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Form F-1122 - Authorization And Consent Of Subsidiary Corporation To Be Included In A Consolidated Income And Emergency Excise Tax Return

F-1122

Authorization and Consent of Subsidiary Corporation to be

R. 01/07

Included in a Consolidated Income and Emergency Excise Tax Return

This form must be attached for each subsidiary included in the consolidated

return, for the first year a Florida consolidated return (Florida Form F-1120) is filed.

(Please type or print)

For Taxable Year beginning _________________________, ________, and ending ___________________ , _________.

Name

Street Address

City

State

ZIP

1 Date incorporated

2 Federal Employer Identification No.

3 Place incorporated

4 Name of Common Parent Corporation

5 Federal Employer Identification No.

(Parent)

The subsidiary corporation named above hereby:

(a) Authorizes the common parent corporation named

corporation (or, in the event of its failure, the

above to make a consolidated income tax return on

Executive Director of the Department of Revenue

its behalf for the taxable year for which this form is

or his designee) to make a consolidated

filed.

computation of emergency excise tax on its

(b) Authorizes the common parent corporation (or, in

behalf for each taxable year thereafter for which a

the event of its failure, the Executive Director of the

consolidated return must be made by the affiliated

Department of Revenue or a designee) to make a

group under the provisions of Chapter 221, F.S.,

consolidated income tax return on its behalf for each

and the provisions of the consolidated return rules.

taxable year thereafter for which a consolidated

return must be made by the affiliated group under the

The subsidiary corporation, in consideration of the

provisions of the consolidated return rules.

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

consolidated return rules.

Signature

Under penalties of perjury, I declare that the subsidiary corporation 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 of Officer

Phone Number

__________________________________________________

_________________________________

Title

Date

Form F-1122 - Authorization And Consent Of Subsidiary Corporation To Be Included In A Consolidated Income And Emergency Excise Tax Return

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