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Schedule
UB
Form CIT-120 W LIST OF MEMBERS IN UNITARY COMBINED GROUP
2022
CORPORATION NAME FEIN
Common year ending for the unitary business group:
MM / DD / YYYY
List all members (See speci fic Instructions)
Year ending
Group# Name FEIN Total Tax from Total Payments & Prior Year
(1 – 3) MM YYYY UB-CR, Column C4 Credits
.00 .00
.00 .00
.00 .00
.00 .00
.00 .00
.00 .00
.00 .00
.00 .00
.00 .00
.00 .00
.00 .00
.00 .00
.00 .00
.00 .00
.00 .00
.00 .00
.00 .00
.00 .00
.00 .00
.00 .00
.00 .00
NOTE: After completing this schedule, see Schedule UB Instructions for Completing Form CIT-120
*B30202213W*
B30202213W
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