Form Ft 1120-Fi - 2001 Corporation Franchise Tax Report For Financial Institutions
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4Mail with remittance to: Treasurer of State of Ohio, P.O. Box 27, Columbus, Ohio 43266-0027
OHIO
FT 1120-FI
Tax Year
2001
Corporation Franchise Tax Report for Financial Institutions
F
D
U
O
OR
EPARTMENT
SE
NLY
2000
Based upon calendar year 2000 or other taxable year beginning ____________________, _____ and ending ____________________,
.
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If this is an amended report, check the box (if the amended report reflects a refund, attach Form FT-REF).
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Corporation Name
O
F
T
I.D. N
.
HIO
RANCHISE
AX
O
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O
C
L
N
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Address (Check box below if you are not receiving forms at the proper mailing address.)
HIO
HARTER OR
ICENSE
O
c
F
E
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N
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EDERAL
MPLOYER
DENTIFICATION
O
City
State
Zip Code
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Statutory Agent
Corporate Officers
c
c
Check the box if both the below-reported statutory agent and the
Check the box if all the below-reported corporate officers are the
address are the same as were reported on the 2000 franchise
same as were reported on the 2000 franchise tax report.
tax report.
First Name
Middle Initial
Last Name
Name
President
Street Address
Secretary
City
State
Zip Code
Treasurer
Schedule A — Computation of Franchise Tax
whole dollars only (no cents)
_________________
1.
00
1. Net value of stock (from Schedule E, line 8 or, if applicable, from Schedule F, line 6) .........................
_________________
2.
00
2. Apportionment ratio (from Schedule D-1, line 4 or Schedule D-2) .......................................................
_________________
3.
00
3. Taxable value (line 1 x line 2) .................................................................................................................
_________________
4.
00
4. Tax on net worth basis (.013 x line 3, but not less than $50) ................................................................
_________________
5.
00
5. Total nonrefundable credits (from Schedule A-1, line 7) .......................................................................
_________________
6.
00
6. Amount due after nonrefundable credits (line 4 minus line 5, but not less than $50) .........................
_________________
00
7.
7. Overpayment carryforward from 2000 ....................................................................................................
_________________
8.
00
8. Estimated payments made in tax year 2001: E __________, ER __________, EX __________ ...
_________________
9.
00
9. New jobs refundable credit (attach Department of Development certificate of verification) .................
_________________
10.
00
10. Total payments and refundable credits (add lines 7, 8 and 9) ..............................................................
_________________
11.
00
11. Tax due (line 6 minus line 10) ................................................................................................................
_________________
00
12.
12. Interest __________, Penalty __________, Total interest and penalty .................................................
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_________________
13.
00
13. Balance due (make payable to Ohio Treasurer of State). Check box if payment made by EFT
....
_________________
14.
00
14. Overpayment ..........................................................................................................................................
_________________
15.
00
15. Amount of line 14 to be credited to tax year 2002 estimated tax ...........................................................
16.
00
16. Amount of line 14 to be refunded ...........................................................................................................
Declaration/Signatures (An officer or managing agent of the corporation must sign this declaration. )
I declare under penalties of perjury that this report (including any
to pay or use any of its money or property for or in aid of or
accompanying schedule or statement) has been examined by
opposition to a political party, a candidate for election or nomina-
me and to the best of my knowledge and belief is a true, correct
tion to public office, or a political action committee, legislation
and complete return and report and that this corporation has not,
campaign fund, or organization that supports or opposes any
during the preceding year, except as permitted by section
such candidate or in any manner used any of its money for any
3517.082, 3599.03 and 3599.031 of the Ohio Revised Code,
partisan political purpose whatever, or for reimbursement or in-
directly or indirectly paid, used or offered, consented, or agreed
demnification of any person for money or property so used.
Date
Signature of officer or managing agent
Title
Date
Signature of preparer other than taxpayer based on
Title
all information of which preparer has knowledge
Do Not Write Below
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OURNAL
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ECEIVED
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ODE
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