New York Report by a Corporation Included in a Combined Franchise Tax Return (OBSOLETE)

Report by a Corporation Included in a Combined Franchise Tax Return (OBSOLETE)
Form CT-3-A/C:2014:Report by a Corporation Included in a Combined Franchise Tax Return:CT3AC
CT-3-A/C Report by a Corporation Included in a
New York State Department of Taxation and Finance

Combined Franchise Tax Return

Final return

Tax Law — Article 9-A

Employer identification number (EIN)	

File number	

)	

Legal name of corporation			

		

Mailing name (if different from legal name above) 		

		
		

c/o

	 Foreign corporations: date began 	
	 business in NYS

City	
State	
ZIP code	
					

NYS principal business activity

	 Combined parent’s corporation legal name	

Date received (for Tax Department use only)

	 Date of incorporation

		

If address/phone
above is new,
mark an X in the box

Trade name/DBA

	 State or country of incorporation

	

Number and street or PO box			

NAICS business code number (from NYS Pub 910)

ending

Business telephone number	

(	

		

All filers must enter tax period:

beginning

If you need to update your address or
phone information for corporation tax, or
other tax types, you can do so online. See
Business information in Form CT-1.
Combined parent’s EIN	

Audit (for Tax Department use only)

Combined issuer’s allocation percentage (from CT-3-A, line B)

%

			

Metropolitan transportation business tax (MTA surcharge) ­— During the tax year, did you do business, employ
capital, own or lease property, or maintain an office in the Metropolitan Commuter Transportation District (MCTD)?
(mark an X in the appropriate box)................................................................................................................................... 	Yes	

No

If you are a real estate investment trust (REIT) or regulated investment company (RIC), mark an X in the box (see instructions). ...........
If you claimed the QEZE tax reduction credit and you had a 100% zone allocation factor, mark an X in the box..................................
If you claimed the tax-free NY area tax elimination credit and you had a 100% area allocation factor, mark an X in the box...............
If you claimed the tax-free NY area excise tax on telecommunications credit and you had a 100% area allocation factor,
  mark an X in the box.............................................................................................................................................................................
If you are an overcapitalized captive insurance company, mark an X in the box...................................................................................
Fixed dollar minimum tax (see instructions)
1a	 New York receipts.............................................................................	 1a
	1b	 Fixed dollar minimum tax (only for the corporation filing this form) ........................................................... 	 1b
	 2	 Corporations organized outside New York State must complete the following for capital stock issued and outstanding:
	 Number of par shares	

Value	

		

$		

Number of no-par shares	

Value

$

Composition of prepayments (see instructions)
Franchise tax
	 Date paid	

Amount	

	 3	 Mandatory first installment		 3	
	4a	 Second installment from Form CT-400		 4a	
4b	 Third installment from Form CT-400		 4b	
4c	 Fourth installment from Form CT-400		 4c	
	 5	 Payment with extension request		 5	
	 6	 Credit from prior years (see instructions) .......... 	 6	
	 7	 Add amount columns (enter here and include			
		  on Form CT‑3‑A, line 107; see instructions) ....... 	 7	
See page 2 for third-party designee, certification, and signature entry areas.
437001140094

MTA surcharge
Date paid	

. .............	 3
. .............	 4a
. .............	 4b
. .............	 4c
. .............	 5
. ................................	

6

(enter here and include on
Form CT-3M/4M, line 51). 	

7

Amount

Page 2 of 2  CT-3-A/C (2014)
Designee’s name (print)	
Third – party 		 Yes	
No
designee 	 Designee’s e-mail address

Designee’s phone number

(		

(see instructions) 				

)

PIN

Certification: Under the penalties of perjury, I declare that this corporation is allowed to file on a combined basis under New York State
Law and is also liable for the group tax liability, and I certify that this report and any attachments are to the best of my knowledge and
belief true, correct, and complete.
Authorized
person
Paid
preparer
use
only
(see instr.)

Printed name of authorized person	

Signature of authorized person	

	 E-mail address of authorized person	

Telephone number	

(		

	 Firm’s name (or yours if self-employed)		
	 Signature of individual preparing this report	

Address	

	 E-mail address of individual preparing this report		

If not e-filing, attach this report to the parent corporation’s Form CT-3-A.

437002140094

Official title

)

Firm’s EIN	

Date
Preparer’s PTIN or SSN

City	
Preparer’s NYTPRIN	

State	
Date

ZIP code