Form F-7004 - Florida Tentative Income Page 3

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F-7004
Signature — Form F-7004 must be signed by a person authorized
R. 01/98
Florida Income/Franchise
by the taxpayer to do so, and who is either (a) an officer or partner
Emergency Excise Tax Due
Six Month Extension of Time Request
of the taxpayer, (b) a person currently enrolled to practice before
1. Tentative amount of Florida tax for the taxable year
1.
the Internal Revenue Service, or (c) an attorney or C.P.A. qualified
2. LESS: Estimated tax payments for the taxable year
2.
to practice before the IRS under P.L. 89-332.
3. Balance due —100% of the tax tentatively determined
3.
Intangible Tax Notice - See Florida Form F-1120 Instructions,
due must be paid with this extension request
section titled “Extension of Time for Filing.”
Transfer the amount in Line 3 to Tentative Tax Due on reverse side.
Information For Filing Form F-7004
A. Has Form 7004 or 8736 been filed with the Internal Revenue
Service for the above taxable year?
Yes
No
When to file — File this application on or before the original due date of
If the answer is "Yes," attach a copy of Form 7004 or 8736 when the
the taxpayer's corporate income tax or partnership return.
F-1120 or F-1065 is filed. If the answer is "No," complete Item B.
B. If applicable, state in detail the reason the extension is needed:
____________________________________________________
____________________________________________________
Penalties for failure to pay tax — If a payment of tax is required with
C. Does this application also cover subsidiaries to be included in a
this application, failure to make such payment will void any extensions
Florida consolidated return?
Yes
No
of time and subject the taxpayer to penalties and interest for failure to
If the answer is "Yes," attach a statement with the name, address,
file a timely return(s) and pay all taxes due.
and FEIN of each subsidiary to be included.
D. Type of federal return filed: ______________________________
F-7004
Signature — Form F-7004 must be signed by a person authorized
R. 01/98
Florida Income/Franchise
by the taxpayer to do so, and who is either (a) an officer or partner
Emergency Excise Tax Due
Six Month Extension of Time Request
of the taxpayer, (b) a person currently enrolled to practice before
1. Tentative amount of Florida tax for the taxable year
1.
the Internal Revenue Service, or (c) an attorney or C.P.A. qualified
2. LESS: Estimated tax payments for the taxable year
2.
to practice before the IRS under P.L. 89-332.
3. Balance due —100% of the tax tentatively determined
3.
Intangible Tax Notice - See Florida Form F-1120 Instructions,
due must be paid with this extension request
section titled “Extension of Time for Filing.”
Transfer the amount in Line 3 to Tentative Tax Due on reverse side.
Information For Filing Form F-7004
A. Has Form 7004 or 8736 been filed with the Internal Revenue
Service for the above taxable year?
Yes
No
When to file — File this application on or before the original due date of
If the answer is "Yes," attach a copy of Form 7004 or 8736 when the
the taxpayer's corporate income tax or partnership return.
F-1120 or F-1065 is filed. If the answer is "No," complete Item B.
B. If applicable, state in detail the reason the extension is needed:
____________________________________________________
____________________________________________________
Penalties for failure to pay tax — If a payment of tax is required with
C. Does this application also cover subsidiaries to be included in a
this application, failure to make such payment will void any extensions
Florida consolidated return?
Yes
No
of time and subject the taxpayer to penalties and interest for failure to
If the answer is "Yes," attach a statement with the name, address,
file a timely return(s) and pay all taxes due.
and FEIN of each subsidiary to be included.
D. Type of federal return filed: ______________________________
F-7004
Signature — Form F-7004 must be signed by a person authorized
R. 01/98
Florida Income/Franchise
by the taxpayer to do so, and who is either (a) an officer or partner
Emergency Excise Tax Due
Six Month Extension of Time Request
of the taxpayer, (b) a person currently enrolled to practice before
1. Tentative amount of Florida tax for the taxable year
1.
the Internal Revenue Service, or (c) an attorney or C.P.A. qualified
2. LESS: Estimated tax payments for the taxable year
2.
to practice before the IRS under P.L. 89-332.
3. Balance due —100% of the tax tentatively determined
3.
Intangible Tax Notice - See Florida Form F-1120 Instructions,
due must be paid with this extension request
section titled “Extension of Time for Filing.”
Transfer the amount in Line 3 to Tentative Tax Due on reverse side.
Information For Filing Form F-7004
A. Has Form 7004 or 8736 been filed with the Internal Revenue
Service for the above taxable year?
Yes
No
When to file — File this application on or before the original due date of
If the answer is "Yes," attach a copy of Form 7004 or 8736 when the
the taxpayer's corporate income tax or partnership return.
F-1120 or F-1065 is filed. If the answer is "No," complete Item B.
B. If applicable, state in detail the reason the extension is needed:
____________________________________________________
____________________________________________________
Penalties for failure to pay tax — If a payment of tax is required with
C. Does this application also cover subsidiaries to be included in a
this application, failure to make such payment will void any extensions
Florida consolidated return?
Yes
No
of time and subject the taxpayer to penalties and interest for failure to
If the answer is "Yes," attach a statement with the name, address,
file a timely return(s) and pay all taxes due.
and FEIN of each subsidiary to be included.
D. Type of federal return filed: ______________________________

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