ALL FIELDS MARKED WITH AN ASTERISK (*) ARE REQUIRED. If you cannot attach a document to this form, please DO NOT EMAIL IT. We will provide you access to a secure portal for any additional documents that are required. Tax Return Information What tax year is this submission for? (Please do not attach documents that are not for the tax year you selected. If you need to file returns for more than one year, please submit each year separately through this form.) 20232022202120202019 Is this an amendment? YesNo C Corporation Information Corporation Name EIN Date Incorporated Mailing Address Address Line 1 Address Line 2 City State ZIP Code Contact Information First Name Middle Name Last Name Suffix Email Address Telephone Number Mailing Address Address Line 1 Address Line 2 City State ZIP Code Filing Information State of Incorporation Coporation’s State of Residence Coporation’s Principal Business Activity Date First Authorized to Do Business in State of Residence Did the corporation have a change of business name during the year? YesNo Is there a change of adresss for this year? YesNo Is this a personal service corporation? YesNo Did any entity own more than 50% of the corporation’s voting stock on the last day of the year? YesNo Accounting Method What accounting method does the corporation use? — select an option — CashAccuralOther Please describe your accounting method if you selected “Other” above. Fiscal Year Does the corporation file under a calendar year? YesNo If the corporation does not file under a calendar year, please describe the corporation’s fiscal year. Shareholder Information Number of Shareholders on Last Day of Year Shareholder 1 Full Name Social Security Number Mailing Address Address Line 1 Address Line 2 City State ZIP Code Percent of Shares Owned at Start of Year Percent of Shares Owned at End of Year Dividends Issued to Shareholder During Year Shareholder 2 Full Name Social Security Number Mailing Address Address Line 1 Address Line 2 City State ZIP Code Percent of Shares Owned at Start of Year Percent of Shares Owned at End of Year Dividends Issued to Shareholder During Year Shareholder 3 Full Name Social Security Number Mailing Address Address Line 1 Address Line 2 City State ZIP Code Percent of Shares Owned at Start of Year Percent of Shares Owned at End of Year Dividends Issued to Shareholder During Year Shareholder 4 Full Name Social Security Number Mailing Address Address Line 1 Address Line 2 City State ZIP Code Percent of Shares Owned at Start of Year Percent of Shares Owned at End of Year Dividends Issued to Shareholder During Year Shareholder 5 Full Name Social Security Number Mailing Address Address Line 1 Address Line 2 City State ZIP Code Percent of Shares Owned at Start of Year Percent of Shares Owned at End of Year Dividends Issued to Shareholder During Year Shareholder 6 Full Name Social Security Number Mailing Address Address Line 1 Address Line 2 City State ZIP Code Percent of Shares Owned at Start of Year Percent of Shares Owned at End of Year Dividends Issued to Shareholder During Year Balance Sheet Assets at End of Year Bank Account Balance Accounts Receivable Loans to Shareholders Mortgages and Loans Held by Corporation Stocks, Bonds, and Securities Inventories Other Debts and Equity at End of Year Accounts Payable Payables Less Than One Year Payables More Than One Year Capital Stock (Preferred) Capital Stock (Common) Loans from Shareholders Retained Earnings Income Gross Receipts (excluding income from rental property) Portion of Receipts Reported on Form 1099-K Portion of Recipts Refunded or Returned Gross Receipts From Rental Property Other Income Did the corporation have any other income form this business activity not inclued in gross receipts above? YesNo Please describe any other corporation income not included elsewhere on this form. Cost of Goods Sold Do you manufacture or produce a product for sale to customers? YesNo Do you operate a wholesale or retail business where you maintain an inventory of goods? YesNo Opening Cost of Inventory on First Day of Year Cost of Purchase for Inventory Products Cost of Labor for Inventory Products Cost of Materials and Supplies Other Costs Closing Cost of Inventory on Last Day of Year Business Expenses Advertising Bank Fees Cell Phone Charitable Contributions Commissions and Fees Contract Labor Dues and Subscriptions Employee Benefit Programs Employee Health Insurance Shareholder Health Insurance Other Insurance Internet Service Mortgage Interest Credit Card Interest Loan Interest Janitorial and Cleaning Legal and Professional Services Local Meals Entertainment Credit Card Processing Fees Office Expense Parking and Tolls Postage and Shipping Professional Education and Training Rent Equipment Rental or Lease Repairs and Maintenance Supplies and Small Tools Local Taxes and Business Licenses Payroll Taxes State Taxes Annual Corporation Fees Telephone Expense Utilities Wages Other Asset Depreciation Please upload