Form 83-181-01-5-1-000 - Supplemental Application For Automatic Six-Month Extension For Corporate Income And Franchise Tax Return - 2001

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Mississippi
MS
CC
Supplemental Application for Automatic Six-Month
Extension for Corporate Income and Franchise Tax Return
831810151000
Form 83-181-01-5-1-000 (Rev. 6/01)
Or
Calendar Year
Fiscal Year Ending
Name of Reporting Corporation
FEIN
1A
1B
11A
11B
21A
21B
2A
2B
12A
12B
22A
22B
3A
3B
13A
13B
23A
23B
4A
4B
14A
14B
24A
24B
5A
5B
15A
15B
25A
25B
6A
6B
16A
16B
26A
26B
7A
7B
17A
17B
27A
27B
8A
8B
18A
18B
28A
28B
9A
9B
19A
19B
29A
29B
10A
10B
20A
20B
30A
30B
AC
PT
For Computer Use Only - Do Not Write Above This Line
Enter additional names of qualified members of an affiliated group below. Use as many of these schedules as needed. Include the subtotal from this
schedule in the total amount for Form 83-180 Page 1, Line 17.
Name of Other Members of an Affiliated Group
Federal Employer Identification Number
Amount of Payment
(Minimum $25.00 Per Corporation)
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
23.
24.
25.
26.
27.
28.
29.
30.
31.
Subtotal (Include this amount in the Total on Line 17, Form 83-180.)
Supplemental Page _____ of _____

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