PA-20S/PA-65 2106010057 PA S Corporation/Partnership

IMPORTANT: FILL IN FORM MUST BE DOWNLOADED ONTO YOUR COMPUTER PRIOR TO COMPLETING

PA-20S/PA-65

PA S Corporation/Partnership Information Return

2106010057

Page 1 of 3 (DR) MOD 05-21 (FI) PA Department of Revenue

2021

PLEASE PRINT. USE BLACK INK.

START ? PA-20S

Filing Status: PA-65

FEIN 9 DIGIT - NO DASH

C

Business Name

Revenue ID

NAICS Code

P-S KOZ Inactive

First Line of Address - Street Address - If Address has Apartment Number, Suite, RR No. - Place on this Line.

Second Line of Address - PO Box

City or Post Office

State ZIP Code

Country Code

Fill in the applicable ovals

Method of Accounting

Accrual

Cash

Other, Describe

Extension Requested

Initial Year

Fiscal Year

Short Year MM/DD/YY

Beginning

Ending

_________

_________

Final Return

FEIN/Name/Address Change

Amended Information Return

Date activity began in PA

____________________________ (MMDDYYYY)

SUBMIT ALL SUPPORTING SCHEDULES

USE BLACK INK

If a loss, fill in the oval next to the line

SECTION I. Total Taxable Business Income (Loss) from Operations Everywhere

LOSS

1a Taxable Business Income (Loss) from Operations Everywhere . . . . . . . . . . . . . . . . . . . . . . . . .

1a

l00

LOSS

1b Share of Business Income (Loss) from All Other Entities . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

1b

l00

LOSS

1c Total Income (Loss). Add Lines 1a and 1b . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

1c

l00

1d Previously Disallowed CNI Deductions - PA S Corporations only . . . . . . . . . . . . . . . . . . . . .

1d

LOSS

1e Total Adjusted Business Income (Loss). Subtract Line 1d from Line 1c . . . . . . . . . . . . . . . . . . . . .

1e

SECTION II. Apportioned/Allocated PA-Taxable

Business Income (Loss) 2 Net Business Income (Loss) . . . . . . . . . . . . . . . . . . LOSS 2a

Outside PA

00 LOSS

l

2e

If a loss, enter "0" l00 l00

PA Source

l00

2

Share of Business Income (Loss) from Other Entities . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

LOSS

2b

2 Previously Disallowed PA Source CNI

Deductions - PA S Corporations only . . . . . . . . .

2c

l00

If a loss, enter "0"

l00

LOSS

2f 2g

l00

If a loss, enter "0"

l00

2

Calculate Adjusted/Apportioned Net Business Income (Loss) . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

LOSS

2d

00 LOSS

l

2h

l00

SECTION III. Allocated Other PA PIT Income (Loss)

Outside PA

PA Source

3 Interest Income from PA Schedule A . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3h

4 Dividend Income from PA Schedule B . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4h

LOSS

LOSS

5 Net Gain (Loss) from PA Schedule D . . . . . . . . . . . . . 5a

l00

5b

6 Rent/Royalty Net Income (Loss) from

LOSS

PA Schedule M, Part II . . . . . . . . . . . . . . . . . . . . . . . . 6a

LOSS

l00

6b

7 Estates or Trusts Income from PA Schedule J . . . . . . . 7a

If a loss, enter "0" l00

7b

LOSS

8 Gambling and Lottery Winnings (Loss) from PA Schedule T 8a

LOSS

l00

8b

LOSS

9 Total Other PA PIT Income (Loss) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

9b

Page 1 of 3 EC

OFFICIAL USE ONLY

If a loss, enter "0" l00 If a loss, enter "0" l00

l00

l00 If a loss, enter "0" l00

l00 l00

FC

2106010057

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PA-20S/PA-65

PA S Corporation/Partnership Information Return

2106110055

2021 Page 2 of 3 (DR) MOD 05-21 (FI)

PA Department of Revenue

FEIN 9 DIGIT - NO DASH

Business Name

C

SECTION IV. Total PA S Corporation or Partnership Income (Loss)

