Free F-7004 - Florida

Rule 12C-1.051 Florida Administrative Code Effective 01/09

Florida Department of Revenue - Corporate Income Tax
Florida Tentative Income / Franchise and Emergency Excise Tax Return and Application for Extension of Time to File Return If typing, type through the boxes. (example)

F-7004 R. 01/09

You must write within the boxes. (example) 0 1 2 3 4 5 6 7 8 9 Write your numbers as shown and enter one number per box. Name Address City/St/ZIP

0123456789

F-7004

FEIN
Taxable year end: Corporation Partnership
FILING STATUS (Mark "X" in one box only) US DOLLARS CENTS

M M D D Y Y
Tentative tax due
(See reverse side)

Under penalties of perjury, I declare that I have been authorized by the above-named taxpayer to make this application, and that to the best of my knowledge and belief the statements herein are true and correct:

Sign here:___________________________________________ Date:__________________
Make checks payable and mail to: Florida Department of Revenue, 5050 W Tennessee St, Tallahassee FL 32399-0135

Check here if you transmitted funds electronically

9100 0 20089999 0002005030 6 3999999999 0000 2

Rule 12C-1.051 Florida Administrative Code Effective 01/09

Florida Department of Revenue - Corporate Income Tax
Florida Tentative Income / Franchise and Emergency Excise Tax Return and Application for Extension of Time to File Return If typing, type through the boxes. (example)

F-7004 R. 01/09

You must write within the boxes. (example) 0 1 2 3 4 5 6 7 8 9 Write your numbers as shown and enter one number per box. Name Address City/St/ZIP

0123456789

F-7004

FEIN
Taxable year end: Corporation Partnership
FILING STATUS (Mark "X" in one box only) US DOLLARS CENTS

M M D D Y Y
Tentative tax due
(See reverse side)

Under penalties of perjury, I declare that I have been authorized by the above-named taxpayer to make this application, and that to the best of my knowledge and belief the statements herein are true and correct:

Sign here:___________________________________________ Date:__________________
Make checks payable and mail to: Florida Department of Revenue, 5050 W Tennessee St, Tallahassee FL 32399-0135

Check here if you transmitted funds electronically

9100 0 20089999 0002005030 6 3999999999 0000 2

Rule 12C-1.051 Florida Administrative Code Effective 01/09

Florida Department of Revenue - Corporate Income Tax
Florida Tentative Income / Franchise and Emergency Excise Tax Return and Application for Extension of Time to File Return If typing, type through the boxes. (example)

F-7004 R. 01/09

You must write within the boxes. (example) 0 1 2 3 4 5 6 7 8 9 Write your numbers as shown and enter one number per box. Name Address City/St/ZIP

0123456789

F-7004

FEIN
Taxable year end: Corporation Partnership
FILING STATUS (Mark "X" in one box only) US DOLLARS CENTS

M M D D Y Y
Tentative tax due
(See reverse side)

Under penalties of perjury, I declare that I have been authorized by the above-named taxpayer to make this application, and that to the best of my knowledge and belief the statements herein are true and correct:

Sign here:___________________________________________ Date:__________________
Make checks payable and mail to: Florida Department of Revenue, 5050 W Tennessee St, Tallahassee FL 32399-0135

Check here if you transmitted funds electronically

9100 0 20089999 0002005030 6 3999999999 0000 2







Information for Filing Form F-7004
When to file -- File this application on or before the original due date of the taxpayer's corporate income tax or partnership return. Do not file before the end of the tax year. To file online go to www.myflorida.com/dor Penalties for failure to pay tax -- If you are required to pay tax with this application, failure to pay will void any extension of time and subject the taxpayer to penalties and interest for failure to file a timely return(s) and pay all taxes due. There is also a penalty for a late-filed return when no tax is due. Signature -- A person authorized by the taxpayer must sign Form F-7004. They must be (a) an officer or partner of the taxpayer, (b) a person currently enrolled to practice before the Internal Revenue Service (IRS), or (c) an attorney or Certified Public Accountant qualified to practice before the IRS under Public Law 89-332. A. Have you filed Form 7004 with the IRS for the taxable year? ................................................................ If the answer is "No," complete Item B. An extension for Florida tax purposes may be granted, even though no federal extension was granted. See Rule 12C-1.0222, F.A.C., for information on the requirements that must be met for your request for an extension of time to be valid.

