Form Mo-22 - Authorization And Consent Of Subsidiary Corporation To Be Included In A Missouri Consolidated Income Tax Return - 2013

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Missouri Department of Revenue
Authorization and Consent of Subsidiary
Form
Corporation to be Included in a Missouri
MO-22
Consolidated Income Tax Return
For the first year a Missouri consolidated income tax return is filed, this form must be attached for each subsidiary. After the first year,
this form is only required of any additional affiliation to the group. This form must be typed or printed and attached to
Form
MO-1120.
For the calendar year 20 ______
or other taxable year beginning ___________________________________
20 ______ and ending
,
,
____________________________________
20 ______ .
,
Will a federal consolidated return election be in effect for the taxable year of this consent with respect to the group with which the
subsidiary corporation is affiliated?
r
r
Yes
No
If the answer is No, the group is not entitled to file a Missouri consolidated income tax return and this form should not be filed.
Name of Subsidiary Corporation
Missouri Tax Identification Number
Number and Street
Federal Identification Number
City or Town, State, and Zip Code
Date Incorporated (MM/DD/YYYY)
Place Incorporated
__ __ / __ __ / __ __ __ __
Kind of Business
r
Active
r
Inactive
Name of Common Parent Corporation
Missouri Tax Identification Number
Federal Identification Number
Address
Has the subsidiary corporation filed Missouri returns in prior years as part of an affiliated group filing
r
r
a consolidated return? .................................................................................................................................
Yes
No
Has the subsidiary corporation filed Federal returns in prior years as part of an affiliated group filing
r
r
a consolidated return? .................................................................................................................................
Yes
No
If the answer to either question is Yes, attach a schedule of the year(s) in which such returns were filed and name(s) of the
parent corporation and all affiliated members of the group.
The subsidiary corporation named above hereby authorizes: (a) the common parent corporation named above to make a
Missouri consolidated income tax return on its behalf for the taxable year for which this form is filed; and (b) the common
parent corporation (or, in the event of its failure, the Director of Revenue or his or her delegate) to make a Missouri
consolidated income tax return on its behalf for each taxable year thereafter for which a Missouri consolidated income tax
return is or must be made by the affiliated group under the provisions of the Missouri consolidated return regulations.
The subsidiary corporation, in consideration of the privilege of joining in the making of a consolidated return with the common
parent corporation, hereby consents to and agrees to be bound by the provisions of the Missouri income tax law and regulations,
agrees that the tax shall be computed on the Missouri consolidated taxable income of the group and consents and agrees that the
liability with respect to such tax shall be joint and several.
Under penalties of perjury, I declare that the above information and any attached supplement is true, complete, and correct. I also declare that
the subsidiary named above has authorized me to sign this form on its behalf, and that this form has been examined by me and the information
contained herein is, to the best of my knowledge and belief, true, correct, and complete.
Signature
Title
Printed Name
Date (MM/DD/YYYY)
__ __ /__ __ /__ __ __ __
Form MO-22 (Revised 11-2013)
Taxation Division
Phone: (573) 751-4541
Mail to:
P.O. Box 3365
TDD: (800) 735-2966
Visit
for
Jefferson City, MO 65105-3365
Fax: (573) 522-1721
additional information.
E-mail:
corporate@dor.mo.gov

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