Form 1045 Form 1045 Application for Tentative Refund

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ro BEREMOYED BEFOBE PRINTIHG

I.R.S. SPECIFIQTIONS

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IhlSTAUC7ONS 7 0 PRNTGflS
FOHM 1045 P G 1 d 4
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Appllcatlon for Tehtatlve Refund
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far an unused credlt created by andher carryback, enter year of frsi carrybeck t ...........
f a t ~ r n(01 3oprai- retumt lor a o m ~ k, t Pol all, i!he lax yeam nvolved rn figwrng .na carryback, 11sf 1ks

IS

H you lilsd a julM
y w s and r ~ s c ~whether
ty
iolnt

U] or separate [SJreiurr tor e x h ................................................
It SSN for carryback year IS dltierenl trom above, entar a SSh t.........................
and b vear(s) ...........................
11 vou chnged y ~ u accounlrngpenod.
r
glue daleper1nls5ioo lo chrnge was gr;ln!ed b
. . . . . . . . .
Have you 11lWa pnXlon 111 T& h u r t tor the yoar(e) !o rrhlch ma wrryback IS :Q be apOlud7
C Yes 3 No
7 4 G I*,?
Is any part ot the decr4899 in tax d M to a 107s or credt from a ta? shplter wu~lredto be reglsierad7

. . . . .

Subtract hns 12 h , m rirw 11 .

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Exernpticns isee page 5 ol me ~nsl~uctionsl
15 Taxable Income hw 13 mlnus lne l a
16 IncQme L a * . SBB p a 9 5 cl ths
~nsVuctlul?s
and anach en orplaiarion
17 Alternaws mlnlmun tax
. .
18 Add lirds 15 and ' 7
,
19 Genera! business credlt (S*m page 5
ot the lnnwnlons,
XI Omercrel~Ls.Ldenr~b . . . .
21 Total credits. Ada lhnss 19 and 20 .
22 SuMracl lnw 2 l llom line 1B . .
14

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23
24
25
28

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. . . . . . . -

sew-emphymen~r~
Mherlaxss.
Total ra* Add IIWS 22 1 nrouph 24
Cntar tns arnnrolt from the * A h
carryoack" column on lbne 25 for

Keapaamof
,% W W W ?
tw your recore

Pm0.r.r

Otnor

Than taxpaydr

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s,gra~ure
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Prlvacq Act, and h p o W O c k AeduCtron *cluotM.
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Form 1 M S

(?md

PW

2

Schedule A--NOL (see p a p 6 of Ine ~nslructions)

:r'

5

If llne 3 is more than line 2, enter rrm a~flwencs.

(see page 6 of the Instructlony

13

If 4lne 8 1s mme than ltne 6, mlsr lha onlerence
otherwise. enter -0-But do nbt enter mum than
line 5
. .
Business caprtal losses beforb Ismrrar~DnEwer a
Business capital galna (wrrhou! regard ro any
swctlon 1202 exclus~on)
.
Add lines 10 and 12

15

Aad llnes 4 and t 4

16

Enter the loss. 11 any, Imrn Ime 16 of Schscluls 0 {Form 10401 (Esiates
and trusts, enlu tna loss. 11 any. irdm Ihne 15, column (31, at SCnaduld O
(Form 104:j.) Enter as a posltlve nummr. H yrlu do no! h u e a ldss an
lhal lvre {and do not have a sactbon 1ZM exclus~oo\.ship llntls I6 lnlouqn
I1 and enter on l~ne22 the amount from line 15

17
18

Section r202 sxclushon. Enter as a posltrve number
5ubtrsct lhne 77 from line 18 If zero or less. sntsr -0-

19

Enter the loss, uf any, from line 21 o l Schsduls D (Form lD40).(Estates
and trusts, enter ths 1m5. ~fany. from Inns 16 of Schedule D (Form l M l l )
Erit~ras a positwe numoer .
,
. . . . . . .
Iflhne 18 1s more lhan l~net9. enter ttm duiierence: othenu~se,entw -0Ifline 19 IS more than line 18. enter the dlffersncs; otherrrqss, enter -0-

70

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H
12

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20
21
22

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. . . .

Subtract 11ne20 from line 15. It zero or less. entar -D-

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5,-

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Schedule &NOL

Canyowr lses page 6 of the instruct~ms)

I

-

carqbach year

M w t h (see OaGe 6 of ;ha
InstNct~ms)Entw as apwlrlve nu-

2

laxah* Income bsiore
C3FtYO%k

page

(56s

$'fnmx,
::

EWW
i ~ d
lrlCreaS9 thrs amount by Ihe sum of
tlw chd"trb10 JmJucl~onand Income
d~-,trlbu'~on ded~ctldn
.
,
lnstrunms)

.

3 Net Captat loss deduct101[seepage

.

