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    CAUTION

These forms are for reference only. 

DO NOT mail to the Division of Taxation.

Form CBT-100 and all related forms and 

schedules must be filed electronically. See 

our website for more information. 



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                                                                                                                                                                                                               2022 – CBT-100 – Page 1
                                          2022                                        DO NOT MAIL THIS FORM
                                                                                                                    New Jersey Corporation Business Tax Return
CBT-100
                                                                                      For Tax Years Ending On or After July 31, 2022, Through June 30, 2023
                                                                                                                   Tax year beginning _________, ____, and ending __________, ____
FEDERAL EMPLOYER I.D. NUMBER N.J. CORPORATION NUMBER                                                                                                    State and date of incorporation 
                                                                                                                                                        Date authorized to do business in New Jersey 
CORPORATION NAME                                                                                                                                        Federal business activity code 
                                                                                                                                                        Corporation books are in the care of 
MAILING ADDRESS                                                                                                                                         at 
                                                                                                                                                        Phone Number   (          ) 
CITY                                                                                  STATE                                 ZIP CODE
                                                                                                                                                        Check if applicable (see instructions):  
                                                                                                                                                            Investment Company                                  Professional Corporation 
Check applicable return type:                                                          Initial                     Amended  
                                                                                                                                                            Real Estate Investment Trust                        Regulated Invest. Company
Enter Amended code:                                                                       If code 10, enter reason: 
                                                                                                                                                            Federal 1120-S Filer                                Claiming P.L. 86-272

1.                                        Tax Base – Enter amount from line 4 of Schedule A, Part III...........................................................................                           1. XXXXXXXXXXXXXXXXXXXXXX
2.                                        Amount of Tax – Multiply line 1 by the applicable tax rate (see instructions) ..................................................                                 2. XXXXXXXXXXXXXXXXXXXXXX
3.                                        Tax Credits – Enter amount from Schedule A-3, Part I, line 30 (see instructions) ...........................................                                     3. XXXXXXXXXXXXXXXXXXXXXX
4. CBT TAX LIABILITY – Subtract line 3 from line 2 .....................................................................................                                                                   4. XXXXXXXXXXXXXXXXXXXXXX
5.                                        a. Surtax on taxable net income – Multiply the amount on Schedule A, Part III, line 2a, 2b, or 2c  
                                                        (whichever is applicable) by the applicable surtax rate (see instructions) ...................................................                     5a. XXXXXXXXXXXXXXXXXXXXXX
                                          b. Pass-Through Business Alternative Income Tax Credit from Form 329 (see instructions) (Amount entered 
                                                        cannot be more than amount on line 5a) ........................................................................................................... 5b. XXXXXXXXXXXXXXXXXXXXXX
                                          c. Balance of surtax – Subtract line 5b from line 5a ...................................................................................                         5c. XXXXXXXXXXXXXXXXXXXXXX
6. a. Enter the total minimum tax (see instructions) ........................                                                          6a. XXXXXXXXXXXXXXXXXXXX
                                          b. Tax Due – Add line 5c to the greater of line 4  orline 6a                      (see instructions) ..................................................          6b. XXXXXXXXXXXXXXXXXXXXXX
7.                                        Installment Payment – Only applies if line 6b is $500 or less (see instructions) .............................................                                   7. XXXXXXXXXXXXXXXXXXXXXX
8.                                        Professional Corporation Fees (from Schedule PC, line 7) ...............................................................................                         8. XXXXXXXXXXXXXXXXXXXXXX
9.                                        TOTAL TAX AND PROFESSIONAL CORPORATION FEES – Add lines 6b, 7, and 8 ..........................                                                                  9. XXXXXXXXXXXXXXXXXXXXXX
10.                                       a.  Payments and Credits (see instructions) ...................................................................................................
                                                                                                                                                                                                           10a. XXXXXXXXXXXXXXXXXXXXXX
                                          b.  Payments made by partnerships on behalf of taxpayer (include copies of all NJK-1s) .................................
                                                                                                                                                                                                           10b. XXXXXXXXXXXXXXXXXXXXXX
                                          c.  Refundable Tax Credits from Schedule A-3, Part II, line 6 (see instructions).............................................
                                                                                                                                                                                                           10c. XXXXXXXXXXXXXXXXXXXXXX
                                          d.  Total Payments and Credits – Add lines 10a, 10b, and 10c ..................................................................
                                                                                                                                                                                                           10d. XXXXXXXXXXXXXXXXXXXXXX
11. Balance of Tax Due – If line 10d is less than line 9, subtract line 10d from line 9 ......................................
                                                                                                                                                                                                           11. XXXXXXXXXXXXXXXXXXXXXX
12.                                       Penalty and Interest Due (see instructions) ....................................................................................................
                                                                                                                                                                                                           12. XXXXXXXXXXXXXXXXXXXXXX
13. Total Balance Due – Add line 11 and line 12 ..............................................................................................
                                                                                                                                                                                                           13. XXXXXXXXXXXXXXXXXXXXXX
14.                                       Amount Overpaid – If line 10d is greater than the sum of line 9 and 12, enter amount of overpayment .....
                                                                                                                                                                                                           14. XXXXXXXXXXXXXXXXXXXXXX
15. Amount of line 14 to be Refunded ............................................................................................................. .
                                                                                                                                                                                                           15. XXXXXXXXXXXXXXXXXXXXXX
16. Amount of line 14 to be Credited to 2023 Tax Return ................................................................................ .
                                                                                                                                                                                                           16. XXXXXXXXXXXXXXXXXXXXXX
17. Amount of line 14 to be Credited to a Combined Group and tax year                                                                                   Unitary ID Number
                                          to which it is to be applied                 2022     or                  2023 .............................. NU                                                 17. XXXXXXXXXXXXXXXXXXXXXX
                                                                           If the corporation is inactive, page 1, the Annual General Questionnaire, and Schedules A (Parts I, II, and III), A-2, A-3, and A-4 must be 
                                                                           completed. A corporate officer must sign and certify below: 
                                                                            By marking the check box to the left, I certify that the corporation did not conduct any business, did not have any income, receipts, or 
                                                                            expenses, and did not own any assets during the entire period covered by the tax return.

                                                        (See Instructions)
                          CERTIFICATION   OF INACTIVITY                        (Date)         (Signature of Corporate Officer)                                                                                 (Title)  

                                                                           Under penalties of perjury, I declare that I have examined this return, including accompanying schedules, forms, and statements, and to the 
                                                                           best of my knowledge and belief, it is true, correct, and complete. I understand that pursuant to N.J.S.A. 54:10A-14(a), I must include copies 
                                                                           of the federal return(s), forms, and schedules with my New Jersey return. If prepared by a person other than the taxpayer, this declaration is 
                                                                           based on all information of which the preparer has any knowledge.

                                                                               (Date)         (Signature of Duly Authorized Officer of Taxpayer)                                                               (Title)
                                          VERIFICATION  (See Instructions)     (Date)                      (Signature of Individual Preparing Return)                    (Address)                             (Preparer’s ID Number)
             SIGNATURE AND
                                                                               (Name of Tax Preparer’s Employer)                                                         (Address)                              (Employer’s ID Number)



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                                                                                                                                 2022 – CBT-100 – Page 2
 NAME AS SHOWN ON RETURN                                                    FEDERAL ID NUMBER

 ANNUAL GENERAL QUESTIONNAIRE  (See Instructions)
 PART I  All taxpayers must answer the following questions. Riders must be provided where necessary.
1.  Type of business
 Principal products handled
2.  State the location of the actual seat of management or control of the corporation 
 
