This is an example of a completed calendar year Form 1120-S (Page 1 only). There are multiple IRS Received Dates stamped in the center of the return from various IRS areas.Top left corner of Form 1120-S reads: DRAFTBox A shows 07/05/2011 for the S election effective dateBox B shows 4615 for the Business Activity CodeBox D shows 00-4262501 for the Employer Identification Number (EIN)Box E shows 07/05/2011 for the date incorporated.Cypress Gold Inc. is shown on the name line and CYPR is underlined as the name control525 Maple Court #2 is shown for the street address lineBaltimore, MD 21233 is shown for the city, state, and ZIP code lineBox F shows $150,000 for Total AssetsBox I shows 4 for the Number of Shareholders during any part of the tax yearLine 1a, Gross receipts or sales, shows 110,000Line 1c, Balance, shows 110,000Line 3, Gross profit, shows 110,000Line 4, Net gain (loss) from Form 4797, shows 1,000Line 6, Total income (loss) shows 111,000Line 7, Compensation of officers, shows 20,000Line 11, Rents, shows 17,000Line 19, Other deductions, shows 6,000Line 20, Total deductions, shows 43,000Line 21, Ordinary business income (loss) shows 68,000There are multiple IRS Received Dates stamped in the center of the return from various IRS areas. The SPC Fresno date stamp and the Kansas City, MO date stamp are circled out in red, leaving the SBSE Field Collection date stamp as the received date.First Received Date Stamp reads:RECEIVED MAR 12 2021 SBSE FIELD COLLECTION GREENVILLE, NC - GROUP 43Second Received Date Stamp reads:Internal Revenue ServiceReceived LB #49MAR 25 2021 - Circled out in redSPC FRESNO,CA Third Received Date Stamp reads:RECEIVED00104152021 - Circled out in redKansas City, MOIRS-KCSCSign Here box: Signature of officer: James BeechSign Here box: Date: 3/10/21