Form Ftb 4684a Meo C3 - Demand For Tax Return printable pdf download

Reply to FTB

This Form and/or a Tax Return

is Due to FTB by

From:

FILING ENFORCEMENT SECTION MS F180

FRANCHISE TAX BOARD

Notice Number:

PO BOX 942857

Code Number:

SACRAMENTO CA 94257-0540

FAX: 916.843.6169

Tax return filed

Provide the following information so we may correct our records:

Mail or fax us the following:

1. On what date did you file the return?.........................

1. A complete copy of your

2. California corporate number under which

California business

you filed: ............................................................................

entity tax return.

3. Federal employer identification number

2. Proof of payment (such as

a copy of the canceled

(FEIN): .................................................................

check, cash receipt,

canceled money order, etc.).

4. California Employment Development

Department account number: .......................................

3. This completed form.

5. California State Board of Equalization

account number: ..................................

6. California Secretary of State Limited

Liability Company Number (SOSL)...........

7. If you filed the return as part of a combined corporate return, please provide the

name and corporate number under which it was filed:

California Corporate Number

Corporate Name

Filed under a different name, account number, or entity type

Provide the following information so we may correct our records:

1. The actual business name and entity type: _____________________________________________________________

2. California corporate number: ........................................................................................................

3. Sole proprietor account number (social security number*): ...........................................

4. Business entity account number (FEIN): .......................................................................

5. California Secretary of State file number: ...........................................................

6. California Employment Development Department account number: ......................................

7. California State Board of Equalization account number: ..............................

8. If your business is no longer operating, indicate the date the business ceased

its operations: .....................................................................................................................

ftb.ca.gov

*Get FTB 1131, Franchise Tax Board Privacy Notice, at

, or call us at 800.338.0505. If outside the United States,

call 916.845.6600.

Continued on next page

FTB 4684A MEO C3

(REV 02-2010) PAGE 3

Form Ftb 4684a Meo C3 - Demand For Tax Return

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