3.  Did one or more other corporations own beneficially, or control, a majority of the stock of taxpayer corporation or did the same interests own 
 beneficially, or control, a majority of the stock of taxpayer corporation and of one or more other corporations?          Yes. Provide a rider indicating 
 the name and FEIN of the controlled corporation, the name and FEIN of the controlling/parent corporation, and the percentage of stock owned or 
 controlled.     OR        No. 
4.  These questions must be answered by corporations with a controlling interest in certain commercial property.
 a.  During the period covered by the return, did the taxpayer acquire or dispose of directly or indirectly a controlling interest in certain commercial 
     property?      Yes. Answer question 4b below.     OR       No. 
 b.  Was the CITT-1, Controlling Interest Transfer Tax, filed with the Division of Taxation?  
           Yes. Provide a rider indicating the information and include a copy of the CITT-1.     OR        No. Provide a rider indicating the name and FEIN 
     of the transferee, the name and FEIN of the transferor, and the assessed value of the property.
5.  Does this corporation own any Qualified Subchapter S Subsidiaries (QSSS)?         Yes. Provide a rider indicating the name, address, and FEIN of the 
 subsidiary, whether the subsidiary made a New Jersey QSSS election, and whether the activities of the subsidiary are included in this return.      
 OR         No. 
6.  If the taxpayer is a unitary subsidiary of a combined group filing a New Jersey combined return from which the taxpayer is excluded,did the taxpayer 
 distribute dividends or deemed dividends in the current tax year?   Yes. Provide a rider indicating the name and FEIN of the entity to which the 
 dividends were paid (deemed), the amount of dividends, and unitary ID number of the combined group.     OR                  No. 
7.  Is the taxpayer an intangible holding company or is the taxpayer’s income, directly or indirectly, from intangible property or related service activities 
 that are deductible against the income of members of a combined group?               Yes. Provide a rider indicating the names and ID numbers of the 
 combined group or the related members and detail the taxpayer’s income that is deductible against their income.     OR           No.
8.  Is income from sources outside the United States included in taxable net income on Schedule A? 
      Yes        No            NA 
 If yes, provide a rider indicating such items of gross income, the source, the deductions and the amount of foreign taxes paid. Enter on Schedule A, 
 Part II, line 10, the difference between the net of such income and the amount of foreign taxes paid not previously deducted (include a rider).
9.   Does the taxpayer have related parties or affiliates that file combined returns in New Jersey?      Yes.     OR        No. 
10.  Does the taxpayer file as part of a group filing combined returns/reports in other states with corporations that either do not file New Jersey returns or 
 file separate New Jersey returns?         Yes.     OR      No.
11.  Is the taxpayer part of a group that files a New Jersey combined return, but is excluded from the combined return?       Yes. Provide information 
 below.     OR       No.  
 Name of the managerial member of the combined group: 
12.  Has the taxpayer or the preparer completing this return on the taxpayer’s behalf taken any uncertain tax positions when filing this return or their 
 federal tax return?      Yes. Include a rider detailing the information.     OR      No.  
 For more information see Financial Accounting Standards Board (FASB) Accounting Standards Codification (ASC) 740-10, formerly FASB 
 Interpretation No. 48 (FIN 48).
13.  Does the taxpayer own or lease real  ortangible property: 
 a.  In New Jersey?       Yes.     OR        No.  
 b.  Outside New Jersey?         Yes. Provide information below.     OR      No. 
     List the states, political subdivisions, and foreign nations (as applicable): 
14.  What percentage of the taxpayer’s worldwide property, real or tangible, is inside the United States? 
15.  Does the taxpayer have payroll: 
 a.  In New Jersey?       Yes.     OR        No.  
 b.  Outside New Jersey?         Yes. Provide information below.     OR      No. 
     List the states, political subdivisions, and foreign nations (as applicable): 
16.  What percentage of the taxpayer’s worldwide payroll is inside the United States? 
17.  Is 20% or more of either or both the taxpayer’s property and payroll inside the United States?       Yes.     OR        No. 
18.  Does the taxpayer own a disregarded entity or utilize a disregarded entity of a related party?      Yes. Include a rider with the entity’s name and tax 
 ID number.     OR         No. 



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                                                                                                         2022 – CBT-100 – Page 3
 NAME AS SHOWN ON RETURN                                               FEDERAL ID NUMBER

 ANNUAL GENERAL QUESTIONNAIRE (Continued)
 PART II REGULATED INVESTMENT COMPANIES (Riders must be provided where necessary)
1.  Is this taxpayer registered and regulated under the Federal Investment Company Act of 1940 (54 Stat. 789, as amended)?   Yes. Provide 
 information below (include rider if necessary).   No. 
                                Securities and Exchange Commission Information
                 Registration Number                                                    Registration Date

 IMPORTANT NOTE: If the taxpayer’s certificate under the Act was not obtained prior to the commencement of the period covered in the return or if 
 such authority was not continued during such entire period, then the taxpayer is not entitled to report as a Regulated Investment Company.
2.  Has the taxpayer satisfied the requirements of IRC § 852(a)?   Yes   OR    No. If no, taxpayer cannot file as a Regulated Investment Company.
3.  Every taxpayer seeking to report as a regulated investment company MUST SUBMIT WITH THIS RETURN ITS PRINTED ANNUAL REPORT TO 
 STOCKHOLDERS for the period covered by this return together with all other stockholder reports issued by the company during such period. 



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                                                                                                                                                                                   2022 – CBT-100 – Page 4
NAME AS SHOWN ON RETURN                                                             FEDERAL ID NUMBER

                                          CALCULATION OF NEW JERSEY TAXABLE NET INCOME (SEE INSTRUCTIONS) 
Schedule A                                EVERY CORPORATION MUST COMPLETE PARTS I, II, AND III OF THIS SCHEDULE
PART I – COMPUTATION OF ENTIRE NET INCOME  (All data must match the federal pro forma or federal return, whichever is applicable.) 
                                                    Income
1.  a.  Gross receipts or sales ....................................................................................................................                           1a. XXXXXXXXXXXXXXXXXXXXXX
    b.  Less: Returns and allowances .........................................................................................................                                 1b. XXXXXXXXXXXXXXXXXXXXXX
    c.  Total – Subtract line 1b from line 1a .................................................................................................                                1c. XXXXXXXXXXXXXXXXXXXXXX
2.  Less: Cost of goods sold (from Schedule A-2, line 8) ...................................................................................                                   2.  XXXXXXXXXXXXXXXXXXXXXX
3.  Gross profit – Subtract line 2 from line 1c .............................................................................................                                  3.  XXXXXXXXXXXXXXXXXXXXXX
4.  a.  Dividends .........................................................................................................................................                    4a. XXXXXXXXXXXXXXXXXXXXXX
    b.  Gross Foreign Derived Intangible Income (see instructions) (include copy of federal Form 8993) .................                                                       4b. XXXXXXXXXXXXXXXXXXXXXX
    c.  Gross Global Intangible Low-Taxed Income (see instructions) (include copy of federal Form 8992) ................                                                       4c. XXXXXXXXXXXXXXXXXXXXXX
5.  Interest...................................................................................................................................................                5.  XXXXXXXXXXXXXXXXXXXXXX
6.  Gross rents ............................................................................................................................................                   6.  XXXXXXXXXXXXXXXXXXXXXX
7.  Gross royalties.......................................................................................................................................                     7.  XXXXXXXXXXXXXXXXXXXXXX
8.  Capital gain net income (include a copy of federal Schedule D) ......................................................................                                      8.  XXXXXXXXXXXXXXXXXXXXXX
9.  Net gain or (loss) (from federal Form 4797, include a copy) .............................................................................                                  9.  XXXXXXXXXXXXXXXXXXXXXX
10. Other income (include schedule(s)) ....................................................................................................................................... 10. XXXXXXXXXXXXXXXXXXXXXX
11. Total Income – Add lines 3 through 10 .................................................................................................                                    11. XXXXXXXXXXXXXXXXXXXXXX
                                                    Deductions
12. Compensation of officers (from Schedule F) ..............................................................................................                                  12. XXXXXXXXXXXXXXXXXXXXXX
13. Salaries and wages (less employment credits).............................................................................................                                  13. XXXXXXXXXXXXXXXXXXXXXX
14. Repairs (Do not include capital expenditures) .................................................................................................                            14. XXXXXXXXXXXXXXXXXXXXXX
15. Bad debts ..............................................................................................................................................                   15. XXXXXXXXXXXXXXXXXXXXXX
16. Rents .....................................................................................................................................................                16. XXXXXXXXXXXXXXXXXXXXXX
17. Taxes .....................................................................................................................................................                17. XXXXXXXXXXXXXXXXXXXXXX
18. Interest...................................................................................................................................................                18. XXXXXXXXXXXXXXXXXXXXXX
19. Charitable contributions .........................................................................................................................                         19. XXXXXXXXXXXXXXXXXXXXXX
20. Depreciation (from federal Form 4562, include a copy)       less depreciation claimed elsewhere on return ..........                                                       20. XXXXXXXXXXXXXXXXXXXXXX
21. Depletion ...............................................................................................................................................                  21. XXXXXXXXXXXXXXXXXXXXXX
22. Advertising .............................................................................................................................................                  22. XXXXXXXXXXXXXXXXXXXXXX
23. Pension, profit-sharing plans, etc ..........................................................................................................                              23. XXXXXXXXXXXXXXXXXXXXXX
24. Employee benefit programs...................................................................................................................                               24. XXXXXXXXXXXXXXXXXXXXXX
25. Reserved for future use .........................................................................................................................                          25.
26. Other deductions (include schedule) ..........................................................................................................                             26. XXXXXXXXXXXXXXXXXXXXXX
27. Total Deductions – Add lines 12 through 26 ........................................................................................                                        27. XXXXXXXXXXXXXXXXXXXXXX
28. Taxable income before federal net operating loss deductions and federal special deductions – 
    Subtract line 27 from line 11 (Must agree with line 28, page 1 of the Unconsolidated federal Form 1120, or the 
    appropriate line of any other federal corporate return filed) (See instructions) ............................................................                              28. XXXXXXXXXXXXXXXXXXXXXX
PART II – NEW JERSEY MODIFICATIONS TO ENTIRE NET INCOME
1.  Taxable income/(loss) before federal net operating loss deductions and special deductions (from 
    Schedule A, Part I, line 28) ...............................................................................................................                               1.  XXXXXXXXXXXXXXXXXXXXXX
                                                    Additions
2.  Reserved for future use .........................................................................................................................                          2.
3.  Other federally exempt income not included in line 1 (see instructions) ....................................................                                               3.  XXXXXXXXXXXXXXXXXXXXXX
4.  Interest on federal, state, municipal, and other obligations not included in line 1 (see instructions) ...........                                                         4.  XXXXXXXXXXXXXXXXXXXXXX
5.  New Jersey State and other states’ taxes deducted in line 1 (see instructions) .........................................                                                   5.  XXXXXXXXXXXXXXXXXXXXXX
6.  Related party interest addback (from Schedule G, Part I) ............................................................................                                      6.  XXXXXXXXXXXXXXXXXXXXXX
7.  Related party intangible expenses and costs addback (from Schedule G, Part II) .......................................                                                     7.  XXXXXXXXXXXXXXXXXXXXXX
8.  Reserved for future use .........................................................................................................................                          8.
9.  Depreciation modification being added to income (from Schedule S) ........................................................                                                 9.  XXXXXXXXXXXXXXXXXXXXXX
10. Other additions. Explain on separate rider (see instructions) .....................................................................                                        10. XXXXXXXXXXXXXXXXXXXXXX
11. Taxable income/(loss) with additions – Add line 1 through line 10 and enter the total .........................                                                            11. XXXXXXXXXXXXXXXXXXXXXX