a list of all assets that were purchased or disposed of during the year. Include a decription of the asset, the date purchased or disposed of, as well as the purchase or sales price. Assets Purchased or Disposed Travel Travel Destinations Please upload a list of all business travel destinations, including the city visited and the number of days in the city, so that per diem rates can be calculated. List of Travel Destinations Travel Expenses Airfare Local Transit (Bus, Train, Taxi) Entertainment Meals (Actual Receipts) Lodging Parking and Tolls Other Other Tax Information Did the corporation purchase a plug-in electric vehicle during the year? YesNo Did the corporation pay wages to any employee who were members of a targeted group? YesNo Did the corporation start a new 401(k) plan during the year? YesNo Did the corporation pay for disabled access equipment during the year? YesNo Did the corporation reimburse employees for childcare expenses during the year? YesNo Did the corporation make energy-efficiency improvements during the year? YesNo U.S. Manufacturing Activity Did the corporation manufacture or build a product inside the United States during the year? YesNo If the corporation manufactured a product in the U.S., please upload details including gross receipts from the product, cost of domestically produced goods, direct and indirect expenses/deductions/losses attibutable to the product, and wages paid for the year. U.S. Manufacturing Details Business Use of Automobile Does the corporation maintain a written policy prohibiting all personal use of company vehicles? YesNo Does the corporation maintain a written policy prohibiting all personal use of company vehicles except commuting? YesNo Does the corporation treat all use of vehicles as personal use? YesNo Does the corporation provide more than five vehicles to employees and keep records? YesNo Automobile Use by Major Shareholders Please upload a document containing the following information for each vehicle used by a 5% or more owner of the business: Purchase price of the vehicle Make and year of the vehicle Date first used in the business Business miles driven this year Commuting miles driven this year Personal-use miles driven this year Interest paid on loan to purchase vehicle Was the vehicle available for personal use? Was the vehicle used primarily by a 5% or more owner of the corporation? Is another personal-use auto available to the shareholder? Was the standard mileage rate user last year? Automobile Use by Major Shareholders Automobile Expenses Mileage Reimbursement Paid to Employees and Shareholders Garage Rent Gas Insurance Licenses Oil Parking Fees Lease Payments Repairs Tires Tolls Registration Fees Other Interest and Dividend Income Please attach copies of all interest and dividend statments below, under “Other Tax Document Uploads”. Do you have money in or ownership of a bank account in a foreign country? YesNo Corporation Foreign Accounts Does the corporation have ownership or control over a foreign financial account or trust? YesNo If yes, provde the name(s) of the country and maximum account values for the year: Sale of Stock, Real Estate, and Other Property Property 1 Description of Property Sold Date Purchased Purchase Price Date Sold Sales Price Property 2 Description of Property Sold Date Purchased Purchase Price Date Sold Sales Price Property 3 Description of Property Sold Date Purchased Purchase Price Date Sold Sales Price Property 4 Description of Property Sold Date Purchased Purchase Price Date Sold Sales Price Other Tax Document Uploads Please attach additional documents below. If you received an electronic document from the issuer, please upload it. If you received a paper document, please scan the document or take a photograph of the document with your smartphone. Make sure the entire page can be read. If the document has multiple pages, please upload it as a pdf. Tax Document 1 Tax Document 2 Tax Document 3 Tax Document 4 Tax Document 5 Tax Document 6 Tax Document 7 Tax Document 8 Tax Document 9 Tax Document 10 Tax Document 11 Tax Document 12 Tax Document 13 Tax Document 14 Tax Document 15 Tax Document 16 Tax Document 17 Tax Document 18 Tax Document 19 Tax Document 20 Additional Comments Is there anything you would like us to know when preparing your tax return? Signature I acknowledge that the above information provided is true and accurate to the best of my knowledge, and I hereby affirm that I have documentation to support this information. I relieve this tax preparer, its agents and affiliates, from any liability whatsoever, regarding the preparation of this/these tax returns, and agree to hold them harmless from any damages I or the corporation may suffer and understand that the sole relief is limited to the return of any fee paid for the preparation of these tax documents. I guarantee payment of the preparation fee and any related charges. Sign this form by typing your name below. Contact Signature X