4
5

091 rrm ~rrat~ur.tur*sl , .
,
Sect~on1202 exclus~onEnter as a
m s ~ t ~ ournnqr
vd
. . . . .
Oornsstlc
productaon acllvnles
dedUNUn

6

7

a

,

.

,

,

Adlustnent to adlusTed g'ossmcome
Ism wqa 7 at ?he ,nslttc[consj .
Adtustment to ~temlzecldgduct~?ns
(see m4e 7 or ms ,ns?rcclms)
.

.

Ind~v~duals. wter
b a W m 5

tor

deducilon

(mks any ampt ?n

ram w l a . H k w m h s M

m.3 Frrarop

a M Turle. FMer
atsmpbq arnuunt . . . . . .
9 MoblllW W ~ ~ C I iRr ~ ~ v r n Corn>lno
e
llnss 2 lhrougn 8 It zero or less.
e17ter-0,
,
,
,
10 HOL carryover (see plya 7 01 the
knstrucf~ons).
Sabtra~t\lie9 from llne
1 H zrro or lers, enter -0-

. . .

Adjustment tc Itsmlr&
DeducUons (Lndivlduals Only)

11

12
13
7.

15
16

17

Cornplcto lhnac ? 1 thgough 1 5 fm lhn
carryback yaar(s) tor uhlch you
Itemlzetl deduel~onsonly ~f I~ne3. 4.
w 5 r b v e I S nwe lhm z w 9 .
Adlustel gross Income before 2007'E
t4OL carrybarn
. , ,
Add hnw 3 twough A abnue
Modd~edad~urtsdgram Income add
!lnes 11 and '2
Mwll;al exparses hem Sch & :Form
104U. 11ns4 (cr as prWlously adllstscl)

. . . . . . .

Medlcal espsnsss flnrr. Sch A lFom
I 0473 lhle 1 irr
PIWOUB?~ adprred]
Munply lhne ' 3 by 7 5% ! 0 7 5 )
SuWrair line I8 from Ilna 15. .im r o

. .

less. elllel -0- . . . .
l I 7 from ' W e 14
16 S u b ~ a r bne

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Or

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3

Schedule B-NOL

cont tin^

Camvsr

Complela one column betore Bung t o the
nexl column Start wlfh the sarliml
carryback veer.

$9 Mhl~lhW adlusted gmss Incoma
from llne 13 on page 3

.

20

21

22

. . .

Enter as a w l ~ v number
e
any NOL
carryback trbrn a year before 2 0 q
that was a e u ~ c r ~tod figure lina 11
on page 3
. , , , ,
Addllnss t 9 a n d 2 0 . . .
Lbnubleconlnbut~ms
lrcm Srh A Form
IadO),IIW
18, or X h . A (Fonn IUWNRI,
IIM 7 (Was W V I ~adlulndl.
Rsfigured c h a r l t ~ l e COfIiIihul~~rrs
(see page 7 of the I.isrrucrlons)
Sublran \ma 23 horn lhre 22

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23

24
25

26

27

28
29

24

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Casualty and then losses from Form
4684 h e 18 (l~ns20 for 2005
as prwausly ddlusled)
Cdsva y and then Isses horn Form
W ,
lhne 18 (11"s1B tor ZW5
la as prev~ousyadlunwl
Mult~plyline 19 by 1C% ( 101

4

7

~ . d

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. . .

Subtract Line 27 horn I~ne26 If zero
or less, emar -0-. . .
.
Subiracl line 28 from llne 25 .

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.

M~scerlanaousdemrzed dnducr~nns
!ram %h A (Form 10401, llne 26. or
scn. A
iMONR). line 15 :or AS

om

prev~ouslyadiunadl

,

,

31

M~scJlaneous ~lnmlrnddeduct~ons
from Sct. A ( F o m 10401,
llne 23, or
Sch. A (Form !O.LONRl. Ihne 12 (or as
~ r a v ~ o u saOlUStedl
lv
. . .

32
33

MultrpJ{ line 19 by 2% (.02)

. .

34

35

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bbtract line 32 from lhne3r If;em
or lass. -mter -0Sutnract lhne 33 from line 30
Complete the wohsheel on pnga IIa!
tne ~nstructsons~fI~na19 ~smoreman
the applicable amount shown h a w
(more than ons-hall that amount If
rnarned hhng s w r & l y for that year).

. .

-D
'-

-a $121,200 for

8
4
4

1997.
$ 1 2 4 . 5 ~tor 19Pa
$lze.eca for i499
$128.950 tor 2000.
$132,950 lOf SOD1
$137 30D ? o r 2 0 2
1139.500 lor 2003
$142,7(10 for 2004
$145.950 lor 2005

r,-I

.,StothewIs~,
combine lbnes 18,24,28.
and 34: enter the result here and dn
line 7 (page 3)
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