SCHEDULE M-3 (Form 1120)
Department of the Treasury Internal Revenue Service
Net Income (Loss) Reconciliation for Corporations With Total Assets of $10 Million or More
Attach to Form 1120. See separate instructions.
OMB No. 1545-0123
2004
Name
Part I
1a Did the corporation file SEC Form 10-K for its income statement period ending with or within this tax year? Yes. Skip lines 1b and 1c and complete lines 2a through 11 with respect to that SEC Form 10-K. No. Go to line 1b. b Did the corporation prepare a certified audited income statement for that period? Yes. Skip line 1c and complete lines 2a through 11 with respect to that income statement. No. Go to line 1c. c Did the corporation prepare an income statement for that period? Yes. Complete lines 2a through 11 with respect to that income statement. No. Skip lines 2a through 10 and enter the corporation’s net income (loss) per its books and records on line 11. / / / / 2a Enter the income statement period: Beginning Ending b Has the corporation’s income statement been restated for the income statement period on line 2a? Yes. (If “Yes,” attach an explanation and the amount of each item restated.) No. c Has the corporation’s income statement been restated for any of the five income statement periods preceeding the period on line 2a? Yes. (If “Yes,” attach an explanation and the amount of each item restated.) No. 3a Is any of the corporation’s voting common stock publicly traded? Yes. No. If “No,” go to line 4. b Enter the symbol of the corporation’s primary U.S. publicly traded voting common stock c Enter the nine-digit CUSIP number of the corporation’s primary publicly traded voting common stock: 4 Worldwide consolidated net income (loss) from income statement source identified in Part I, line 1 4 5a ( 5b 6a ( 6b 7a 7b 8 9 10 ) )
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Financial Information and Net Income (Loss) Reconciliation
Employer identification number
5a Net income from nonincludible foreign entities (attach schedule) b Net loss from nonincludible foreign entities (attach schedule and enter as a positive amount) 6a Net income from nonincludible U.S. entities (attach schedule) b Net loss from nonincludible U.S. entities (attach schedule and enter as a positive amount) 7a Net income of other includible entities (attach schedule) b Net loss of other includible entities (attach schedule and enter as a negative amount) 8 9 10 11 Adjustment to eliminate transactions between includible and nonincludible entities (attach schedule) Adjustment to reconcile income statement year to tax year of tax return (attach schedule) Other adjustments to reconcile to amount on line 11 (attach schedule) Net income (loss) per income statement of includible corporations. Combine lines 4 through 10
Cat. No. 37961C
11
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Forms 1120 and 1120-A.
Schedule M-3 (Form 1120) 2004
Schedule M-3 (Form 1120) 2004
Page
2
Part II
Reconciliation of Net Income (Loss) per Income Statement of Includible Corporations With Taxable Income per Return Income (Loss) Items
(a) Income (Loss) per Income Statement (optional) (b) Temporary Difference (c) Permanent Difference (d) Income (Loss) per Tax Return (optional)
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34
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Income (loss) from equity method foreign corporations Gross foreign dividends not previously taxed Subpart F, QEF, and similar income inclusions Section 78 gross-up Gross foreign distributions previously taxed Income (loss) from equity method U.S. corporations U.S. dividends not eliminated in tax consolidation Minority interest for includible corporations Income (loss) from U.S. partnerships (attach schedule) Income (loss) from foreign partnerships (attach schedule) Income (loss) from other pass-through entities (attach schedule) Items relating to reportable transactions (attach details) Tax-exempt interest Total accrual to cash adjustment Hedging transactions Mark-to-market income (loss) other than from inventory Inventory valuation adjustments Sale versus lease Section 481(a) adjustments Unearned/deferred revenue Income recognition from long-term contracts Original issue discount and other imputed interest Income statement gain/loss on disposition of assets other than inventory Gain/loss reported on Form 4797, line 18 Gross capital gain from includible corporations Gross capital loss from includible corporations Other gain/loss on disposition of assets other than inventory Disallowed capital loss in excess of capital gains Utilization of capital loss carryforward Other income (loss) items with differences (attach schedule) Other income (loss) items with no differences Total income through 31 (loss) items. Combine lines 1
Total expense/deduction items (from Part III, line 41) Reconciliation totals. Subtract line 33 from line 32 Note. Line 34, column (a), must equal the amount on Part I, line 11, and column (d) must equal the amount on Form 1120, page 1, line 28.
Schedule M-3 (Form 1120) 2004
Schedule M-3 (Form 1120) 2004
Part III
Page 3 Reconciliation of Net Income (Loss) per Income Statement of Includible Corporations With Taxable Income per Return—Expense/Deduction Items
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41
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Expense/Deduction Items
U.S. current income tax expense U.S. deferred income tax expense State and local current income tax expense State and local deferred income tax expense Foreign current income tax expense (other than foreign withholding taxes) Foreign deferred income tax expense Foreign withholding taxes Incentive stock options Nonqualified stock options Other equity-based compensation Meals and entertainment Fines and penalties Punitive damages Excess parachute payments Excess section 162(m) compensation Pension and profit-sharing Other post-retirement benefits Deferred compensation Charitable contribution of cash and tangible property Charitable contribution of intangible property Charitable contribution limitation Charitable contribution carryforward used Current year acquisition or reorganization investment banking fees Current year acquisition or reorganization legal and accounting fees Current year acquisition/reorganization other costs Amortization/impairment of goodwill Amortization of acquisition, reorganization, and start-up costs Other amortization or impairment write-offs Abandonment losses Worthless stock deduction (attach details) Section 198 environmental remediation costs Depletion Depreciation Bad debt expense Expense for contingent liabilities (attach details) Expense for other reserves (attach details) Corporate owned life insurance premiums Section 481(a) adjustments Other expense/deduction items with differences (attach schedule) Other expense/deduction items with no differences Total expense/deduction items. Combine lines 1 through 40. Enter here and on Part II, line 33
(a) Expense per Income Statement (optional)
(b) Temporary Difference
(c) Permanent Difference
(d) Deduction per Tax Return (optional)
Schedule M-3 (Form 1120) 2004