Form Dr-601i - Florida Intangible Personal Property Tax Return For Individual And Joint Filers - 2003

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DR-601I
2003 Florida Intangible Personal Property Tax Return for Individual and Joint Filers as of January 1, 2003
R. 01/03
Name
Address
City/State/ZIP
Use black ink. Example A - Handwritten
Example B - Typed
DOR
0 1 2 3 4 5 6 7 8 9
Use
/ / / / /
/ / / / /
0123456789
Only
Check here if:
#1
#2
Social Security Number
Spouse’s Social Security Number
Joint
Individual
Address or
Spouse is
Amended Return
(only if filing a joint return)
SSN Incorrect
Deceased
See Instructions,
Filing Status
(see back #4)
(see back #3C)
Page 7
Schedule A
US Dollars
Cents
,
,
,
1. Loans, Notes, and Accounts Receivable
(From Schedule B, Line 12) .......
1.
,
,
,
2. Beneficial Interest in Any Trust
(From Schedule C, Line 13) ........................
2.
,
,
,
3. Bonds
3.
(From Schedule D, Line 14) ...................................................................
4. Stocks, Mutuals, Money Market Funds, and Limited
,
,
,
Partnership Interests
4.
(From Schedule E, Line 15) .........................................
5. Total Taxable Intangible Assets
(Total of Lines 1 through 4)
,
,
,
Also enter on Line 1 of Tax Calculation Worksheet (on back)
. ................
5.
6. Total Tax Due
(From Tax Calculation Worksheet, Line 5)
,
,
If Line 6 is less than $60, no payment or return is due. ..............................................
6.
7. Discount
(Jan. or Feb. - 4%; March - 3%; April - 2%; May - 1%; June - 0%; if submitted or
,
postmarked on or before the last day of the discount period. The discount period is not ..................
7.
extended when ending on a Saturday, Sunday, or federal or state holiday. See Instructions, Page 8.)
601-I
,
8. Penalty
(See Instructions, Page 8.) ...................................................................................................
8.
,
9. Interest
(See Instructions, Page 8.) ...................................................................................................
9.
0 0
10. Voluntary Election Campaign Contribution
(See Instructions, Page 8.) ...................................................................
10.
,
,
11. Total Due
11.
(Enter here and on Line 11a of the Coupon below. See Instructions, Page 8.)
Under penalties of perjury, I declare that I have examined this return, accompanying schedules and statements, and it is true, correct, and complete. If prepared by a
person other than the taxpayer, this declaration is based on all information of which the preparer has any knowledge [ss. 199.232(2), 92.525(2), 837.06, F.S.].
Signature of Taxpayer
Date
Signature of Individual or Firm Preparing the Return
Signature of Spouse
Telephone No.
Preparer's SSN or FEIN
Date
(
)
Payment Coupon 2003 Florida Intangible Tax
Do Not Detach
DR-601I
R. 01/03
Return and payment must be submitted or postmarked no later than June 30, 2003, to avoid penalty
and interest.
,
11a. Total Due From Line 11 ......................................................................
11a.
,
,
11b. Less Amount Paid with Extension ......................................................
11b.
,
,
,
11c. Total Due (Line 11a less Line 11b; U.S. funds only) ...........................
11c.
Total Due cannot be a negative number. If the total due is less than or equal to zero, enter "0".
Any overpayment will be refunded automatically.
Enter Social Security number(s) (SSN) below, if not pre-addressed:
Name
SSN #1
Address
Spouse's
City/State/ZIP
SSN #2
(only if filing a joint return)
601-I

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