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 $0.00. The Corrected Taxable income displays $888,888, and the Corrected Tax Liability displays $302,222. Line 12 Total Tax Shown on Return or as Previously Adjusted displays $292,022. The Deficiency and Balance Due both display $10,200.In the column for tax year 2000, one adjustment to Income is shown in the amount of $50,000, the Corrected Taxable Income displays $20,000, and the Corrected Tax Liability displays $3,000. The Total Tax Shown on the Return is $0.00, and the Deficiency and Balance Due display $3,000.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