type or print
Name
Number, street, and room or suite no. If a P.O. box, see instructions.
City or town, state, and ZIP code
A Check if:
1
Consolidated return
(attach Form 851)
2
Schedule M-3 (Form
1120) attached
3
Form 1120 filed in
previous tax year
B Employer identification number
C Check if:
(1)
Farmers’ tax exempt
cooperative . . .
(2) Nonexempt
cooperative . . .
D Check if: (1) Initial return (2) Final return (3) Name change (4) Address change (5) Amended return
Income
1 a
Gross receipts or sales b Less returns and allowances
c Bal
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1c
2 Cost of goods sold (see instructions-attach Form 1125-A) . . . . . . . . . . . . 2
3 Gross profit. Subtract line 2 from line 1c . . . . . . . . . . . . . . . . . . 3
4 Dividends (Schedule C, line 19) . . . . . . . . . . . . . . . . . . . . . 4
5 Interest . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
6 Gross rents and royalties . . . . . . . . . . . . . . . . . . . . . . . 6
7 Capital gain net income (attach Schedule D (Form 1120)) . . . . . . . . . . . . . 7
8 Net gain or (loss) from Form 4797, Part II, line 17 (attach Form 4797) . . . . . . . . . 8
9 Other income (see instructions—attach statement) . . . . . . . . . . . . . . . 9
10 Total income. Add lines 3 through 9 . . . . . . . . . . . . . . . . . .
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10
Deductions (See instructions for limitations on deductions.)
11 Compensation of officers (attach Form 1125-E) . . . . . . . . . . . . . . . . 11
12 Salaries and wages (less employment credits) . . . . . . . . . . . . . . . . 12
13 Bad debts . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
14 Rents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
15 Taxes and licenses . . . . . . . . . . . . . . . . . . . . . . . . . 15
16 Interest . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
17 Charitable contributions . . . . . . . . . . . . . . . . . . . . . . . . 17
18 Depreciation not claimed on Form 1125-A or elsewhere on return (attach Form 4562) . . . 18
19 Advertising . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
20 Pension, profit-sharing, etc., plans . . . . . . . . . . . . . . . . . . . . 20
21 Employee benefit programs . . . . . . . . . . . . . . . . . . . . . . 21
22 Domestic production activities deduction (attach Form 8903) . . . . . . . . . . . 22
23 Other deductions (attach statement) 23
24 Total deductions. Add lines 11 through 23 . . . . . . . . . . . . . . . .
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24
25 a
Taxable income before adjustments and special deductions. Subtract line 24 from line 10
25a
b Deductions and adjustments from Schedule H, line 5 . . . . . 25b
c
Taxable income before net operating loss and special deductions. Subtract line 25b from line 25a
25c
26 Less: a Net operating loss deduction (see instructions) . . . . 26a
b Special deductions (Schedule C, line 20) . . . . . . 26b 26c
Tax, Refundable Credits, and Payments
27 Taxable income. Subtract line 26c from line 25c (see instructions) . . . . . . . . . . 27
28 Total tax (Schedule J, line 9) . . . . . . . . . . . . . . . . . . . . . . 28
29a
2011 overpayment credited to 2012
29a
b 2012 estimated tax payments . 29b
c
2012 refund applied for on Form 4466
29c
(
)
d Bal
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29d
e Tax deposited with Form 7004 . . . . . . . . . . . . 29e
f
Credits: (1) Form 2439 (2) Form 4136
29f
g Refundable credits from Form 8827, line 8c . . . . . . . . 29g
h Section 1383 adjustment (see instructions) . . . . . . . . 29h 29i
30 Estimated tax penalty (see instructions). Check if Form 2220 is attached . . . . . .
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30
31 Amount owed. If line 29i is smaller than the total of lines 28 and 30, enter amount owed . . 31
32 Overpayment. If line 29i is larger than the total of lines 28 and 30, enter amount overpaid . . 32
33
Enter amount of line 32 you want: Credited to 2013 estimated tax
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Refunded
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33
Sign
Here
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true,
correct, and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge.
▲
Signature of officer Date
▲
Title
May the IRS discuss this return
with the preparer shown below
(see instructions)?
Yes No
Paid
Preparer
Use Only
Print/Type preparer’s name Preparer’s signature Date
Check if
self-employed
PTIN
Firm’s name
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Firm’s address
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Firm's EIN
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Phone no.
