For. 1 045

For. 1 045 Department of the Treason. Internal Revenue Service Application for Tentative Refund So Separate instructions and additional information are available at Irs.govIlom11045. Pio Do not attach to your income tax return. Mall In a separate envelope. hir For use by individuals estates. or trusts. OMB No. 1545-0098 2014 g t a ° Name(s) shown on return Social security or emp oyer identification number Number. street. and apt. or stile no. It a M . box. see instructions. Spouse's social security number (SSN) City. town or post office. state, and ZIP coda. If a foreign address. also complete spaces below (see instructions). Daytime phone number Foreign country name Foreign province/county Foreign postal code 1 This application is filed to carry back: a Net operating loss (NOL) (Sch. A, line 25. page 2)' $ b Unused general business credit $ e Net section 1256 contracts loss $ year 2014, or other tax year 2a For the calendar beginning , 2014, and ending , 20 b Date tax return was filed 3 ff this application is for an unused credit created by another carryback, enter year of first carryback ► 4 If you filed a joint return (or separate return) for some, but not all, of the tax years involved in figuring the canyback, list the years and specify whether joint (J) or separate (S) return for each O. 5 If SSN for canyback year is different from above, enter a SSN ► and b Year(s) ► 6 If you changed your accounting period, give date permission to change was granted ► 7 Have you filed a petition in Tax Court for the year(s) to which the carryback is to be applied? 0 Yes 0 No 8 Is any part of the decrease in tax due to a loss or credit resulting from a reportable transaction required to be disclosed on Form 8886, Reportable Transaction Disclosure Statement? 9 If you are carrying back an NOL or net section 1256 contracts loss, did this cause the release of foreign tax credits or the release of other credits due to the release of the foreign tax credit (see instructions)? . . . 0 Yee 0 No 0 Yes 0 No Computation of Decrease in Tax (see instructions) Note: If la and lc are blank, slop lines 10 through i5. preceding IP preceding llo• preced ng lio tax year ended tax year ended tax year ended Before After canyback Before canyback After canyback Before carryback After canyback 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 NOL deduction after canyback (see instructions) Adjusted gross income Deductions (see instructions) . . Subtract line 12 from line 11 . . Exemptions (see instructions) . . Taxable income. Line 13 minus line 14 Income tax. See instructions and attach an explanation Alternative minimum tax Add lines 16 and 17 General business credit (see instructions) Other credits. Identify Total credits. Add lines 19 and 20 . Subtract line 21 from line 18 . . Self-employment tax Other taxes Total tax. Add lines 22 through 24 . Enter the amount from the "After carryback" column on line 25 for each year Decrease in tax. Line 25 minus line 26 IMINI 28 Overpayment of tax due to a claim of right adjustment under section 1341(b)(1) (attach computation) . . . Sign Here Keep a copy of this application for your records. and belief, they are true. correct. and complete. Your signature Date Spouse's signature. If Form 1045 is fled jointly, both must sign. Date Paid Preparer Use Only Print/Type preparer's name Preparer's signature Date Check 0 ff self-employed PTIN Firm's name P. Arm's EIN ► Fin's address a. Phone no. Under penalties of perjury. I declare that I have exarnmed this appbcabon and accompanying schedules and statements. and to the best of my knowledge For Disclosu e, Privacy Act, and Paperwork Reduction Act Notice, see Instructions. Forrn 10450014 EFTA01220962 Forth 1045 (2014) Page 2 Schedule A— NOL (see instructions) 1 Enter the amount from your 2014 Form 1040, line 41, or Form 1040NR, line 39. Estates and trusts, enter taxable income increased by the total of the charitable deduction, income distribution deduction, and exemption amount 2 Nonbusiness capital losses before limitation. Enter as a positive number 3 Nonbusiness capital gains (without regard to any section 1202 exclusion) 3 4 If line 2 is more than line 3, enter the difference. Otherwise, enter -0- 5 If line 3 is more than line 2, enter the difference. Otherwise, enter -0- 6 Nonbusiness deductions (see instructions) 7 Nonbusiness income other than capital gains (see instructions) 8 Add lines 5 and 7 9 If line 6 is more than line 8, enter the difference. Otherwise, enter -0- 10 If line 8 is more than line 6, enter the difference. Otherwise, enter -0-. But do not enter more than line 5 10 11 Business capital losses before limitation. Enter as a positive number 12 Business capital gains (without regard to any section 1202 exclusion) 12 13 Add lines 10 and 12 14 Subtract line 13 from line 11. If zero or less, enter -0 15 Add lines 4 and 14 16 Enter the loss, if any, from line 16 of your 2014 Schedule D (Form 1040). (Estates and trusts, enter the loss, if any, from