Form Dr-144 - Gas And Sulfur Production Quarterly Tax Return Form - Florida Department Of Revenue
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6Mail to:
DR-144
Gas and Sulfur Production Quarterly Tax Return
Florida Department of Revenue
R. 04/06
5050 W. Tennessee Street
❑
Check here if amending your return
Tallahassee, Florida 32399-0150
DOR USe Only
POSTmaRk OR hanD DelIveRy DaTe
Use black ink. Example A - Handwritten Example B - Typed
0 1 2 3 4 5 6 7 8 9
0123456789
Certificate No. :
name
FEIN
:
address
Quarter Ending :
City/St/ZIP
Return Due By :
Late After:
Complete Return Schedules First
Tax Due with Return Calculation
US DOLLARS
CENTS
,
,
11. Gross Tax Due:
............................................................................ $
(from Lines 6 and 10)
,
,
12. Payments and Other Credits:
12a. Estimated Tax Payments: ............................................................................... $
,
,
............................................................................ $
12b. Other Credits
(see instructions)
,
,
13. Total Tax Due: ......................................................................................................... $
,
,
14. Penalty: ................................................................................................................... $
,
,
15. Interest: ................................................................................................................... $
,
,
16. Total Due with Return: ........................................................................................... $
,
,
17. Credit: ...................................................................................................................... $
,
,
18. Refund: ................................................................................................................... $
Under penalties of perjury, I declare that I have read the foregoing and the facts stated in it are true.
_____________________________________________________________________________________________________________________________
Signature of officer
Title
Phone number
Date
_____________________________________________________________________________________________________________________________
Signature of preparer
Address of preparer
Phone number
Date
Do Not Detach Coupon
DR-144
Gas and Sulfur Production Quarterly Tax Return
R. 04/06
To ensure proper credit to your account, enclose your check with this payment coupon and mail with tax return.
Return is due on or before the 25
of the second month following the end of the quarter.
th
Quarter
Y
M
M
D
D Y
US DOLLARS
Ending
CENTS
,
,
Total amount due
from Line 16
Check here if you transmitted funds electronically
,
,
Enter name and address, if not pre-printed:
Total credit
from Line 17
,
,
name
Total refund
from Line 18
address
City/St/ZIP
FEIN
Enter FEIN if not pre-printed
DR-144
Do Not Write in the Space Below
0100 0 20069999 0012037031 4 3999999999 0000 2
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