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                                                                                                                                                                  2022 – CBT-100 – Page 5
NAME AS SHOWN ON RETURN                                                 FEDERAL ID NUMBER

                                CALCULATION OF NEW JERSEY TAXABLE NET INCOME (SEE INSTRUCTIONS) 
Schedule A                      EVERY CORPORATION MUST COMPLETE PARTS I, II, AND III OF THIS SCHEDULE
                                                 Deductions
12. Depreciation modification being subtracted from income (from Schedule S) ............................................                                    12.  XXXXXXXXXXXXXXXXXXXXXX
13. Previously Taxed Dividends (from Schedule PT) .......................................................................................                    13.  XXXXXXXXXXXXXXXXXXXXXX
14. a.  Enter the I.R.C. § 250(a) deduction amount allowed federally for GILTI if GILTI income is 
       included on line 1 .............................................................................................................................      14a. XXXXXXXXXXXXXXXXXXXXXX
    b.  Enter the I.R.C. § 250(a) deduction amount allowed federally for FDII if FDII income is included 
       on line 1............................................................................................................................................ 14b. XXXXXXXXXXXXXXXXXXXXXX
    c.  Net GILTI previously taxed by New Jersey not deducted or excluded elsewhere ...........................                                              14c. XXXXXXXXXXXXXXXXXXXXXX
15. I.R.C. § 78 Gross-up included in line 1 (do not include dividends that were excluded/deducted elsewhere) .............                                   15.  XXXXXXXXXXXXXXXXXXXXXX
16. Reserved for future use ............................................................................................................................     16.
17. a.  Elimination of nonoperational activity (from Schedule O, Part I) ............................................................                        17a. XXXXXXXXXXXXXXXXXXXXXX
    b.  Elimination of nonunitary partnership income/loss (from Schedule P-1, Part II, line 4) ............................                                  17b. XXXXXXXXXXXXXXXXXXXXXX
18. Other deductions. Explain on separate rider (see instructions) .................................................................                         18.  XXXXXXXXXXXXXXXXXXXXXX
19. Total deductions – Add line 12 through line 18 and enter the total .......................................................                               19.  XXXXXXXXXXXXXXXXXXXXXX
                                Taxable Net Income/(Loss) Calculation
20. Entire Net Income/(Loss) Subtotal – Subtract line 19 from line 11 .......................................................                                20.  XXXXXXXXXXXXXXXXXXXXXX
21. Allocation factor from Schedule J (if all receipts were derived from only New Jersey sources, enter 1.000000) ......                                     21.  XXXXXXXXXXXXXXXXXXXXXX
22. Allocated entire net income/(loss) before net operating loss deductions and dividend exclusion – 
    Multiply line 20 by line 21 and enter the result here (if zero or less, enter zero on line 29) ............................                              22.  XXXXXXXXXXXXXXXXXXXXXX
23. Prior year net operating loss (PNOL) deduction (from Form 500, Section A) (Amount entered cannot be more 
    than amount on line 22)...............................................................................................................................   23.  XXXXXXXXXXXXXXXXXXXXXX
24. Allocated entire net income before post allocation net operating loss deduction – Subtract line 23 
    from line 22 (If zero or less, enter zero here and on line 29) .............................................................................             24.  XXXXXXXXXXXXXXXXXXXXXX
25. Post allocation net operating loss (NOL) deduction (from Form 500, Section B) (Amount entered cannot be 
    more than amount on line 24) .......................................................................................................................     25.  XXXXXXXXXXXXXXXXXXXXXX
26. Allocated entire net income before allocated dividend exclusion – Subtract line 25 from line 24 (If 
    zero or less, enter zero here and on line 29) ...................................................................................................        26.  XXXXXXXXXXXXXXXXXXXXXX
27. Allocated Dividend Exclusion (from Schedule R) (see instructions) ..................................................................                     27.  XXXXXXXXXXXXXXXXXXXXXX
28. Reserved for future use ........................................................................................................................         28.
29. Taxable net income – Subtract line 27 from line 26 ............................................................................                          29.  XXXXXXXXXXXXXXXXXXXXXX
    Did the taxpayer have any discharge of indebtedness excluded from federal taxable income  
    in the current tax year pursuant to subparagraph (A), (B), or (C) of paragraph (1) of  
    subsection (a) of IRC § 108  Yes. See instructions for Form 500.  OR     No. 
PART III – COMPUTATION OF NEW JERSEY TAX BASE 
1.  Enter taxable net income from Schedule A, Part II, line 29 ..................................................................                            1.   XXXXXXXXXXXXXXXXXXXXXX
2.  a. Investment Company – Enter 40% of line 1 .....................................................................................                        2a.  XXXXXXXXXXXXXXXXXXXXXX
    b.  Real Estate Investment Trust – Enter 4% of line 1..........................................................................                          2b.  XXXXXXXXXXXXXXXXXXXXXX
    c.  All Others – Enter the amount from line 1 .......................................................................................                    2c.  XXXXXXXXXXXXXXXXXXXXXX
3.  a.  New Jersey Nonoperational Income (from Schedule O, Part III) (if zero or less, enter zero) .........................                                 3a.  XXXXXXXXXXXXXXXXXXXXXX
    b.  Nonunitary Partnership Income (from Schedule P-1, Part II, line 5) (if zero or less, enter zero) ......................                              3b.  XXXXXXXXXXXXXXXXXXXXXX
4.  Tax Base – Add lines 3a and 3b to line 2a, 2b, or 2c, whichever is applicable. Enter total here and 
    on line 1, page 1 ...................................................................................................................................    4.   XXXXXXXXXXXXXXXXXXXXXX



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                                                                                                                                                       2022 – CBT-100 – Page 6
NAME AS SHOWN ON RETURN                                               FEDERAL ID NUMBER

                                  COST OF GOODS SOLD (See Instructions) All data must match amounts reported on federal  
Schedule A-2                      Form 1125-A of the federal pro forma or federal return, whichever is applicable.
1.  Inventory at beginning of year ................................................................................................                1.  XXXXXXXXXXXXXXXXXXXXXX
2. Purchases...............................................................................................................................        2.  XXXXXXXXXXXXXXXXXXXXXX
3. Cost of labor ...........................................................................................................................       3.  XXXXXXXXXXXXXXXXXXXXXX
4. Additional section 263A costs .................................................................................................                 4.  XXXXXXXXXXXXXXXXXXXXXX
5. Other costs (include schedule) ....................................................................................................             5.  XXXXXXXXXXXXXXXXXXXXXX
6. Total – Add lines 1 through 5 ..................................................................................................                6.  XXXXXXXXXXXXXXXXXXXXXX
7.  Inventory at end of year ..........................................................................................................            7.  XXXXXXXXXXXXXXXXXXXXXX
8.  Cost of goods sold – Subtract line 7 from line 6. Include here and on Schedule A, Part I, 
    line 2 ....................................................................................................................................... 8.  XXXXXXXXXXXXXXXXXXXXXX
Schedule A-3                      SUMMARY OF TAX CREDITS (See Instructions)
PART I – Tax Credits Used Against Liability 
1. New Jobs Investment Tax Credit from Form 304 ...................................................................                                1.  XXXXXXXXXXXXXXXXXXXXXX
2. Angel Investor Tax Credit from Form 321 ...............................................................................                         2.  XXXXXXXXXXXXXXXXXXXXXX
3.  Business Employment Incentive Program Tax Credit from Form 324 ....................................                                            3.  XXXXXXXXXXXXXXXXXXXXXX
4. Pass-Through Business Alternative Income Tax Credit from Form 329                                                                               4.  XXXXXXXXXXXXXXXXXXXXXX
5.  EITHER: a) Urban Enterprise Zone Employee Tax Credit from Form 300 .........................
    OR b) Urban Enterprise Zone Investment Tax Credit from Form 301 ........................                                                       5.  XXXXXXXXXXXXXXXXXXXXXX
6.  Redevelopment Authority Project Tax Credit from Form 302 .................................................                                     6.  XXXXXXXXXXXXXXXXXXXXXX
7.  Manufacturing Equipment and Employment Investment Tax Credit from Form 305 ..............                                                      7.  XXXXXXXXXXXXXXXXXXXXXX
8.  Research and Development Tax Credit from Form 306 ........................................................                                     8.  XXXXXXXXXXXXXXXXXXXXXX
9.  Neighborhood Revitalization State Tax Credit from Form 311 ................................................                                    9.  XXXXXXXXXXXXXXXXXXXXXX
10. Effluent Equipment Tax Credit from Form 312 .......................................................................                            10. XXXXXXXXXXXXXXXXXXXXXX
11. Economic Recovery Tax Credit from Form 313 ......................................................................                              11. XXXXXXXXXXXXXXXXXXXXXX
12. AMA Tax Credit from Form 315 ..............................................................................................                    12. XXXXXXXXXXXXXXXXXXXXXX
13. Business Retention and Relocation Tax Credit from Form 316 ..............................................                                      13. XXXXXXXXXXXXXXXXXXXXXX
14. Sheltered Workshop Tax Credit from Form 317 .....................................................................                              14. XXXXXXXXXXXXXXXXXXXXXX
15. Film Production Tax Credit from Form 318 .............................................................................                         15. XXXXXXXXXXXXXXXXXXXXXX
16. Urban Transit Hub Tax Credit from Form 319 .........................................................................                           16. XXXXXXXXXXXXXXXXXXXXXX
17. Grow NJ Tax Credit from Form 320 ........................................................................................                      17. XXXXXXXXXXXXXXXXXXXXXX
18. Wind Energy Facility Tax Credit from Form 322 .....................................................................                            18. XXXXXXXXXXXXXXXXXXXXXX
19. Residential Economic Redevelopment and Growth Tax Credit from Form 323 ....................                                                    19. XXXXXXXXXXXXXXXXXXXXXX
20. Public Infrastructure Tax Credit from Form 325 ......................................................................                          20. XXXXXXXXXXXXXXXXXXXXXX
21. Reserved for future use ..........................................................................................................             21.
22. Film and Digital Media Tax Credit from Form 327 ..................................................................                             22. XXXXXXXXXXXXXXXXXXXXXX
23. Tax Credit for Employers of Employees With Impairments from Form 328 ............................                                              23. XXXXXXXXXXXXXXXXXXXXXX
24. Apprenticeship Program Tax Credit from Form 330 ...............................................................                                24. XXXXXXXXXXXXXXXXXXXXXX
25. Tax Credit for Employer of Organ/Bone Marrow Donor from Form 331 .................................                                             25. XXXXXXXXXXXXXXXXXXXXXX
26. Tiered Subsidiary Dividend Pyramid Tax Credit from Form 332 .............................................                                      26. XXXXXXXXXXXXXXXXXXXXXX
27. Innovation Evergreen Fund Tax Credit from Form 334 .........................................................                                   27. XXXXXXXXXXXXXXXXXXXXXX
28. Unit Concrete Products Tax Credit from Form 335 ................................................................                               28. XXXXXXXXXXXXXXXXXXXXXX
29. Other Tax Credit (see instructions) ........................................................................................                   29. XXXXXXXXXXXXXXXXXXXXXX
30. Total tax credits  – Add lines 1 through 29. Enter here and on page 1, line 3 .......................                                          30. XXXXXXXXXXXXXXXXXXXXXX
PART II – Refundable Tax Credits
1.  Refundable portion of New Jobs Investment Tax Credit from Form 304 ................................                                            1.  XXXXXXXXXXXXXXXXXXXXXX
2.  Refundable portion of Angel Investor Tax Credit from Form 321 ............................................                                     2.  XXXXXXXXXXXXXXXXXXXXXX
3.  Refundable portion of Business Employment Incentive Program Tax Credit from Form 324 ....                                                      3.  XXXXXXXXXXXXXXXXXXXXXX
4.  Refundable portion Pass-Through Business Alternative Income Tax Credit from Form 329 ..                                                        4.  XXXXXXXXXXXXXXXXXXXXXX
5. Other Tax Credit to be refunded .............................................................................................                   5.  XXXXXXXXXXXXXXXXXXXXXX
6.  Total amount of tax credits to be refunded. Enter here and on page 1, line 10c ....................                                            6.  XXXXXXXXXXXXXXXXXXXXXX