For Paperwork Reduction Act Notice, see separate instructions.
Cat. No. 47554F
Form 1120-C (2012)
Form 1120-C (2012)
Page 2
Schedule C
Dividends and Special Deductions
(see instructions)
(a) Dividends
received
(b) %
(c) Deduction
((a) × (b))
1
Dividends from less-than-20%-owned domestic corporations (other than
debt-financed stock) . . . . . . . . . . . . . . . . .
2
Dividends from 20%-or-more-owned domestic corporations (other than
debt-financed stock) . . . . . . . . . . . . . . . . .
3
Dividends on debt-financed stock of domestic and foreign
corporations . . . . . . . . . . . . . . . . . . . .
4
Dividends on certain preferred stock of less-than-20%-owned public
utilities . . . . . . . . . . . . . . . . . . . . . .
5
Dividends on certain preferred stock of 20%-or-more-owned public
utilities . . . . . . . . . . . . . . . . . . . . .
6
Dividends from less-than-20%-owned foreign corporations and certain
FSCs . . . . . . . . . . . . . . . . . . . . . .
7
Dividends from 20%-or-more-owned foreign corporations and certain
FSCs . . . . . . . . . . . . . . . . . . . . . .
8 Dividends from wholly owned foreign subsidiaries . . . . . . .
9 Total. Add lines 1 through 8. See instructions for limitation . . . .
10
Dividends from domestic corporations received by a small business investment
company operating under the Small Business Investment Act of 1958 . . .
11 Dividends from affiliated group members . . . . . . . . . .
12 Dividends from certain FSCs . . . . . . . . . . . . . .
13
Dividends from foreign corporations not included on lines 3, 6, 7, 8, 11,
or 12 . . . . . . . . . . . . . . . . . . . . . .
14
Income from controlled foreign corporations under subpart F (attach
Form(s) 5471) . . . . . . . . . . . . . . . . . . .
15 Foreign dividend gross-up . . . . . . . . . . . . . . .
16 IC-DISC and former DISC dividends not included on lines 1, 2, or 3 .
17 Other dividends . . . . . . . . . . . . . . . . . . .
18 Deduction for dividends paid on certain preferred stock of public utilities
19
Total dividends. Add lines 1 through 17. Enter here and on page 1,
line 4 . . . . . . . . . . . . . . . . . . . . .
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20
Total special deductions. Add lines 9, 10, 11, 12, and 18. Enter here and on page 1, line 26b . .
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Form 1120-C (2012)
70
80
See
instructions
42
48
70
80
100
100
100
See
instructions
Form 1120-C (2012)
Page 3
Schedule G
Allocation of Patronage and Nonpatronage Income and Deductions. Before completing,
see Schedule K, Question 14.
(a) Patronage (b) Nonpatronage
1 Gross receipts or sales . . . . . . . . . . . . . . . . . . 1
2 Cost of goods sold . . . . . . . . . . . . . . . . . . . . 2
3 Gross profit. Subtract line 2 from line 1 . . . . . . . . . . . . . 3
4 Other income . . . . . . . . . . . . . . . . . . . . . 4
5 Total income. Combine lines 3 and 4 . . . . . . . . . . . . . 5
6a Domestic production activities deduction (attach Form 8903) . . . . . . 6a
b Other deductions . . . . . . . . . . . . . . . . . . . . 6b
c Total deductions (add lines 6a and 6b) . . . . . . . . . . . . . 6c
7 Taxable income before section 1382, NOL, and special deductions. Subtract
line 6c from line 5 . . . . . . . . . . . . . . . . . . . .
7
8 Deductions and adjustments under section 1382 from Schedule H, line 5 (see
instructions) . . . . . . . . . . . . . . . . . . . . . .
8
9a Net operating loss deduction (attach statement) . . . . . . . . . . 9a
b Special deductions (see instructions) . . . . . . . . . . . . . . 9b
10 Taxable income. Subtract the total of lines 8, 9a, and 9b from line 7 . . . 10
11 Combined taxable income. Combine columns (a) and (b) of line 10 (see
instructions) . . . . . . . . . . . . . . . . . . . . . .
