This is an example of completed Form 1120-S (Page 1 top portion only) with the Name Control edited.Form 1120-S, Page 1, Current year returnTop left corner of Form 1120-S reads: DRAFTBox A shows Feb 10, 1981 for the effective date of the S electionBox B shows 446110 for the Business Activity CodeBox D shows 00-1106960 for the Employer Identification Number (EIN)Box E shows February 10, 1981, for the date incorporated.Maple Pharmacy shown on the name line and MAPL is underlined as the name control1213 Hemlock Dr is shown for the street address lineBuffalo, NY 14240 is shown for the city, state, and ZIP code lineBox F shows 110,200 for Total AssetsBox I shows 1 for the Number of Shareholders during any part of the tax year