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                                                                                                                                                                        2022 – CBT-100 – Page 7
NAME AS SHOWN ON RETURN                                                        FEDERAL ID NUMBER

Schedule A-4                      SUMMARY SCHEDULE (See Instructions) 
PNOL Deduction and Carryover                                                   Net Operational Income Information
1. Form 500, Section A, line 5 minus line 7 ...             1. XXXXXXXXXXXXXXX 8. Schedule O, Part III, line 31...................                                      8. XXXXXXXXXXXXXXX
NOL Deduction and Carryover                                                    Dividend Exclusion Information
2. Form 500, Section B, line 6 minus line 8 ...             2. XXXXXXXXXXXXXXX 9.  Schedule R, line 7 ...............................                                   9. XXXXXXXXXXXXXXX
Interest and Intangible Costs and Expenses
3. Schedule G, Part I, line b..........................     3. XXXXXXXXXXXXXXX 10. Schedule R, line 9 ...............................                                   10. XXXXXXXXXXXXXXX

4. Schedule G, Part II, line b.........................     4. XXXXXXXXXXXXXXX 11.  Schedule R, line 11 .............................                                   11. XXXXXXXXXXXXXXX
Schedule J Information                                                         Schedule P Information
5. Schedule J, line 1f .................................... 5. XXXXXXXXXXXXXXX 12. Schedule P, Part III, line 1 ...................                                     12. XXXXXXXXXXXXXXX

6. Schedule J, line 1g ...................................  6. XXXXXXXXXXXXXXX 13. Schedule P, Part III, line 2 ...................                                     13. XXXXXXXXXXXXXXX

7. Schedule J, line 1h ...................................  7. XXXXXXXXXXXXXXX
                              CORPORATE OFFICERS – GENERAL INFORMATION AND COMPENSATION (See Instructions)
Schedule F                    Data must match amounts reported on federal Form 1125-E of the federal pro forma or federal return, whichever is applicable.
                                                                               (4)                             (5)
(1)                                                         (2)   (3)          Dates Employed  Percentage of Corpora-                                                   (6)
Name and Current Address of Officer        Social Security Number Title        in this position        tion Stock Owned                                                 Amount of Compensation
                                                                               From      To     Common            Preferred
XXXXXXXXXXXXXXXXXXXXXX                     XXXXXXXXXXXXXXX        XXXXX        XXXXX XXXXX           XXXXX        XXXXX                                                 XXXXXXXXXXXXXXX
XXXXXXXXXXXXXXXXXXXXXX                     XXXXXXXXXXXXXXX        XXXXX        XXXXX XXXXX           XXXXX        XXXXX                                                 XXXXXXXXXXXXXXX
XXXXXXXXXXXXXXXXXXXXXX                     XXXXXXXXXXXXXXX        XXXXX        XXXXX XXXXX           XXXXX        XXXXX                                                 XXXXXXXXXXXXXXX
XXXXXXXXXXXXXXXXXXXXXX                     XXXXXXXXXXXXXXX        XXXXX        XXXXX XXXXX           XXXXX        XXXXX                                                 XXXXXXXXXXXXXXX
XXXXXXXXXXXXXXXXXXXXXX                     XXXXXXXXXXXXXXX        XXXXX        XXXXX XXXXX           XXXXX        XXXXX                                                 XXXXXXXXXXXXXXX
XXXXXXXXXXXXXXXXXXXXXX                     XXXXXXXXXXXXXXX        XXXXX        XXXXX XXXXX           XXXXX        XXXXX                                                 XXXXXXXXXXXXXXX
XXXXXXXXXXXXXXXXXXXXXX                     XXXXXXXXXXXXXXX        XXXXX        XXXXX XXXXX           XXXXX        XXXXX                                                 XXXXXXXXXXXXXXX
a.  Total compensation of officers .................................................................................................................................... XXXXXXXXXXXXXXX
b.  Less: Compensation of officers claimed elsewhere on the return ..............................................................................                       XXXXXXXXXXXXXXX
c.  Balance of compensation of officers (include here and on Schedule A, Part I, line 12) .............................................                                 XXXXXXXXXXXXXXX



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                                                                                                                                                                   2022 – CBT-100 – Page 8
NAME AS SHOWN ON RETURN                                             FEDERAL ID NUMBER

Schedule G
Part I – Interest (See Instructions)
Was interest paid, accrued, or incurred to a related member(s) deducted from entire net income? 
  Yes. Fill out the following schedule.     No.

 Name of Related Member                    Federal ID Number           Relationship to Taxpayer                                                                    Amounts 
 XXXXXXXXXXXXXXX                           XXXXXXXXXXXXXXX             XXXXXXXXXXXXXXX                                                                             XXXXXXXXXXXXXXX
 XXXXXXXXXXXXXXX                           XXXXXXXXXXXXXXX             XXXXXXXXXXXXXXX                                                                             XXXXXXXXXXXXXXX
 XXXXXXXXXXXXXXX                           XXXXXXXXXXXXXXX             XXXXXXXXXXXXXXX                                                                             XXXXXXXXXXXXXXX
 XXXXXXXXXXXXXXX                           XXXXXXXXXXXXXXX             XXXXXXXXXXXXXXX                                                                             XXXXXXXXXXXXXXX
a.  Total amount of interest deducted.................................................................................................................             XXXXXXXXXXXXXXX
b.  Subtract: Exceptions (see instructions) .............................................................................................................          (XXXXXXXXXXXXXXX)
c.  Related Party Interest Expenses Disallowed for New Jersey Purposes (include here and on Schedule A, 
 Part II, line 6) ................................................................................................................................................ XXXXXXXXXXXXXXX
Part II – Interest Expenses and Costs and Intangible Expenses and Costs (See instr.)
Were intangible expenses and costs, including intangible interest expenses and costs, paid, accrued or incurred to related members, deducted 
from entire net income?    Yes. Fill out the following schedule.    No.
                                                                        Type of Intangible 
Name of Related Member    Federal ID Number    Relationship to Taxpayer Expense Deducted                                                                           Amounts
XXXXXXXXXXXXXXX           XXXXXXXXXXXXXXX      XXXXXXXXXXXXXXX          XXXXXXXXXXXXXXX                                                                            XXXXXXXXXXXXXXX
XXXXXXXXXXXXXXX           XXXXXXXXXXXXXXX      XXXXXXXXXXXXXXX          XXXXXXXXXXXXXXX                                                                            XXXXXXXXXXXXXXX
XXXXXXXXXXXXXXX           XXXXXXXXXXXXXXX      XXXXXXXXXXXXXXX          XXXXXXXXXXXXXXX                                                                            XXXXXXXXXXXXXXX
XXXXXXXXXXXXXXX           XXXXXXXXXXXXXXX      XXXXXXXXXXXXXXX          XXXXXXXXXXXXXXX                                                                            XXXXXXXXXXXXXXX
a.  Total amount of intangible expenses and costs deducted ..............................................................................                          XXXXXXXXXXXXXXX
b.  Subtract: Exceptions (see instructions) ...............................................................................................................        (XXXXXXXXXXXXXXX)
c.  Related Party Intangible Expenses and Costs addback (include here and on Schedule A, Part II, line 7) ....                                                     XXXXXXXXXXXXXXX
NOTE: For tax years beginning on or after January 1, 2018, the treaty exceptions have been limited pursuant to P.L. 2018, c. 48. See Schedule G-2 
      instructions for more information. 



