FOR INFORMATIONAL PURPOSES ONLY
1 Cash ............................................................. 1
2 Trade notes and accounts receivable .......... 2
(a) Less allowance for bad debts ................2a
3 Inventories ................................................... 3
4 Government obligations:
(a) U.S. and instrumentalities ......................4a
(b) State, subdivision, thereof, etc ..............4b
5 Other current assets (provide schedule) ..... 5
6 Loans to shareholders ................................. 6
7 Mortgage and real estate loans ................... 7
8 Other investments (provide schedule) ........ 8
9
Buildings and other xed depreciable assets
.. 9
(a) Less accumulated depreciation .............9a
10 Depletable assets .......................................10
(a) Less accumulated depletion ................10a
11 Land (net of any amortization) ....................11
12 Intangible assets (amortization only) ..........12
(a) Less accumulated amortization ...........12a
13 Other assets (provide schedule) ................13
14 Total assets .................................................14
(A) Amount (B) Total
(C) Amount
(D) Total
BEGINNING OF TAXABLE YEAR
( ) ( )
SCHEDULE OK M-1: RECONCILIATION OF INCOME PER BOOKS WITH INCOME PER RETURN
1 Net income (loss) per books ........................ 1
2 Federal income tax ...................................... 2
3 Excess of capital losses over capital gains .. 3
4 Taxable income not recorded on books this
year (provide schedule) .............................. 4
5 Expenses recorded on books this year not
deducted in this return (provide schedule)
(a) Depreciation $ ___________________
(b) Depletion $ ___________________
(c) Other ___________________________
________________________________
(d) Total of lines 5a, 5b and 5c ....................5d
6 Total of lines 1 through 4 and 5d .................. 6
7 Income recorded on books this year not
included in this return (provide schedule)
(a) Tax exempt interest $ ________________
(b) Other $ ________________
(c) Total of lines 7a and 7b ...........................7c
8 Deductions in this tax return not charged
against book income this year (provide schedule)
(a) Depreciation $ _____________________
(b) Depletion $ _____________________
(c) Other ____________________________
(d) Total of lines 8a, 8b and 8c .................... 8d
9 Total of lines 7c and 8d .................................. 9
10 Net income: line 6 less line 9 ....................... 10
1 Balance at beginning of year ....................... 1
2 Net income (loss) per books ........................ 2
3 Other increases (provide schedule)
___________________________________
__________________________________ 3
4 Total of lines 1, 2 and 3 ................................ 4
5 Distributions: (a) Cash ............................. 5a
(b) Stock ............................. 5b
(c) Property .........................5c
6 Other decreases (provide schedule)
__________________________________ 6
7 Total of lines 5 and 6 ..................................... 7
8 Balance at end of year (line 4 less line 7) ..... 8
BALANCE SHEETS
SCHEDULE OK M-2: ANALYSIS OF UNAPPROPRIATED RETAINED EARNINGS PER BOOKS (LINE 24 ABOVE)
15 Accounts payable ........................................15
16
Mtgs-notes-bonds payable in less than1 yr
...16
17
Other current liabilities (provide schedule)
...17
18 Loans from shareholders ............................18
19
Mtgs-notes-bonds payable in 1 yr. or more
...19
20 Other liabilities (provide schedule) .............20
21 Capital stock: (a) preferred stock ............ 21a
(b) common stock.............21b
22 Paid-in capital surplus (provide reconciliation) ....22
23
Retained earnings-appropriated
(provide sch.)
..23
24 Retained earnings-unappropriated .............24
25
Adjustments to shareholders’ equity
(provide sch.) 25
26 Less cost of treasury stock .........................26
27 Total liabilities and shareholders’ equity ......27
END OF TAXABLE YEAR
PART 3
2021 Form 512 - Page 5
Corporation Income Tax
Name shown
on Form 512:
FEIN