line 19, column (3), of Schedule D (Form 1041).) Enter as a positive number. If you do not have a loss on that line (and do not have a section 1202 exclusion), skip lines 16 through 21 and enter on line 22 the amount from line 15 1 17 Section 1202 exclusion. Enter as a positive number 18 Subtract line 17 from line 16. If zero or less, enter -0- 19 Enter the loss, if any, from line 21 of your 2014 Schedule D (Form 1040). (Estates and trusts, enter the loss, if any, from line 20 of Schedule 0 (Form 1041).) Enter as a positive number 20 If line 18 is more than line 19, enter the difference. Otherwise, enter -0- 20 21 If line 19 is more than line 18, enter the difference. Otherwise, enter -0- 22 Subtract line 20 from line 15. If zero or less, enter -0- 23 Domestic production activities deduction from your 2014 Form 1040, line 35, or Form 1040NR, line 34 (or included on Form 1041, line 15a) 24 NOL deduction for losses from other years. Enter as a positive number 25 NOL Combine lines 1, 9, 17, and 21 through 24. If the result is less than zero, enter it here and on page 1, line la. If the result is zero or more, you do not have an NOL 13 14 15 16 18 19 17 21 22 23 24 25 Form 1045 (2010) EFTA01220963 Fomi 1045 (2014) Par 3 Schedule B—NOL Carryover (see instructions) Complete one column before going to the next column. Start with the earliest canyback year. 1 NOL deduction (see instructions). Enter as a positive number . . . 2 Taxable income before 2014 NOL carryback (see instructions). Estates and trusts, increase this amount by the sum of the charitable deduction and income distribution deduction . . 3 Net capital loss deduction (see instructions) 4 Section 1202 exclusion. Enter as a positive number 5 Domestic production activities deduction 6 Adjustment to adjusted gross income (see instructions) 7 Adjustment to itemized deductions (see instructions) 8 Individuals, enter deduction for exemptions (minus any amount on Fomi 8914, line 6, for 2006 and 2009; line 2 for 2005 and 2008). Estates and trusts, enter exemption amount . 9 Modified taxable income. Combine lines 2 through 8. If zero or less, enter -0- 10 NOL carryover (see instructions) . . Adjustment to Itemized Deductions (Individuals Only) Complete lines 11 through 38 for the carryback year(s) for which you itemized deductions only if line 3, 4, or 5 above is more than zero 11 Adjusted gross income before 2014 NOL carryback 12 Add lines 3 through 6 above . . 13 Modified adjusted gross income. Add lines 11 and 12 14 Medical expenses from Sch. A (Form 1040), line 4 (or as previously adjusted) 15 Medical expenses from Sch. A (Form 1040), line 1 (or as previously adjusted) 16 Multiply line 13 by percentage from Sch. A (Form 1040), line 3 . . . . 17 Subtract line 16 from line 15. If zero or less, enter -0- 18 Subtract line 17 from line 14. . . . 19 Mortgage insurance premiums from Sch. A (Form 1040), line 13 (or as previously adjusted) 20 Refigured mortgage insurance premiums (see instructions) . . 21 Subtract line 20 from line 19 . preceding preceding tax year ended ► tax year ended ► preced ng tax year ended ► Form 1045 (2014) EFTA01220964 Form 1045 (2014) Page 4 Schedule B—NOL Carryover (Continued Complete one column before going to the next column. Start with the earliest canyback year. preceding Dv preced ng Doi preced ng liii tax • ar ended ended tax ear ended 22 23 24 25 26 27 28 2g 30 31 32 33 34 35 36 37 38 Modified adjusted gross income from line 13 on page 3 of the form . . Enter as a positive number any N0L carryback from a year before 2014 that was deducted to figure line 11 on page 3 of the form Add lines 22 and 23 Charitable contributions from Sch. A form 1040). line 19 pine 18 for 2004 through 2006), or Sch. A (Form 1040NR), line 5 pine 7 for 2004 through 2010). or as previously adjusted Refigured charitable contributions (see instructions) Subtract line 26 from line 25 . . Casualty and theft losses from Form 4684, line 18 (line 23 for 2008; line 21 for 2009; line 20 for 2005, 2006, and 2010) Casualty and theft losses from Form 4.684, line 16 (line 21 for 2008; line 18 for 2005, 2006, and 2010; line 19 for 2009) Multiply line 22 by 10% (.10) . . Subtract line 30 from line 29. If zero or less, enter -0- Subtract line 31 from line 28 . . Miscellaneous itemized deductions from Sch. A (Fan 1040). line 27 Oine 26 for 2004 through 2006), ix Sch. A (Form 1040NR). line 13 Pine 15 for 2004 through 2010), or as previously adjusted Miscellaneous itemized deductions from Sch. A (Fnm 1040). line 24 Oine 23 for 2004 through 2006), cri Sch. A (Form 1040NR). line 10 (line 12 for 2004 through 2010), or as previously adjusted Multiply line 22 by 2% (.02) . . . Subtract line 35 from line 34. If zero or less, enter -0- Subtract line 36 from line 33 . . Complete the worksheet in the instructions if line 22 is more than the applicable amount shown in the instructions. Otherwise, combine lines 18, 21, 27, 32, and 37; enter the result here and on line 7 (page 3) . . . Form 1045 pout EFTA01220965