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                                                                                                                                             2022 – CBT-100 – Page 9
NAME AS SHOWN ON RETURN                                                     FEDERAL ID NUMBER

                           TAXES (See Instructions)
Schedule H                 Include all taxes paid or accrued during the accounting period wherever deducted on Schedule A.
                           (a)                        (b)                   (c)              (d)                                         (e)            (f)
                           Corporation                Corporation
                           Franchise                  Business/             Property      U.C.C. or                                   Other Taxes/      Total
                           Business Taxes Occupancy Taxes                   Taxes         Payroll Taxes                                  Licenses
                                                                                                                                      (include schedule)
1. New Jersey Taxes        XXXXXXXXXX     XXXXXXXXXX                 XXXXXXXXXX           XXXXXXXXXX                                  XXXXXXXXXX        XXXXXXXXXX

2. Other States & U.S.     XXXXXXXXXX     XXXXXXXXXX                 XXXXXXXXXX           XXXXXXXXXX                                  XXXXXXXXXX        XXXXXXXXXX
   Possessions
3. City and Local Taxes    XXXXXXXXXX     XXXXXXXXXX                 XXXXXXXXXX           XXXXXXXXXX                                  XXXXXXXXXX        XXXXXXXXXX

4. Taxes Paid to Foreign   XXXXXXXXXX     XXXXXXXXXX                 XXXXXXXXXX           XXXXXXXXXX                                  XXXXXXXXXX        XXXXXXXXXX
   Countries*
5. Total                   XXXXXXXXXX     XXXXXXXXXX                 XXXXXXXXXX           XXXXXXXXXX                                  XXXXXXXXXX        XXXXXXXXXX

6. Combine lines 5(a)                     XXXXXXXXXX
   and 5(b)
7. Sales & Use Taxes Paid                 XXXXXXXXXX
   by a Utility Vendor
8. Add lines 6 and 7                      XXXXXXXXXX

9. Federal Taxes                                                                          XXXXXXXXXX                                  XXXXXXXXXX        XXXXXXXXXX

10. Total (Combine line 5  XXXXXXXXXX     XXXXXXXXXX                 XXXXXXXXXX           XXXXXXXXXX                                  XXXXXXXXXX        XXXXXXXXXX
   and line 9)
* Include on line 4 taxes paid or accrued to any foreign country, state, province, territory, or subdivision thereof.
Schedule J                 COMPUTATION OF ALLOCATION FACTOR (See Instructions)
All taxpayers, regardless of entire net income reported on Schedule A, Part II, line 20, Form CBT-100, must complete Schedule J.
For tax years ending on and after July 31, 2019, services are sourced based on market sourcing, not cost of performance. 
1. Receipts:                                                                                                                             AMOUNTS (omit cents)
   a.  From sales of tangible personal property shipped to points within New Jersey.....................................              a. XXXXXXXXXXXXXXXXXXXX
   b.  From services if the benefit of the service is received in New Jersey ..................................................       b. XXXXXXXXXXXXXXXXXXXX
   c.  From rentals of property situated in New Jersey .............................................................................. c. XXXXXXXXXXXXXXXXXXXX
   d.  From royalties for the use in New Jersey of patents, copyrights, and trademarks .................................              d. XXXXXXXXXXXXXXXXXXXX
   e.  All other business receipts earned in New Jersey (See instructions) ...................................................        e. XXXXXXXXXXXXXXXXXXXX
   f.  Total New Jersey receipts (Total of lines 1a to 1e, inclusive) ..............................................................  f. XXXXXXXXXXXXXXXXXXXX
   g.  Total receipts from all sales, services, rentals, royalties, and other business transactions everywhere ....                   g. XXXXXXXXXXXXXXXXXXXX
   h.  Allocation Factor (Percentage in New Jersey) (Line 1f divided by line 1g). Carry the fraction 6 decimal 
                                                                                                                                      h. XXXXXXXXXXXXXXXXXXXX
     places. Do not express as a percent. Include here and on Schedule A, Part II, line 21 ...........................
NOTE: Include the GILTI and the receipts attributable to the FDII, net of the respective allowable IRC §250(a) deductions, in the allocation factor. The 
     net amount of GILTI (i.e., the GILTI reduced by the I.R.C. § 250(a) GILTI deduction) and the net FDII (i.e., the receipts attributable to the FDII 
     reduced by the I.R.C. § 250(a) FDII deduction) amounts are included in the numerator (if applicable) and the denominator.



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                                                                                                                                                               2022 – CBT-100 – Page 10
NAME AS SHOWN ON RETURN                                                 FEDERAL ID NUMBER

Schedule P-1                 PARTNERSHIP INVESTMENT ANALYSIS (See Instructions)
Part I – Partnership Information 
                 (1)                             (2)         (3)                (4)                                                            (5)             (6)     (7)
   Partnership, LLC, or Other Entity Information Date and    Percentage                       Tax Accounting Method                                         New Jersey  Tax Payments Made 
                                                 State where of         Limited General           Flow                                             Separate Nexus   on Behalf of Taxpayer 
       Name           Federal ID Number          Organized   Ownership  Partner Partner       Through                                          Accounting*  Yes  No    by Partnerships
XXXXXXXXXXXXXX XXXXXXXXXXXXXX XXXXXXX                        XXXXXXX    XXXXX   XXXXX         XXXXXXX                                          XXXXXXX      XX  XX  XXXXXXXXXXXX
XXXXXXXXXXXXXX XXXXXXXXXXXXXX XXXXXXX                        XXXXXXX    XXXXX   XXXXX         XXXXXXX                                          XXXXXXX      XX  XX  XXXXXXXXXXXX
XXXXXXXXXXXXXX XXXXXXXXXXXXXX XXXXXXX                        XXXXXXX    XXXXX   XXXXX         XXXXXXX                                          XXXXXXX      XX  XX  XXXXXXXXXXXX
XXXXXXXXXXXXXX XXXXXXXXXXXXXX XXXXXXX                        XXXXXXX    XXXXX   XXXXX         XXXXXXX                                          XXXXXXX      XX  XX  XXXXXXXXXXXX
XXXXXXXXXXXXXX XXXXXXXXXXXXXX XXXXXXX                        XXXXXXX    XXXXX   XXXXX         XXXXXXX                                          XXXXXXX      XX  XX  XXXXXXXXXXXX
Enter total of column 7 here and on page 1, line 10b.............................................................................................................   XXXXXXXXXXXX
*Taxpayers using a separate accounting method must complete Part II. 
Part II – Separate Accounting of Nonunitary Partnership Income 
            (1)                                      (2)                                      (3)                                                                   (4)
                                                                                                                                                            Taxpayer’s Share of Income 
   Nonunitary Partnership’s          Distributive Share of Income/Loss    Partnership’s Allocation Factor                                                   Allocated to New Jersey  
        Federal ID Number            from Nonunitary Partnership                    (See Instructions)                                             (Multiply Column 2 by Column 3)
1.      XXXXXXXXXXXXXXX                          XXXXXXXXXXXXXXX                XXXXXXXXXXXXXXX                                                             XXXXXXXXXXXXXXX
2.      XXXXXXXXXXXXXXX                          XXXXXXXXXXXXXXX                XXXXXXXXXXXXXXX                                                             XXXXXXXXXXXXXXX
3.      XXXXXXXXXXXXXXX                          XXXXXXXXXXXXXXX                XXXXXXXXXXXXXXX                                                             XXXXXXXXXXXXXXX
4. Total column 2. Enter amount here and Schedule A, Part II, line 17b .........................................................................                   XXXXXXXXXXXXXXX
5. Total column 4. Enter amount here and Schedule A, Part III, line 3b ..........................................................................                  XXXXXXXXXXXXXXX
If additional space is needed, include a rider. 
Schedule PC                  PER CAPITA LICENSED PROFESSIONAL FEE (See Instructions)
1. Is the corporation a Professional Corporation (PC) formed pursuant to N.J.S.A. 14A:17-1 et seq. or any similar law from a possession or territory of 
   the United States, a state, or political subdivision thereof?     Yes. This schedule must be included with the return.                                        No.
2. How many licensed professionals are owners, shareholders, and/or employees from this Professional Corporation (PC) as of the first day of the 
   privilege period?   2 or less, complete Part I.          More than 2, complete Part I and Part II (if additional space is needed, include a rider).  
Part I – Provide the following information for each of the licensed professionals in the PC. Include a rider if additional space is needed.
                      Name                                              Address                                                                             FID/SSN
1.      XXXXXXXXXXXXXXXXXXXXXXXXX                            XXXXXXXXXXXXXXXXXXXXXXXXX                                                             XXXXXXXXXXXXXXXXXXXXXXXXX
2.      XXXXXXXXXXXXXXXXXXXXXXXXX                            XXXXXXXXXXXXXXXXXXXXXXXXX                                                             XXXXXXXXXXXXXXXXXXXXXXXXX
3.      XXXXXXXXXXXXXXXXXXXXXXXXX                            XXXXXXXXXXXXXXXXXXXXXXXXX                                                             XXXXXXXXXXXXXXXXXXXXXXXXX
4.      XXXXXXXXXXXXXXXXXXXXXXXXX                            XXXXXXXXXXXXXXXXXXXXXXXXX                                                             XXXXXXXXXXXXXXXXXXXXXXXXX
5.      XXXXXXXXXXXXXXXXXXXXXXXXX                            XXXXXXXXXXXXXXXXXXXXXXXXX                                                             XXXXXXXXXXXXXXXXXXXXXXXXX
Part II – Complete only if there are more than 2 licensed professionals listed above. 
1. Enter number of resident and nonresident professionals with physical nexus with                                                                 XXXXXXXXXXXXXXXXXXXXXXXXX
   New Jersey                 x $150  .............................................................................................            1.
2. Enter number of nonresident professionals without physical nexus with                                                                           XXXXXXXXXXXXXXXXXXXXXXXXX
   New Jersey                 x $150 x allocation factor of the PC .................................................                           2.
3. Total Fee Due – Add line 1 and line 2 .........................................................................................             3.  XXXXXXXXXXXXXXXXXXXXXXXXX
4. Installment Payment – 50% of line 3 ..........................................................................................              4.  XXXXXXXXXXXXXXXXXXXXXXXXX
5. Total Fee Due (line 3 plus line 4) ................................................................................................         5.  XXXXXXXXXXXXXXXXXXXXXXXXX
6. Less prior year 50% installment payment and credit (if applicable) ...........................................                              6.  (XXXXXXXXXXXXXXXXXXXXXXXXX)
7. Balance of Fee Due (line 5 minus line 6). If the result is zero or more, include the amount here                                                XXXXXXXXXXXXXXXXXXXXXXXXX
   and on Form CBT-100, page 1, line 8 ........................................................................................                7.
8. Credit to next year’s Professional Corporation Fee (if line 7 is less than zero, enter the                                                      XXXXXXXXXXXXXXXXXXXXXXXXX
   amount here) .............................................................................................................................. 8.



