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Utah Partnership/Limited Liability Partnership/ 2021
65101
Limited Liability Company Return TC-65
9998 For calendar year 2021 or fiscal year (mm/dd/yyyy):
beginning - // and ending - //
USTC ORIGINAL FORM
• Amended Return (code 1-4) • Mark “X” if you filed federal form 8886
Partnership name
Address Employer Identification Number
City State ZIP + 4
Foreign country (if not U.S.) Telephone number
ENTITY TYPE (check one): • General partnership • Limited partnership • Other (describe below)
• Limited liability partnership • Limited liability company
1 Date registered in Utah (mm/dd/yyyy) • 1 //
2 If dissolved, date of dissolution (mm/dd/yyyy) • 2 //
3 Total pass-through withholding tax - enter the amount from Schedule N, column I • 3
Note: This amount must be paid by the due date of the return, without extensions
4 Utah use tax • 4
5 Total tax - add line 3 and line 4 5
6 Prepayments made for the year (do not include any pass-through withholding tax or credits - see instr.) • 6
7 Amended return only (see instructions) • 7
8 Total payments - add line 6 and line 7 • 8
9 Tax Due - subtract line 8 from line 5 (not less than zero) • 9
10 Penalties and interest (see instructions) 10
11 Total Due - Pay this amount - add line 9 and line 10 • 11
12 Overpayment - subtract the sum of line 5 and line 10 from line 8 (not less than zero) 12
13 Amount of overpayment on line 12 to be applied to next year • 13
14 Refund - subtract line 13 from line 12 • 14 USTC USE ONLY
Under penalties of perjury, I declare to the best of my knowledge and belief,
this return and accompanying schedules are true, correct and complete.
SIGN Signature of general partner or member manager Date Title “X” if USTC may discuss
HERE this return with preparer below:
Preparer’s signature Date Preparer’s telephone number Preparer’s PTIN
Paid •
Preparer’s Firm’s name and address Preparer’s EIN
Section •