Sample Form 4549-A - Income Tax Examination ChangesThe sample form is an example of Form 4549-A, which is the basic report form prepared by examiners for unagreed and excepted agreed individual and corporate income tax cases. The sample form is an example of a completed form reflecting examination results for tax periods ending 12/31/1998 and 12/31/2000. In the column for tax year 1998, Line 1 displays a Net Operating Loss Deduction (NOLD) from 2000 as a proposed adjustment in the amount of ($30,000). The Corrected Taxable income displays $858,888. The Corrected Tax Liability displays $292,022. Line 12 Total Tax Shown on Return or as Previously Adjusted displays $292,022. The Deficiency and Balance Due are both zero.In the column for tax year 2000, no adjustments are shown and the Corrected Taxable Income displays ($30,000).The Deficiency and Balance Due are both zero.The Other information contains the following remarks regarding the previous tentative allowance: Line 12: Total Tax Shown on Return or as Previously AdjustedTax per original return $302,222Less refund per Form 1139 filed 5/30/01 $10,2001998 Tax - Form 4549 -Line 12 = $292,022