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                                                                                                                                                                      2022 – CBT-100 – Page 11
NAME AS SHOWN ON RETURN                                                      FEDERAL ID NUMBER

Schedule P                            SUBSIDIARY INVESTMENT ANALYSIS (See Instructions)
NOTE: Taxpayers must hold 80% of the combined voting power of all classes of stock entitled to vote and at least 80% of the total number of shares 
      of all other classes of stock, except non-voting stock which is limited and preferred as to dividends, for each subsidiary. Do not include 
      advances to subsidiaries in book value. Do not include any previously taxed dividends. Instead, report those amounts on Schedule PT.
PART I  DOMESTIC SUBSIDIARY
                                      (1)                                (2)                                           (3)                                            (4) 
                                      Name of             Percentage of Interest                                       Book Value                                     Domestic Dividend Income  
    Federal ID Number                Subsidiary           (a) Voting     (b) Non-Voting                                                                              (as reported on Schedule A)
XXXXXXXXXXXXXXX           XXXXXXXXXXXXXXX                 XXXXXXXX         XXXXXXXX                                    XXXXXXXXXXXXX                                  XXXXXXXXXXXXXXX
XXXXXXXXXXXXXXX           XXXXXXXXXXXXXXX                 XXXXXXXX         XXXXXXXX                                    XXXXXXXXXXXXX                                  XXXXXXXXXXXXXXX
XXXXXXXXXXXXXXX           XXXXXXXXXXXXXXX                 XXXXXXXX         XXXXXXXX                                    XXXXXXXXXXXXX                                  XXXXXXXXXXXXXXX
XXXXXXXXXXXXXXX           XXXXXXXXXXXXXXX                 XXXXXXXX         XXXXXXXX                                    XXXXXXXXXXXXX                                  XXXXXXXXXXXXXXX
Totals ............................................................................................................... XXXXXXXXXXXXX                                  XXXXXXXXXXXXXXX
PART II  FOREIGN SUBSIDIARY
                                      (1)                                (2)                                           (3)                                            (4) 
                                      Name of             Percentage of Interest                                       Book Value                                     Foreign Dividend Income  
    Federal ID Number                Subsidiary           (a) Voting     (b) Non-Voting                                                                              (as reported on Schedule A)
XXXXXXXXXXXXXXX           XXXXXXXXXXXXXXX                 XXXXXXXX         XXXXXXXX                                    XXXXXXXXXXXXX                                  XXXXXXXXXXXXXXX
XXXXXXXXXXXXXXX           XXXXXXXXXXXXXXX                 XXXXXXXX         XXXXXXXX                                    XXXXXXXXXXXXX                                  XXXXXXXXXXXXXXX
XXXXXXXXXXXXXXX           XXXXXXXXXXXXXXX                 XXXXXXXX         XXXXXXXX                                    XXXXXXXXXXXXX                                  XXXXXXXXXXXXXXX
XXXXXXXXXXXXXXX           XXXXXXXXXXXXXXX                 XXXXXXXX         XXXXXXXX                                    XXXXXXXXXXXXX                                  XXXXXXXXXXXXXXX
Totals ............................................................................................................... XXXXXXXXXXXXX                                  XXXXXXXXXXXXXXX
PART III  TOTAL OF 80% OR MORE OWNED SUBSIDIARY DIVIDENDS
1. Enter total from Part I, column 4 (include here and on Schedule A-4)  ........................................................................                 1. XXXXXXXXXXXXXXX
2. Enter total from Part II, column 4 (include here and on Schedule A-4)  .......................................................................                 2. XXXXXXXXXXXXXXX
3. Total dividends. Add lines 1 and 2 (include here and on Schedule R) ........................................................................                   3. XXXXXXXXXXXXXXX

Schedule R                           DIVIDEND EXCLUSION (See Instructions) 
1.  Enter the total dividends and deemed dividends reported on Schedule A  ...................................................                                    1.  XXXXXXXXXXXXXXX
2.  Enter amount from Schedule PT, Section D, line 3 .......................................................................................                      2.  XXXXXXXXXXXXXXX
3.  Dividends eligible for dividend exclusion – Subtract line 2 from line 1 ..........................................................                            3.  XXXXXXXXXXXXXXX
4.  Enter amount from Schedule P, Part III, line 3 ...............................................................................................                4.  XXXXXXXXXXXXXXX
5.  Multiply line 4 by .95 ...................................................................................................................................... 5.  XXXXXXXXXXXXXXX
6.  Subtract line 4 from line 3 ..............................................................................................................................    6.  XXXXXXXXXXXXXXX
7.  Dividend income from investments where taxpayer owns less than 50% of voting  
    stock and less than 50% of all other classes of stock (do not incl. amounts subtracted on line 2) ..............................                              7.  (XXXXXXXXXXXXXXX)
8.  Subtract line 7 from line 6 ..............................................................................................................................    8.  XXXXXXXXXXXXXXX
9.  Multiply line 8 by 50% ....................................................................................................................................   9.  XXXXXXXXXXXXXXX
10. Reserved for future use .................................................................................................................................     10.
11. DIVIDEND EXCLUSION: Add lines 5 and 9 ................................................................................................                        11. XXXXXXXXXXXXXXX
12. Allocation factor from current Schedule J (if all receipts are derived from only NJ sources, enter 1.000000) .................                                12. XXXXXXXXXXXXXXX
13. ALLOCATED DIVIDEND EXCLUSION: Multiply line 11 by line 12 (include here and on Schedule A, Part II, line 27)                                                  13. XXXXXXXXXXXXXXX



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                                                                                                                                                                               2022 – CBT-100 – Page 12
NAME AS SHOWN ON RETURN                                                   FEDERAL ID NUMBER

Schedule S – Depreciation and Safe Harbor Leasing (See Instructions)
Part I – From Federal Form 4562
1.  IRC § 179 Deduction ........................................................................................................................................           1.  XXXXXXXXXXXXXXX
2.  Special Depreciation Allowance – for qualified property placed in service during the tax year ........................                                                 2.  XXXXXXXXXXXXXXX
3.  MACRS ................................................................................................................................................................ 3.  XXXXXXXXXXXXXXX
4.  ACRS................................................................................................................................................................   4.  XXXXXXXXXXXXXXX
5.  Other Depreciation ...........................................................................................................................................         5.  XXXXXXXXXXXXXXX
6.  Listed Property ..................................................................................................................................................     6.  XXXXXXXXXXXXXXX
7.  Total federal depreciation claimed in arriving at Schedule A, Part II, line 1 ......................................................                                   7.  XXXXXXXXXXXXXXX
                                     Include Federal Form 4562 and Federal Depreciation Worksheet
         Modification at Schedule A, Part II, line 9 or line 12 – Depreciation and Certain Safe Harbor Lease Transactions
8.  Prior year New Jersey depreciation (see instructions) ......................................................................................                           8.  XXXXXXXXXXXXXXX
9.  Current year New Jersey depreciation (see instructions). Enter total from Depreciation Worksheet I .............                                                       9.  XXXXXXXXXXXXXXX
10. Total New Jersey Depreciation. Add lines 8 and 9 ...........................................................................................                           10. XXXXXXXXXXXXXXX
11. IRC § 179 limitation – Enter the lesser of line 1 or $25,000 ..............................................................................                            11. XXXXXXXXXXXXXXX
12. Accumulated MACRS or bonus depreciation over accumulated New Jersey depreciation on physical 
    disposal of recovery property. Enter total from Depreciation Worksheet II .......................................................                                      12. XXXXXXXXXXXXXXX
13. Other additions (include an explanation/reconciliation) .....................................................................................                          13. XXXXXXXXXXXXXXX
14. Other deductions (include an explanation/reconciliation)..................................................................................                             14. XXXXXXXXXXXXXXX
15. ADJUSTMENT – Add lines 7 and 13. Subtract lines 10, 11, and 14. If line 12 is positive, add line 12 
    to the result. If line 12 is negative, subtract line 12 from the result. (If line 15 is positive, enter at 
    Schedule A, Part II, line 9. If line 15 is negative, enter at Schedule A, Part II, line 12) ....................................                                       15. XXXXXXXXXXXXXXX

