Form Ft-Qp - Indiana Financial Institution Tax Return - Estimated Quarterly Payment Page 2
ADVERTISEMENT
1
2Form FT-QP
Indiana Department of Revenue
Do not use the space above.
SF 49171
Indiana Financial Institution Tax Return - Extension Payment
Revised 8-99
Due 15th day of the 4th month following close of your tax year.
XXXXXBusiness NameXXXXX
XXXXXDBA NameXXXXXXXX
Federal Identification Number
Signature of Officer
Title
XXXXXXXXX XX XX
(
)
Extension
Date
Daytime Phone #
Due Date
Calendar or FiscalYear Ending
Payment
XXX XXXX
XX XX XXXX
.
Enter Financial Institution Tax Return Extension Payment Below.
.
,
,
$
INDIANA DEPARTMENT OF REVENUE
Q
P.O. BOX 7228
Pay this amount. Do not send cash.
INDIANAPOLIS, IN 46207-7228
Make check payable to the Indiana Department of Revenue.
If you have address changes or name corrections,
XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
use the Change Form found in this packet.
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Financial