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INSTRUCTIONS TO PRINTERS
SCHEDULE G (FORM 1120), PAGE 1 of 2
MARGINS: TOP 13mm (1⁄ 2 ”), CENTER SIDES.
PRINTS: HEAD to HEAD
PAPER: WHITE WRITING, SUB. 20.
INK: BLACK
FLAT SIZE: 432mm (17") x 279mm (11") FOLDS TO: 216mm (81⁄ 2 ”) x 279mm (11”)
PERFORATE: (NONE)
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Action
Date
O.K. to print
Revised proofs
requested
Information on Certain Persons Owning the
Corporation’s Voting Stock
SCHEDULE G
(Form 1120)
Name
OMB No. 1545-0123
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Department of the Treasury
Internal Revenue Service
Signature
Attach to Form 1120.
2009
Employer identification number (EIN)
Part I
Certain Entities Owning the Corporation’s Voting Stock. (Form 1120, Schedule K, Question 4a).
Complete columns (i) through (v) below for any foreign or domestic corporation, partnership (including
any entity treated as a partnership), trust, or tax-exempt organization that owns directly 20% or more, or
owns, directly or indirectly, 50% or more of the total voting power of all classes of the corporation’s
stock entitled to vote (see instructions).
(i) Name of Entity
Part II
(ii) Employer Identification
Number (if any)
(iii) Type of Entity
(iv) Country of Organization
(v) Percentage Owned in Voting Stock
Certain Individuals and Estates Owning the Corporation’s Voting Stock. (Form 1120, Schedule K,
Question 4b). Complete columns (i) through (iv) below for any individual or estate that owns directly 20%
or more, or owns, directly or indirectly, 50% or more of the total voting power of all classes of the
corporation’s stock entitled to vote (see instructions).
(i) Name of Individual or Estate
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions.
(ii) Identifying
Number (if any)
(iii) Country of
Citizenship (see
instructions)
Cat. No. 52684S
(iv) Percentage Owned
in Voting Stock
Schedule G (Form 1120) 2009