11
12 Unused patronage loss (see instructions) . . . . . . . . . . . . 12
13 Unused nonpatronage loss (see instructions) . . . . . . . . . . . 13
Schedule H Deductions and Adjustments Under Section 1382 (see instructions)
1 Dividends paid on capital stock (section 521 cooperatives only) . . . . . . . . . . . . 1
2 Nonpatronage income allocated to patrons (section 521 cooperatives only) . . . . . . . . 2
3 Patronage dividends:
a Money . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3a
b Qualified written notices of allocation . . . . . . . . . . . . . . . . . . . . . 3b
c Other property (except nonqualified written notices of allocation) . . . . . . . . . . . 3c
d Money or other property (except written notices of allocation) in redemption of nonqualified written
notices of allocation . . . . . . . . . . . . . . . . . . . . . . . . . .
3d
4 Domestic production activities deduction allocated to patrons . . . . . . . . . . . . 4
( )
5
Total. Combine lines 1 through 4. Enter here and on page 1, line 25b, and Schedule G, line 8 . .
5
Form 1120-C (2012)
Form 1120-C (2012)
Page 4
Schedule J Tax Computation (see instructions)
1 Check if the cooperative is a member of a controlled group (attach Schedule O (Form 1120))
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2 Income tax (see instructions) . . . . . . . . . . . . . . . . . . . . . . . 2
3 Alternative minimum tax (attach Form 4626) . . . . . . . . . . . . . . . . . . 3
4 Add lines 2 and 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
5 a Foreign tax credit (attach Form 1118) . . . . . . . . . . . 5a
b Credit from Form 8834, line 30 . . . . . . . . . . . . . 5b
c General business credit (attach Form 3800) . . . . . . . . . 5c
d Credit for prior year minimum tax (attach Form 8827) . . . . . . 5d
e Bond credits from Form 8912 (attach Form 8912) . . . . . . . 5e
6 Total credits. Add lines 5a through 5e . . . . . . . . . . . . . . . . . . . . 6
7 Subtract line 6 from line 4 . . . . . . . . . . . . . . . . . . . . . . . . 7
8 Other taxes. Check if from: Form 4255 Form 8611
Other (attach statement)
Form 8902
8
9
Total tax. Add lines 7 and 8. Enter here and on page 1, line 28 . . . . . . . . . . . .
9
Schedule K Other Information (see instructions)
1 Check accounting method:
Yes No
a Cash
b Accrual
c
Other (specify)
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2 See the instructions and enter the:
a
Business activity code no.
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b
Business activity
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c
Product or service
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d
Date of incorporation
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3 Check the accounting method used to compute
distributable patronage:
a
Book
b
Tax
c
Other (specify)
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4
At the end of the tax year, did the cooperative
own, directly or indirectly, 50% or more of the
voting stock of a domestic corporation? (For
rules of attribution, see section 267(c).) . . .
If “Yes,” attach a statement showing: (a) name
and employer identification number (EIN), (b)
percentage owned, and (c) taxable income or
(loss) before NOL and special deductions of
such corporation for the tax year ending with or
within your tax year.
5
Is the cooperative a subsidiary in an affiliated
group or a parent-subsidiary controlled group?
If “Yes,” enter name and EIN of the parent
corporation
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6 At the end of the tax year, did any individual,
partnership, corporation, estate, or trust own,
directly or indirectly, 50% or more of the
cooperative’s voting stock? (For rules of
attribution, see section 267(c).) . . . . .
If “Yes,” attach a statement showing name and
identifying number. (Do not include any
information already entered in 5 above.) Enter
percentage owned
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7 Enter the cooperative’s total assets (see
instructions)
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$
8
At any time during the tax year, did one foreign
person own, directly or indirectly, at least 25%
of (a) the total voting power of all classes of
stock of the cooperative entitled to vote or (b)
the total value of all classes of stock of the
cooperative? . . . . . . . . . . . .
If “Yes,” enter: (a) Percentage owned
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Yes No
and (b) Owner’s country
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c
The cooperative may have to file Form 5472, Information
Return of a 25% Foreign-Owned U.S. Corporation or a
Foreign Corporation Engaged in a U.S. Trade or Business.
Enter number of Forms 5472 attached
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9
Check this box if the cooperative issued publicly offered
debt instruments with original issue discount . . .
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If checked, the cooperative may have to file Form
8281, Information Return for Publicly Offered
Original Issue Discount Instruments.