LOSS

10 Total Income (Loss) per Books and Records . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

10

l00

LOSS

11 Total Reportable Income (Loss). Add Lines 1e and 9 or add Lines 2h and 9 . . . . . . . . . . . . . . . .

11

l00

LOSS

12 Total Nontaxable/Nonreportable Income (Loss). Subtract Line 11 from Line 10 . . . . . . . . .

12

l00

SECTION V. Pass Through Credits - See the PA-20S/PA-65 instructions

13a Total Other Credits. Submit PA-20S/PA-65 Schedule OC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13a 13b Resident Credit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13b 14a PA 2021 Quarterly Tax Withholding Payments/Extension Payment for Nonresident Owners . . . . . . 14a 14b Final Payment of Nonresident Withholding Tax . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14b 14c Total PA Income Tax Withheld. Add Lines 14a and 14b . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14c

If a loss, enter "0" l00 If a loss, enter "0" l00 If a loss, enter "0" l00 If a loss, enter "0" l00 If a loss, enter "0" l00

SECTION VI. Distributions - See the PA-20S/PA-65 instructions ? Partnerships Only

15 Distributions of Cash, Marketable Securities, and Property . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 16 Guaranteed Payments for Capital or Other Services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16

If a loss, enter "0" l00 If a loss, enter "0" l00

17 All Other Guaranteed Payments for Services Rendered . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17 If a loss, enter "0" l00

18 Guaranteed Payments to Retired Partners . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18 If a loss, enter "0" l00

Distributions - See the PA-20S/PA-65 instructions ? PA S Corporations Only

19 Distributions from PA Accumulated Adjustments Account . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19 20 Distributions of Cash, Marketable Securities, and Property . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20

If a loss, enter "0" l00 If a loss, enter "0" l00

SECTION VII. Other Information ? See the PA-20S/PA-65 instructions for each line

Yes or No

01 During the entity's tax year, did the entity own any interest in another partnership or in any foreign entity that was disregarded as an entity separate from its owner under federal regulations Sections 301.7701-2 and 301.7701-3? If yes, submit statement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

02 Does the entity have any tax-exempt partners/members/shareholders? If yes, submit statement . . . . . . . . . . . . . . . . . 2

03 Does the entity have any foreign partners/members/shareholders (outside the U.S.)? If yes, submit statement . . . . . 3

04 Was there a distribution of property or a transfer (e.g., by sale or death) of a partner/member interest during the tax year? (Partnership only) If yes, submit statement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4

05 Has the federal government changed taxable income as originally reported for any prior period? If yes, indicate period on supplemental statement, and submit final IRS determination paperwork . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

06 Does the entity elect to be subject to assessment at the entity level under Act 52 of 2013? . . . . . . . . . . . . . . . . . . . . . 6

07 Is this entity involved in a reportable transaction, listed transaction, or registered tax shelter within this return? If yes, submit statement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7

08 Does the entity filing as a partnership have other partnerships as partners? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

09 Has the entity sold any tax credits? If yes, submit statement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9

10 Has the entity changed its method of accounting for federal income tax purposes during this tax year? If yes, submit federal Form 3115 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

11 Has the entity entered into any like-kind exchanges under IRC Section 1031? If yes, submit federal Form 8824 . . . 11

12 PA Apportionment as reported on PA-20S/PA-65 Schedule H-Corp . . . . . . . . . . . . . . . . . . . . . . . . . . 12

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PA-20S/PA-65

PA S Corporation/Partnership Information Return

2021 Page 3 of 3 (DR) MOD 05-21 (FI)

PA Department of Revenue

FEIN 9 DIGIT - NO DASH

Business Name

C

2106210053

SECTION VIII. PA S Corporations Only - Accumulated Adjustments Account (AAA) and Accumulated Earnings and Profits (AE&P)

LOSS

1 Balance at the beginning of the taxable year . . . . . If AAA is negative, fill in the oval

1

AAA

2 Total reportable income from Section IV, Line 11 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 If a loss, enter "0"

3 Other additions. Submit an itemized statement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

LOSS

4 Loss from Section IV, Line 11 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

4

LOSS

5 Other reductions. Submit an itemized statement . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

5

LOSS

6 Sum of Lines 1 through 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6

If a loss, enter "0"

7 Distributions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7

LOSS

8 Balance at taxable year-end. Subtract Line 7 from Line 6 . . . . . . . . . . . . . . . . . . . . . . . .

8

AE&P

If a loss, enter "0"

N/A

If a loss, enter "0"

N/A

If a loss, enter "0"

SECTION IX. Ownership in Pass Through Entities

If the entity received income (loss) from an S corporation, partnership, estate or trust, limited liability company, qualified subchapter S subsidiary (QSSS) or disregarded entity, list below the FEIN, name and address for each entity. If the income (loss) is from a QSSS, enter "yes" in the QSSS box. If the income (loss) is from a disregarded entity other than a QSSS, enter "yes" in the D box. See Instructions for further details.

