The statement from the pass-through entity should include the taxpayer’s Social Security number, name, tax year, and the pass-through entity’s name, and Federal Employer Identification Number. In addition, it should include the state, if the taxpayer elected to participate in the composite filing (Yes or No), gross income, taxable income, and tax liability. 

State Election to Participate   Gross Income   Taxable Income   Tax Liability
State A Yes $ 100,000 $ 93,265 $ 5,643
State B No $ 22,450 $ 19,767 $ 1,324
State C Yes $ 152 $ 147 $ 9
State D Yes $ 3,065 $ 2,978 $ 253
State E Yes $ 174,623 $ 169,441 $ 15,721