This is an example of a completed Form 1120-S (Page 1 top portion only). An attachment indicates an address change. The new address information is edited to the entity area of Form 1120-S.Form 1120-S, Page 1, Entity portion, current year returnTop left corner of Form 1120-S reads: DRAFTBox A shows 12-12-92 for the effective date of the S electionBox B shows 523900 for the Business Activity CodeBox D shows 00-0181650 for the Employer Identification Number (EIN)Box E shows 12-12-92 for the date incorporated.Balsam Finance Co is shown on the name line and BALS is underlined as the name control206 Pine Lane is circled out in red and the new address 3501 Chestnut Ave is written in red to the right of the old address on the street address lineSan Jose CA 95101 is circled out in red and the new city Miami, FL 33152 is written in red to the right of the old city for the city, state, and ZIP code lineBox F shows 79,850 for Total AssetsBox H(3): Address change, has an X markAn attachment indicates an address change. There is an attachment text box that reads: To Whom It May Concern: Please change my address to:3501 Chestnut AvenueMiami, FL 33152Thank youSincerely,John CedarJohn Cedar