B. If applicable, state the reason you need the extension: ______________________ ______________________________________________________________________ ______________________________________________________________________ C. Type of federal return filed:_______________________________________________ Contact person for questions: ____________________________________________ Telephone number: (________) ___________________________________________

F-7004 R. 01/09

Extension of Time Request 1. Tentative amount of Florida tax for the taxable year 1. 2.

Florida Income/Franchise Emergency Excise Tax Due



Yes



No

2. LESS: Estimated tax payments for the taxable year

3. Balance due -- You must pay 100% of the tax 3. tentatively determined due with this extension request. Transfer the amount on Line 3 to Tentative tax due on reverse side.

Information for Filing Form F-7004
When to file -- File this application on or before the original due date of the taxpayer's corporate income tax or partnership return. Do not file before the end of the tax year. To file online go to www.myflorida.com/dor Penalties for failure to pay tax -- If you are required to pay tax with this application, failure to pay will void any extension of time and subject the taxpayer to penalties and interest for failure to file a timely return(s) and pay all taxes due. There is also a penalty for a late-filed return when no tax is due. Signature -- A person authorized by the taxpayer must sign Form F-7004. They must be (a) an officer or partner of the taxpayer, (b) a person currently enrolled to practice before the Internal Revenue Service (IRS), or (c) an attorney or Certified Public Accountant qualified to practice before the IRS under Public Law 89-332. A. Have you filed Form 7004 with the IRS for the taxable year? ................................................................ If the answer is "No," complete Item B. An extension for Florida tax purposes may be granted, even though no federal extension was granted. See Rule 12C-1.0222, F.A.C., for information on the requirements that must be met for your request for an extension of time to be valid.

B. If applicable, state the reason you need the extension: ______________________ ______________________________________________________________________ ______________________________________________________________________ C. Type of federal return filed:_______________________________________________ Contact person for questions: ____________________________________________ Telephone number: (________) ___________________________________________

F-7004 R. 01/09

Extension of Time Request 1. Tentative amount of Florida tax for the taxable year 1. 2.

Florida Income/Franchise Emergency Excise Tax Due



Yes



No

2. LESS: Estimated tax payments for the taxable year

3. Balance due -- You must pay 100% of the tax 3. tentatively determined due with this extension request. Transfer the amount on Line 3 to Tentative tax due on reverse side.

Information for Filing Form F-7004
When to file -- File this application on or before the original due date of the taxpayer's corporate income tax or partnership return. Do not file before the end of the tax year. To file online go to www.myflorida.com/dor Penalties for failure to pay tax -- If you are required to pay tax with this application, failure to pay will void any extension of time and subject the taxpayer to penalties and interest for failure to file a timely return(s) and pay all taxes due. There is also a penalty for a late-filed return when no tax is due. Signature -- A person authorized by the taxpayer must sign Form F-7004. They must be (a) an officer or partner of the taxpayer, (b) a person currently enrolled to practice before the Internal Revenue Service (IRS), or (c) an attorney or Certified Public Accountant qualified to practice before the IRS under Public Law 89-332. A. Have you filed Form 7004 with the IRS for the taxable year? ................................................................ If the answer is "No," complete Item B. An extension for Florida tax purposes may be granted, even though no federal extension was granted. See Rule 12C-1.0222, F.A.C., for information on the requirements that must be met for your request for an extension of time to be valid.

B. If applicable, state the reason you need the extension: ______________________ ______________________________________________________________________ ______________________________________________________________________ C. Type of federal return filed:_______________________________________________ Contact person for questions: ____________________________________________ Telephone number: (________) ___________________________________________

F-7004 R. 01/09

Extension of Time Request 1. Tentative amount of Florida tax for the taxable year 1. 2.

Florida Income/Franchise Emergency Excise Tax Due



Yes



No

2. LESS: Estimated tax payments for the taxable year

3. Balance due -- You must pay 100% of the tax 3. tentatively determined due with this extension request. Transfer the amount on Line 3 to Tentative tax due on reverse side.