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                          2016   DELAWARE 2016                           DO NOT WRITE OR STAPLE IN THIS AREA - REVENUE CODE 0042 
     CORPORATION INCOME TAX RETURN 
                          FORM 1100 
                            FOR CALENDAR YEAR 2016                                                                                                                                                   Reset
for Fiscal year beginning                     and ending
                                                                                                                                                                                                     Print Form

EMPLOYER IDENTIFICATION NUMBER 
Name of Corporation 

Street Address

City                                    State            Zip Code
                                                                                                                                                  CHECK APPLICABLE BOX: 
Delaware Address if Different than Above
                                                                         INITIAL RETURN                                                           CHANGE OF ADDRESS                                  EXTENSION ATTACHED
City                                             State           Zip Code
                                                                         IF OUT OF BUSINESS, ENTER DATE HERE: 
State of Incorporation:   Nature of Business:                                                                                                     DATE OF INCORPORATION: 
                          ATTACH COMPLETED COPY OF FEDERAL FORM 1120
1.  Federal Taxable Income (See Specific Instructions) .......................................................................................................................... 
2.  Subtractions:   (a)  Foreign dividends, interest and royalties ...........................................................
                    (b)  Net interest from U.S. securities (Schedule 1, Column 2) .................................
                    (c)  Interest from affiliated companies (Schedule 1, Column 3) ............................... 
                    (d)  Gain from sale of U.S. or Delaware securities ...................................................
                    (e)  Wage deduction - Federal Jobs Credit ..............................................................
                    (f)   Handicapped accessibility deduction (Attach statement) ...................................
                    (g)  Net operating loss carry-over .............................................................................
                    (h)  Other .................................................................................................................. 
                    (i)   Total. Add Lines 2(a) through 2(h) .....................................................................................................................
3.  Line 1 minus Line 2(i) .......................................................................................................................................................................
4.  Additions:    (a)  All state and political subdivision income taxes deducted in computing Line 1 ....
                  (b)  Loss from sale of U.S. or Delaware securities ......................................................
                  (c) Interest income from obligations of any state except DE (Schedule 1, Column 4)
                  (d)  Depletion expense - oil and gas ............................................................................
                  (e)  Interest paid affiliated companies (See Instructions) ............................................. 
                  (f) Donations included in Line 1 for which Delaware income tax credits were granted
                  (g)  Total. Add Lines 4(a) through 4(f) .........................................................................................................................
5.  Entire net income [Line 3 plus Line 4(g)] ..........................................................................................................................................
WHERE LINE 5 IS DERIVED ENTIRELY FROM SOURCES WITHIN DELAWARE, ENTER AMOUNT ON LINE 11.
WHERE THE ENTIRE INCOME IS NOT DERIVED FROM SOURCES WITHIN DELAWARE, COMPLETE ITEMS 6 TO 10 INCLUSIVE. 
6.  Total non-apportionable income (or loss) (Schedule 2, Column 3, Line 8) .......................................................................................
7.   Income (or loss) subject to apportionment (Line 5 minus Line 6) ....................................................................................................
8.   Apportionment percentage (Schedule 3D, Line 8) .......................................................................... 
9.   Income (or loss) apportioned to Delaware (Line 7 multiplied by Line 8) ..........................................................................................
10.  Non-apportionable income (or loss) (Schedule 2, Column 1, Line 8) ...............................................................................................
11.  Total (Line 9 plus or minus Line 10) .................................................................................................................................................
12.  Delaware Taxable Income (Line 5 or Line 11, whichever is less) ....................................................................................................
13.  Tax @ 8.7%  ....................................................................................................................................................................................
14.  Delaware tentative tax paid .............................................................................................................
15.  Credit carry-over from prior year ......................................................................................................
16.  Other payments (attach statement) .................................................................................................
17.  Approved income tax credits ...........................................................................................................
18.  Total payments and credits. Add Lines 14 through 17 .....................................................................................................................
19.  If Line 13 is greater than Line 18 enter BALANCE DUE AND PAY IN FULL ...................................................................................
20. If Line 18 is greater than Line 13 enter OVERPAYMENT:                (a) Total OVERPAYMENT ........................................ 
                                                                         (b)  to be REFUNDED ............................................... 
               *DF11016019999*                                           (c)  to be CREDITED to 2017 TENTATIVE TAX ....... 
                          DF11016019999
                          PLEASE SEE REVERSE SIDE FOR SIGNATURE LINES AND MAILING INSTRUCTIONS. 



