Free F-1161 - Florida

Application for Rescindment of Corporate Income Tax and Insurance Premium Tax Credit for Contributions to Nonprofit Scholarship Funding Organizations (SFOs)
(Under section 220.187 and 624.51055, Florida Statutes)

F-1161 R. 07/09

Business name ___________________________________________________________________________________________ Federal Employer Identification Number (FEIN) ­

Mailing address __________________________________________________________________________________________ City ___________________________________________ State _____________ ZIP __________________________________ Contact person ___________________________ Contact's telephone number ____________________________________ If included in a consolidated Florida corporate income tax return, provide: Parent Corporation's FEIN ­ , , .

Original amount of planned contribution $

Confirmation number of original credit application (if known) __________________________________________________ Enter the name of the SFO the credit was originally approved for: _________________________________________________________________________________________________________ Enter the taxable year the credit was originally approved for: Beginning date
MM

/

DD

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and ending date
YY MM

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DD

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YY

Enter the amount you wish to rescind $

,

,

.

Has any of the above amount already been contributed to the SFO? q Yes q No Do you give permission and grant authority to the Florida Department of Education to share the corporation's name, address, telephone number, and tax credit amount with the SFO identified in this application? q Yes q No I hereby certify that I have examined this application form and the information contained here is, to the best of my knowledge and belief, true, correct, and complete.

________________________________________________ Signature of officer, owner, or partner

______________________ Date

F-1161 R. 07/09

Instructions for Completing Form F-1161
You may apply to the Department for rescindment of all or part of a previously approved credit allocation for a contribution to an SFO. You must submit a separate application for the rescindment of each previously approved credit allocation. Applications for rescindment can be made on the Department's Internet site: dor.myflorida.com/dor. Once you have entered the requested information, a confirmation screen with a confirmation number will appear. This screen will display the information entered and confirm receipt of the electronic application for rescindment. You can print this screen or simply record the confirmation number to prove that you submitted an application for rescindment. If you paid $20,000 or more in corporate income tax or insurance premium tax in the state fiscal year before application, you must apply for rescindment online. If you paid less than $20,000 in corporate income tax or insurance premium tax in the state fiscal year before application, you are encouraged to apply for rescindment online. However, you may also apply by completing and mailing Form F-1161 to: Revenue Accounting - CIT/IPT SFO Credit Florida Department of Revenue 5050 W Tennessee St Bldg I Tallahassee FL 32399-0100 Within ten working days of receipt of an electronic or paper application, we will send written correspondence regarding the approved amount or the reason we could not approve the rescindment. We will approve the rescindment unless: (1) You have had more than one approved rescindment of this credit within the last three (3) tax years. (2) You have claimed the approved credit allocation amount to be rescinded on a previously filed Florida corporate income tax or insurance premium tax return. (3) The allocation year is closed for all taxpayers. The allocation for a particular year is closed for all taxpayers at the end of the following calendar year. For example, the allocation year beginning January 1, 2009, closes for all taxpayers on December 31, 2010, regardless of whether the annual allotment has been reached because there are no more tax years remaining open that began in calendar year 2009 as of December 31, 2010.