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1120
OMB No. 1545-0123
U.S. Corporation Income Tax Return
Form
Department of the Treasury
Internal Revenue Service
For calendar year 2004 or tax year beginning , 2004, ending
䊳 See separate instructions.
, 20
2004
A Check if: Name B Employer identification number
1 Consolidated return Use
(attach Form 851) IRS
2 Personal holding co. label. Number, street, and room or suite no. If a P.O. box, see page 9 of instructions. C Date incorporated
(attach Sch. PH) Other-
3 Personal service corp. wise,
(see instructions) print or City or town, state, and ZIP code D Total assets (see page 8 of instructions)
4 Schedule M-3 required type.
(attach Sch. M-3) $
E Check if: (1) Initial return (2) Final return (3) Name change (4) Address change
5 Interest 5
6 Gross rents 6
7 Gross royalties 7
8 Capital gain net income (attach Schedule D (Form 1120)) 8
9 Net gain or (loss) from Form 4797, Part II, line 17 (attach Form 4797) 9
10 Other income (see page 11 of instructions—attach schedule) 10
11 Total income. Add lines 3 through 10 䊳 11
12
Deductions (See instructions for limitations on deductions.)
䊳
Date Preparer’s SSN or PTIN
Paid Preparer’s Check if
signature self-employed
Preparer’s
䊳
Firm’s name (or EIN
Use Only yours if self-employed),
Phone no. ( )
address, and ZIP code
For Privacy Act and Paperwork Reduction Act Notice, see separate instructions. Cat. No. 11450Q Form 1120 (2004)
8
I.R.S. SPECIFICATIONS TO BE REMOVED BEFORE PRINTING
INSTRUCTIONS TO PRINTERS
FORM 1120, PAGE 2 of 4
MARGINS: TOP 13 mm (1⁄2 "), CENTER SIDES. PRINTS: HEAD TO FOOT
PAPER: WHITE, WRITING, SUB. 20 INK: BLACK
FLAT SIZE: 216 mm (81⁄2 ") 559 mm (22"), FOLD TO: 216 mm (81⁄2 ") 279 mm (11")
PERFORATE: HORIZONTALLY ON FOLD
DO NOT PRINT — DO NOT PRINT — DO NOT PRINT — DO NOT PRINT
d If the LIFO inventory method was used for this tax year, enter percentage (or amounts) of closing
inventory computed under LIFO 9d
e If property is produced or acquired for resale, do the rules of section 263A apply to the corporation? Yes No
f Was there any change in determining quantities, cost, or valuations between opening and closing inventory? If “Yes,”
attach explanation Yes No
Schedule C Dividends and Special Deductions (see page 18 of (a) Dividends
(b) %
(c) Special deductions
instructions) received (a) (b)
Schedule E Compensation of Officers (see instructions for page 1, line 12, on page 13 of instructions)
Note: Complete Schedule E only if total receipts (line 1a plus lines 4 through 10 on page 1) are $500,000 or more.
(c) Percent of Percent of corporation
(a) Name of officer (b) Social security number time devoted to stock owned (f) Amount of compensation
business (d) Common (e) Preferred
1 % % %
% % %
% % %
% % %
% % %
2 Total compensation of officers
3 Compensation of officers claimed on Schedule A and elsewhere on return
4 Subtract line 3 from line 2. Enter the result here and on page 1, line 12
Form 1120 (2004)
8
I.R.S. SPECIFICATIONS TO BE REMOVED BEFORE PRINTING
INSTRUCTIONS TO PRINTERS
FORM 1120, PAGE 3 of 4
MARGINS: TOP 13 mm (1⁄2 "), CENTER SIDES. PRINTS: HEAD TO FOOT
PAPER: WHITE, WRITING, SUB. 20 INK: BLACK
FLAT SIZE: 216 mm (8 ⁄2 ") 559 mm (22"), FOLD TO: 216 mm (81⁄2 ") 279 mm (11")
1