Form Dr-142es - Declaration/installment Payment Of Estimated Solid Mineral Severance Tax
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4DR-142ES
Declaration/Installment Payment of Estimated Solid Mineral Severance Tax
R. 04/03
■ ■
Check here if this is an amended declaration
Name and Address:
FEIN:
Taxable Year:
Declaration is based on (check one):
A
B
C
■ ■
80% of estimated production this year
■ ■
Phosphate
Heavy
Other Solid
Prior year’s return
Rock
Minerals
Minerals
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7
1. Enter Expected Tonnage of Phosphate Rock
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7
or Heavy Minerals
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4
2. Enter Expected Taxable Value of Other Solid Minerals
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4
3. Tax Rate for Taxable Year Indicated at Top of Form
per ton
per ton
of value
4. Estimated Tax Due
$
$
$
(line 3 multiplied by line 1 or 2)
5. Total Estimated Tax Due (enter total of line 4, columns A, B, and C)
5. $ ____________________
6. Less Total Amount of Installments Paid to Date for this Taxable Year
(applies only if this is an amended declaration)
6. $ ____________________
7. Balance of Estimated Payments Due (line 5 minus line 6)
7. $ ____________________
8. Number of Remaining Payments this Year (4 installments per year)
8.
_____________________
9. Amount of Installments
9. $ ____________________
(line 7 divided by line 8; enter here and on installment payment coupons)
*** Do Not Detach Coupon ***
DR-142ES
Declaration/Installment Payment of Estimated Solid Mineral Severance Tax
R. 04/03
FEIN:
Make check payable and mail to:
Installment Number
FLORIDA DEPARTMENT OF REVENUE
Taxable Year:
5050 W TENNESSEE STREET
For RDS validation only - Do not write or stamp in this space.
TALLAHASSEE FL 32399-0150
Name and Address:
Installment Payment Amount (from reverse side) $ ____________________________________
Check here if you transmitted funds
electronically
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