Part II – New Jersey Depreciation for Gas, Electric, and Gas and Electric Public Utilities (See Instructions)
1.  Total depreciation claimed in arriving at Schedule A, Part II, line 1  .................................................................                               1.  XXXXXXXXXXXXXXX
2.  Federal depreciation for assets placed in service after January 1, 1998 .........................................................                                      2.  XXXXXXXXXXXXXXX
3.  Net – Subtract line 2 from line 1 .......................................................................................................................              3.  XXXXXXXXXXXXXXX
4.  New Jersey depreciation allowable on the Single Asset Account (Assets placed in service prior to  
    January 1, 1998)
    a.  Total adjusted federal depreciable basis as of December 31, 1997............................................................                                       4a. XXXXXXXXXXXXXXX
    b.  Excess book depreciable basis over federal tax basis as of December 31, 1997 ......................................                                                4b. XXXXXXXXXXXXXXX
    c.  Less accumulated federal basis for all Single Asset Account property sold, retired or disposed of to date ...                                                      4c. XXXXXXXXXXXXXXX
    d.  Total (line 4a plus line 4b less line 4c).........................................................................................................                 4d. XXXXXXXXXXXXXXX
5.  New Jersey Depreciation – Divide line 4d by 30 ..............................................................................................                          5.  XXXXXXXXXXXXXXX
6.  New Jersey Adjustment
    a.  Depreciation adjustment for assets placed in service prior to Jan. 1, 1998 – Subtract line 5 from line 3 ...                                                       6a. XXXXXXXXXXXXXXX
    b.  Special bonus depreciation adjustment from Schedule S, Part I, line 15 (see instructions) .......................                                                  6b. XXXXXXXXXXXXXXX
7.  Total Adjustment – Add lines 6a and 6b and enter the result. (If line 7 is positive, enter at Schedule A, 
    Part II, line 9. If line 7 is negative, enter as a positive number at Schedule A, Part II, line 12) ........................                                           7.  XXXXXXXXXXXXXXX



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                                                                                                             2022 – CBT-100 – Page 13
NAME AS SHOWN ON RETURN                                            FEDERAL ID NUMBER

New Jersey Depreciation Worksheet I (See instructions)
    (A)                           (B)                          (C)     (D)              (E)              (F)                                                                                                               (G)
    Classification of Property    Basis for     Bonus Depreciation Convention       Method               Federal                                                                                                           New Jersey 
                                  Depreciation  (30% or 50%)                                             Depreciation                                                                                                      Depreciation 
                                                                                                         Deduction                                                                                                         Deduction (See 
                                                                                                                                                                                                                           Instructions)
1.  3-year property               XXXXXXXXXXXXX XXXXXXXXXXXXX      XXXXXXXXXXXXX    XXXXXXXXXXXXX        XXXXXXXXXXXXX                                                                                                     XXXXXXXXXXXXX
2.  5-year property               XXXXXXXXXXXXX XXXXXXXXXXXXX      XXXXXXXXXXXXX    XXXXXXXXXXXXX        XXXXXXXXXXXXX                                                                                                     XXXXXXXXXXXXX
3.  7-year property               XXXXXXXXXXXXX XXXXXXXXXXXXX      XXXXXXXXXXXXX    XXXXXXXXXXXXX        XXXXXXXXXXXXX                                                                                                     XXXXXXXXXXXXX
4.  10-year property              XXXXXXXXXXXXX XXXXXXXXXXXXX      XXXXXXXXXXXXX    XXXXXXXXXXXXX        XXXXXXXXXXXXX                                                                                                     XXXXXXXXXXXXX
5.  15-year property              XXXXXXXXXXXXX XXXXXXXXXXXXX      XXXXXXXXXXXXX    XXXXXXXXXXXXX        XXXXXXXXXXXXX                                                                                                     XXXXXXXXXXXXX
6.  20-year property              XXXXXXXXXXXXX XXXXXXXXXXXXX      XXXXXXXXXXXXX    XXXXXXXXXXXXX        XXXXXXXXXXXXX                                                                                                     XXXXXXXXXXXXX
7.  25-year property              XXXXXXXXXXXXX XXXXXXXXXXXXX      XXXXXXXXXXXXX    XXXXXXXXXXXXX        XXXXXXXXXXXXX                                                                                                     XXXXXXXXXXXXX
8.  Residential rental property   XXXXXXXXXXXXX XXXXXXXXXXXXX      XXXXXXXXXXXXX    XXXXXXXXXXXXX        XXXXXXXXXXXXX                                                                                                     XXXXXXXXXXXXX
9.  Nonesidential rental property XXXXXXXXXXXXX XXXXXXXXXXXXX      XXXXXXXXXXXXX    XXXXXXXXXXXXX        XXXXXXXXXXXXX                                                                                                     XXXXXXXXXXXXX
10. Total Column G (Enter amount on Schedule S, Part I, line 9) .................................................................................................................................                          XXXXXXXXXXXXX

New Jersey Depreciation Worksheet II – Disposal of Recovery Property (See Instructions)
        (A)                                     (B)                (C)              (D)                  (E)                                                                                                               (F)
    Description of Property                 Date Acquired:         Date Sold:       Federal Depreciation New Jersey                                                                                                        Excess/Deficiency
                                            month, day, year       month, day, year                      Depreciation
1.  XXXXXXXXXXXXXXXXXXXXXXXXXXX   XXXXXXXXXXXXXX                   XXXXXXXXXXXXXX   XXXXXXXXXXXXXX       XXXXXXXXXXXXXX                                                                                                    XXXXXXXXXXXXXX
2.  XXXXXXXXXXXXXXXXXXXXXXXXXXX   XXXXXXXXXXXXXX                   XXXXXXXXXXXXXX   XXXXXXXXXXXXXX       XXXXXXXXXXXXXX                                                                                                    XXXXXXXXXXXXXX
3.  XXXXXXXXXXXXXXXXXXXXXXXXXXX   XXXXXXXXXXXXXX                   XXXXXXXXXXXXXX   XXXXXXXXXXXXXX       XXXXXXXXXXXXXX                                                                                                    XXXXXXXXXXXXXX
4.  XXXXXXXXXXXXXXXXXXXXXXXXXXX   XXXXXXXXXXXXXX                   XXXXXXXXXXXXXX   XXXXXXXXXXXXXX       XXXXXXXXXXXXXX                                                                                                    XXXXXXXXXXXXXX
5.  XXXXXXXXXXXXXXXXXXXXXXXXXXX   XXXXXXXXXXXXXX                   XXXXXXXXXXXXXX   XXXXXXXXXXXXXX       XXXXXXXXXXXXXX                                                                                                    XXXXXXXXXXXXXX
6.  XXXXXXXXXXXXXXXXXXXXXXXXXXX   XXXXXXXXXXXXXX                   XXXXXXXXXXXXXX   XXXXXXXXXXXXXX       XXXXXXXXXXXXXX                                                                                                    XXXXXXXXXXXXXX
7.  XXXXXXXXXXXXXXXXXXXXXXXXXXX   XXXXXXXXXXXXXX                   XXXXXXXXXXXXXX   XXXXXXXXXXXXXX       XXXXXXXXXXXXXX                                                                                                    XXXXXXXXXXXXXX
8.  XXXXXXXXXXXXXXXXXXXXXXXXXXX   XXXXXXXXXXXXXX                   XXXXXXXXXXXXXX   XXXXXXXXXXXXXX       XXXXXXXXXXXXXX                                                                                                    XXXXXXXXXXXXXX
9.  XXXXXXXXXXXXXXXXXXXXXXXXXXX   XXXXXXXXXXXXXX                   XXXXXXXXXXXXXX   XXXXXXXXXXXXXX       XXXXXXXXXXXXXX                                                                                                    XXXXXXXXXXXXXX
10. XXXXXXXXXXXXXXXXXXXXXXXXXXX   XXXXXXXXXXXXXX                   XXXXXXXXXXXXXX   XXXXXXXXXXXXXX       XXXXXXXXXXXXXX                                                                                                    XXXXXXXXXXXXXX
11. XXXXXXXXXXXXXXXXXXXXXXXXXXX   XXXXXXXXXXXXXX                   XXXXXXXXXXXXXX   XXXXXXXXXXXXXX       XXXXXXXXXXXXXX                                                                                                    XXXXXXXXXXXXXX
12. XXXXXXXXXXXXXXXXXXXXXXXXXXX   XXXXXXXXXXXXXX                   XXXXXXXXXXXXXX   XXXXXXXXXXXXXX       XXXXXXXXXXXXXX                                                                                                    XXXXXXXXXXXXXX
13. XXXXXXXXXXXXXXXXXXXXXXXXXXX   XXXXXXXXXXXXXX                   XXXXXXXXXXXXXX   XXXXXXXXXXXXXX       XXXXXXXXXXXXXX                                                                                                    XXXXXXXXXXXXXX
14. XXXXXXXXXXXXXXXXXXXXXXXXXXX   XXXXXXXXXXXXXX                   XXXXXXXXXXXXXX   XXXXXXXXXXXXXX       XXXXXXXXXXXXXX                                                                                                    XXXXXXXXXXXXXX
15. XXXXXXXXXXXXXXXXXXXXXXXXXXX   XXXXXXXXXXXXXX                   XXXXXXXXXXXXXX   XXXXXXXXXXXXXX       XXXXXXXXXXXXXX                                                                                                    XXXXXXXXXXXXXX
16. Total Column F ....................................................................................................................................................................................................... XXXXXXXXXXXXXX



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                                                                                                                                                                   2022 – CBT-100 – Page 14
NAME AS SHOWN ON RETURN                                            FEDERAL ID NUMBER

              Computation of the 2022 Post Allocation Net Operating Loss (NOL) and  
Form 500 
              Prior Net Operating Loss Conversion Carryover (PNOL) Deductions (See Instructions)

Does the taxpayer have any Prior Net Operating Loss Conversion Carryovers?      Yes. Begin Form 500 at Section A, line 1.  OR                                       No. Enter zero 
on Schedule A, Part II, line 23 and continue with Section B.