FEIN

9 DIGIT - NO DASH

QSSS D

NAME & ADDRESS

a

b

c

d e

f

SECTION X. Signature and Verification

Under penalties of perjury, I declare I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of paid preparer is based on all information of which preparer has any knowledge.

Print/Type name of general partner, principal officer or authorized individual

Signature of general partner, principal officer or authorized individual

Date MM/DD/YY Daytime phone no.

Please Sign Your Return after printing.

Paid Preparer's Use Only

Print/Type preparer's name

Firm's name (or yours if self-employed)

Preparer's signature

Date

Please Sign Your Return after printing.

Check if self-employed

Daytime phone no.

Firms's address

E-File Opt Out

Preparer's PTIN 9 DIGIT - NO DASH

Firm's FEIN 9 DIGIT - NO DASH

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Form PA-20S/PA-65 IN (DR) MOD 05-21

2021

Instructions for Form PA-20S/PA-65

PA S Corporation/Partnership Information Return

WHAT'S NEW

ELECTRONIC PAYMENT SERVICES Individuals can remit estimated, extension and tax due payments through the department's myPATH portal. Visit mypath. and select Make a payment to pay via electronic funds transfer. Payments made after December 31, 2021, equal to or greater than $15,000 must be made electronically. Payments not made electronically will be subject to a penalty equal to 3% of the payment amount not to exceed $500.

PA-20S/PA-65 V Please use this payment voucher found on the department's website to submit final nonresident withholding payments. This voucher would accompany a paper check being submitted to the department for annual nonresident withholding payments only. Final nonresident withholding payments can also be paid via mypath.

DIRECTORY OF CORPORATE PARTNERS Directory of Corporate Partners added new fields for FEIN/Name/Address Change, Fiscal Year, Short Year Beginning /Ending Periods and Country Code.

SCHEDULE E For each rental real estate property (e.g., townhouse) and/or royalty income (e.g., mineral extracts), enter street address, city or town, and state and the type of property. The type of property MUST be specified as described on FF8825 codes. Single Family Residence multi family residence Vacation, Commercial, Land, Royalties. If the property is outside Pennsylvania, fill in the oval.

Properties should not have the same address AND must be clearly identified as to property description and Lot #, Apt. # or Unit #.

NOTE: The address must be specific. If a multi-unit rental property, the address must include Unit/Apt for each unit. Example: Apt A or Unit 1201.

SCHEDULE NW The PA-40 NRC-I was eliminated in 2020 and replaced with the PA-20S/PA-65 Schedule NW Section II. DO NOT create your own substitute Schedule NRC-I to include with the PA-40 NRC, Nonresident Consolidated Return. This will cause delays in processing your return.

revenue.

PREVIOUS PAGE

SCHEDULE OC Line 1 "PA Employment Incentive Payments Tax Credit" was removed. Line 5 expanded to "Entertainment Economic Enhancement Program Tax Credit and PA Live Events Industry Credit".

PA-40 NRC PA-40 NRC added new Line 9 for "2021 Extension Payment."

TWO-CHARACTER COUNTRY CODE FIELD If the form has this field and the entity is out of country, it MUST be populated. Please see the directions for each form on the Department's website. You can find the appropriate Country Codes at .

HOW TO GET FORMS AND PUBLICATIONS

INTERNET Visit the department's website at revenue. to:

Download forms, instructions and publications; Research tax questions by using the Online Customer

Service Center; or Search publications online by topic or keyword.

If you do not have Internet access, visit your local public library or district office.

EMAIL Forms for tax year 2010 through the current year can be found on the department's website at revenue.. Requests for forms prior to 2010 should be sent to ra-forms@.

WRITTEN REQUESTS Send written requests for forms to:

PA DEPARTMENT OF REVENUE TAX FORM SERVICE UNIT 1854 BROOKWOOD ST HARRISBURG PA 17104-2244

BY PHONE AND IN PERSON You can order forms and publications by calling the department's automated, 24-hour, toll-free forms ordering message service at 1-800-362-2050.

You can also get most forms and publications at your nearest district office. Please call ahead to verify a district office's address and services or visit revenue. for more information. Taxpayer assistance hours are 8:30 a.m. to 5:00 p.m.

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