10
Enter the amount of tax-exempt income received or
accrued during the tax year (for example, interest or
extraterritorial income)
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$
11 a Enter the number of foreign patrons at the end of
the tax year
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b
Enter the total amount of patronage distributions
described in (or deducted under) IRC 1382(b) paid
or allocated to foreign patrons
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12
If the cooperative has an NOL for the tax year and is
electing to forego the carryback period, check here
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If the cooperative is filing a consolidated return, the
statement required by Regulations section 1.1502-21(b)
(3) must be attached or the election will not be valid.
13
Enter the available NOL carryover from prior tax years
(Do not reduce it by any deduction on page 1, line
26a.)
Patronage
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$
Nonpatronage
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$
14
Are the cooperative’s total receipts (page 1, line 1a
plus lines 4 through 9) for the tax year and its total
assets at the end of the tax year less than $250,000?
If “Yes,” the cooperative is not required to complete
Schedules G, L, M-1, or M-2. Instead, enter the total
amount of cash distributions and the book value of
property distributions (other than cash) made during
the tax year.
▶
$
15 Enter the amount of outstanding nonqualified
notices of allocation (attach statement)
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Form 1120-C (2012)
Form 1120-C (2012)
Page 5
Schedule L Balance Sheets per Books
Beginning of tax year End of tax year
( ) ( )
( ) ( )
( ) ( )
( ) ( )
( ) ( )
Assets
(a) (b) (c) (d)
1 Cash . . . . . . . . . . . . . . .
2a Trade notes and accounts receivable . . . . .
b Less allowance for bad debts . . . . . . .
3 Inventories . . . . . . . . . . . . .
4 Other current assets (attach statement) . . . .
5 Investments (see instructions) . . . . . . .
6 Loans to shareholders . . . . . . . . .
7 Mortgage and real estate loans . . . . . .
8a Buildings and other depreciable assets . . . .
b Less accumulated depreciation . . . . . .
9a Depletable assets . . . . . . . . . . .
b Less accumulated depletion . . . . . . .
10 Land (net of amortization) . . . . . . . .
11a Intangible assets (amortizable only) . . . . .
b Less accumulated amortization . . . . . .
12 Other assets (attach statement) . . . . . .
13 Total assets . . . . . . . . . . . . .
Liabilities and Capital
14 Accounts payable . . . . . . . . . . .
15
Mortgages, notes, bonds payable in less than 1 year
16 Other current liabilities (attach statement) . . .
17 Loans from shareholders . . . . . . . . .
18 Mortgages, notes, bonds payable in 1 year or more
19 Other liabilities (attach statement) . . . . . .
20 Capital stock: a Preferred stock . . . . .
b Common stock . . . . .
21 Additional paid-in capital . . . . . . . . .
22 Patronage dividends allocated in noncash form .
23 Per-unit retains allocated in noncash form . . .
24 Retained earnings—Appropriated (attach statement)
25 Retained earnings—Unappropriated . . . . .
26
Adjustments to shareholders’ equity (attach statement)
27 Less cost of treasury stock . . . . . . . .
28
Total liabilities and capital . . . . . . . .
Schedule M-1
Reconciliation of Income (Loss) per Books With Income per Return
Note: Schedule M-3 required instead of Schedule M-1 if total assets are $10 million or more—see instructions
1 Net income (loss) per books . . . .
2 Federal income tax per books . . .
3
Excess of capital losses over capital gains
4
Income subject to tax not recorded on
books this year (itemize):
5 Expenses recorded on books this year
not deducted in this return (itemize):
a Depreciation . . .
$
b
Charitable contributions
$
c
Travel and entertainment
$
6
Add lines 1 through 5
7
Income recorded on books this year
not included in this tax return (itemize):
Tax-exempt interest
$
8
Deductions in this tax return not charged
against book income this year (itemize):
a Depreciation . . . .
$
b Charitable contributions
$
9 Add lines 7 and 8 . . . . . . .
10
Income (page 1, line 25a)—line 6 less line 9
Schedule M-2 Analysis of Unappropriated Retained Earnings per Books (Schedule L, line 25)
1 Balance at beginning of year . . .
2 Net income (loss) per books . . . .
3 Other increases (itemize):
4
Add lines 1, 2, and 3 . . . . . .
5 Distributions: a Cash . . . . .
b Stock . . . . .
c Property . . . .
6 Other decreases (itemize):
7 Add lines 5 and 6 . . . . . . .
8
Balance at end of year (line 4 less line 7)
Form 1120-C (2012)