Section A – Computation of Prior Net Operating Losses (PNOL) Deduction from periods ending PRIOR to July 31, 2019
Complete this section only if the allocated entire net income/(loss) before net operating loss deductions and dividend exclusion on Schedule A, Part II, line 22 is positive (income).
1. Prior Net Operating Loss Conversion Carryover (PNOL) – Enter the total of Worksheet 500-P, Part II,                                                             XXXXXXXXXXXXXXX
   column 3 .................................................................................................................................................. 1.
2. Enter the portion of line 1 previously deducted .......................................................................................                     2.  XXXXXXXXXXXXXXX
3. Enter the portion of line 1 that expired.....................................................................................................               3.  XXXXXXXXXXXXXXX
4. Enter any discharge of indebtedness excluded from federal taxable income in the current tax period                                                              XXXXXXXXXXXXXXX
   pursuant to subparagraph (A), (B), or (C) of paragraph (1) of subsection (a) of IRC § 108*...................                                               4.
5. PNOL available in the current tax year – Subtract lines 2, 3, and 4 from line 1 (if zero or less, enter zero) ...                                           5.  XXXXXXXXXXXXXXX
6. Enter the allocated net income from Schedule A, Part II, line 22 ............................................................                               6.  XXXXXXXXXXXXXXX
7. Current tax year’s PNOL deduction – Enter the lesser of line 5 or line 6 here and on Schedule A,                                                                XXXXXXXXXXXXXXX
   Part II, line 23 .......................................................................................................................................... 7.
* If the allocated discharge of indebtedness exceeds the amount of PNOL that is available and the taxpayer has post allocation net operating loss 
carryover in Form 500 Section B, carry the remaining balance to line 5 of Section B.
Section B – Post Allocation Net Operating Losses (NOLs) For Tax Years Ending ON AND AFTER July 31, 2019
Check the box next to each period if the unused, unexpired, post allocation NOL carryovers are from a tax period in which the taxpayer was a taxable 
member on a New Jersey combined return. Otherwise, leave the box blank.
1. Allocated Net Operating Loss Carryover – See instructions.
                                                                                                                                                                   XXXXXXXXXXXXXXX
   a. Return Period Ending                          .............................................................................                              1a.
   b. Return Period Ending                          .............................................................................                              1b. XXXXXXXXXXXXXXX
   c.  Return Period Ending                         .............................................................................                              1c. XXXXXXXXXXXXXXX
   d. Return Period Ending                          .............................................................................                              1d. XXXXXXXXXXXXXXX
   e. Return Period Ending                          .............................................................................                              1e. XXXXXXXXXXXXXXX
   f.  Return Period Ending                         .............................................................................                              1f. XXXXXXXXXXXXXXX
   g. Return Period Ending                          .............................................................................                              1g. XXXXXXXXXXXXXXX
   h. Return Period Ending                          .............................................................................                              1h. XXXXXXXXXXXXXXX
   i.  Return Period Ending                         .............................................................................                              1i. XXXXXXXXXXXXXXX
   j.  Return Period Ending                         .............................................................................                              1j. XXXXXXXXXXXXXXX
2. Total Post Allocation Net Operating Losses (NOLs) – Add lines 1a through 1j .........................................                                       2.  XXXXXXXXXXXXXXX
3. Portion of line 2 previously deducted.........................................................................................................              3.  XXXXXXXXXXXXXXX
4. Portion of line 2 that expired (after 20 privilege periods) ...........................................................................                     4.
5. Enter the amount of any adjustments required under provisions of the federal Internal Revenue Code                                                              XXXXXXXXXXXXXXX
   (see instructions) ......................................................................................................................................   5.
6. NOLs available for current tax year – Subtract lines 3, 4, and 5 from line 2 .............................................                                  6.  XXXXXXXXXXXXXXX
7. Enter Allocated Entire Net Income Before Post Allocation Net Operating Loss Deduction from                                                                      XXXXXXXXXXXXXXX
   Schedule A, Part II, line 24 ......................................................................................................................         7.
8. Current tax year’s NOL deduction – Enter the lesser of line 6 or line 7 here and on Schedule A,                                                                 XXXXXXXXXXXXXXX
   Part II, line 25 .......................................................................................................................................... 8.



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                                                                                                       2022 – CBT-100 – Page 15
NAME AS SHOWN ON RETURN                               FEDERAL ID NUMBER

worksheet                      NEW JERSEY CORPORATION BUSINESS TAX

500-P                          Prior Net Operating Loss Conversion Worksheet 
                               Use this worksheet to calculate the converted prior net operating losses for use  
                               for tax years ending on and after July 31, 2019. (See Instructions)

NOTE:  This is used to calculate your converted prior net operating losses from pre-allocated net operating loss carryovers to post-allocated net 
     operating loss carryovers for the last tax periods ending before July 31, 2019. Use the allocation factor calculated on Schedule J in the last 
     tax period ending prior to July 31, 2019, for Part I, line 1. This is the taxpayer’s base year allocation factor for the last tax period ending before 
     July 31, 2019, pursuant to N.J.S.A. 54:10A-4(u). Submit a copy of this worksheet to substantiate calculations and to determine usable 
     amounts for future years. If more space is needed, enclose a rider listing the information.

Part I

1.  Allocation Factor For The Last Tax Period Ending Prior to July 31, 2019 (from Schedule J) ........ XXXXXXXXXXXXXXX

Part II
          Column 1                                    Column 2                                         Column 3
                                                                                                       Converted Prior Net Operating  
                                                      Prior Net Operating Losses                       Loss Carryover
       Tax Period Ending                              (see instructions)                               Multiply line I, Part I by amount in column 2, Part II
2.     XXXXXXXXXXXXXXX                                XXXXXXXXXXXXXXX                                  XXXXXXXXXXXXXXX

3.     XXXXXXXXXXXXXXX                                XXXXXXXXXXXXXXX                                  XXXXXXXXXXXXXXX

4.     XXXXXXXXXXXXXXX                                XXXXXXXXXXXXXXX                                  XXXXXXXXXXXXXXX

5.     XXXXXXXXXXXXXXX                                XXXXXXXXXXXXXXX                                  XXXXXXXXXXXXXXX

6.     XXXXXXXXXXXXXXX                                XXXXXXXXXXXXXXX                                  XXXXXXXXXXXXXXX

7.     XXXXXXXXXXXXXXX                                XXXXXXXXXXXXXXX                                  XXXXXXXXXXXXXXX

8.     XXXXXXXXXXXXXXX                                XXXXXXXXXXXXXXX                                  XXXXXXXXXXXXXXX

9.     XXXXXXXXXXXXXXX                                XXXXXXXXXXXXXXX                                  XXXXXXXXXXXXXXX

10.    XXXXXXXXXXXXXXX                                XXXXXXXXXXXXXXX                                  XXXXXXXXXXXXXXX

11.    XXXXXXXXXXXXXXX                                XXXXXXXXXXXXXXX                                  XXXXXXXXXXXXXXX

12.    XXXXXXXXXXXXXXX                                XXXXXXXXXXXXXXX                                  XXXXXXXXXXXXXXX

13.    XXXXXXXXXXXXXXX                                XXXXXXXXXXXXXXX                                  XXXXXXXXXXXXXXX

14.    XXXXXXXXXXXXXXX                                XXXXXXXXXXXXXXX                                  XXXXXXXXXXXXXXX

15.    XXXXXXXXXXXXXXX                                XXXXXXXXXXXXXXX                                  XXXXXXXXXXXXXXX

16.    XXXXXXXXXXXXXXX                                XXXXXXXXXXXXXXX                                  XXXXXXXXXXXXXXX

17.    XXXXXXXXXXXXXXX                                XXXXXXXXXXXXXXX                                  XXXXXXXXXXXXXXX

18.    XXXXXXXXXXXXXXX                                XXXXXXXXXXXXXXX                                  XXXXXXXXXXXXXXX

19.    XXXXXXXXXXXXXXX                                XXXXXXXXXXXXXXX                                  XXXXXXXXXXXXXXX

20.    XXXXXXXXXXXXXXX                                XXXXXXXXXXXXXXX                                  XXXXXXXXXXXXXXX

                               Enclose a Copy with Tax Return






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