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        SCHEDULE 1 - INTEREST INCOME                                        2016                 FORM 1100            PAGE 2
        Description Of                         Column 1                     Column 2           Column 3                              Column 4               Column 5 
         Interest                            Foreign Interest       Interest Received       Interest Received From                   Interest Received      Other Interest 
                                                                    From U.S. Securities    Affiliated Companies                     From State Obligations Income
1                                                                                                                                                                                   1
2                                                                                                                                                                                   2
3                                                                                                                                                                                   3
4                                                                                                                                                                                   4
5                                                                                                                                                                                   5
6 Totals                                                                                                                                                                            6
        SCHEDULE 2 - NON-APPORTIONABLE INCOME ALLOCATED WITHIN AND WITHOUT DELAWARE 
                  Description                                                 Column 1                                               Column 2               Column 3 
                                                                            Within Delaware             Without Delaware                                    Total
1 Rentsand royalties from tangible property                                                 00                                                00                                 00 1
2 Royalties from patents and copyrights                                                     00                                                00                                 00 2
3 Gains or(losses) from sale ofreal property                                                00                                                00                                 00 3
4 Gains or(losses) from sale ofdepreciable tangible property                                00                                                00                                 00 4
5 Interest income from Schedule 1, Columns 4 and 5, Line 6                                  00                                                00                                 00 5
6 Total                                                                                     00                                                00                                 00 6
7 Less: Applicable expenses (Attach statement)                                              00                                                00                                 00 7
8 Total non-apportionable income                                                            00                                                00                                 00 8
        SCHEDULE 3 - APPORTIONMENT PERCENTAGE 
                                               Schedule 3-A - Gross Real and Tangible Personal Property 
                                                                    Within Delaware                                                  Within and Without Delaware 
         Description
                                                                    Beginning of Year       End of Year                              Beginning of Year      End of Year 
1 Real and tangible property owned                                                    00                00                                             00                        00 1
2 Real and tangible property rented (Eight times annualrental paid)                   00                00                                             00                        00 2
3 Total                                                                               00                00                                             00                        00 3
4 Less: Value at original cost of real and tangible property, the                     00                00                                             00                        00 4
  income from which is separately allocated (See instructions)
5 Total                                                                               00                00                                             00                        00 5
6 Average value (See instructions)                                                                      00                                                                       00 6
                       Schedule 3-B - Wages, Salaries, and Other Compensation Paid or Accrued to Employees 
                                        Description                                            Within Delaware                                       Within and Without Delaware 
1 Wages, salaries, and other compensation of all employees                                                                                    00                           00       1
2 Less: Wages, salaries, and other compensation of general executive officers                                                                 00                           00       2
3 Total                                                                                                                                       00                           00       3
                                               Schedule 3-C - Gross Receipts Subject to Apportionment 
1 Gross receipts from sales of tangible personal property                                                                                     00                           00       1
2 Gross income from other sources (Attach statement)                                                                                          00                           00       2
3 Total                                                                                                                                       00                           00       3
                                               Schedule 3-D - Determination of Apportionment Percentage 
1 Averagevalue ofreal and tangible propertywithin Delaware                                                                                    00                           %        1
                                                                                                                                                     =
2 Averagevalue ofreal and tangible propertywithin and without Delaware                                                                        00                                    2

3 Wages, salaries and other compensation paid toemployees within Delaware                                                                     00     =                     %        3
4 Wages, salaries and other compensation paid toemployees within and without Delaware                                                         00                                    4

5 Gross receipts and gross income from within Delaware                                                                                        00     =                     %        5
6 Gross receipts and gross income from within and without Delaware                                                                            00                                    6

7 Total                                                                                                                                                                             7
                                                                              *DF11016029999*
8 Apportionment percentage (See instructions)                                               DF11016029999                                                                  %        8
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief it is true, correct, and complete. 
If prepared by a person other than the taxpayer, the declaration is based on all information of which the preparer has any knowledge.

  Date                                  Signature of Officer                                   Title                                                        Email Address

  Date                 Signature of individual or firm preparing the return                                                                   Address

        MAKE CHECK PAYABLE AND MAIL TO:        Delaware Division of Revenue, P.O. Box 2044, Wilmington, DE 19899-2044 
                                                                                                                                                     (Form Revised 07/2016)






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