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Form Ct-1120cc-R - Revocation Of Election And Consent To File Combined Corporation Business Tax Return

Department of Revenue Services

Form CT-1120CC-R

State of Connecticut

Revocation of Election and Consent to File

(Rev. 12/14)

Combined Corporation Business Tax Return

Purpose

Use Form CT-1120CC-R, Revocation of Election and Consent to File Combined Corporation Business Tax Return, to revoke

a prior election to be included in a Combined Corporation Business Tax Return or a Unitary Corporation Business Tax Return.

General Instructions

Complete and attach this form to Form CT-1120, Corporation Business Tax Return, for the initial income year in which

an afﬁ liated corporation revokes its election to ﬁ le a Combined Corporation Business Tax Return or a Unitary Corporation

Business Tax Return.

For Income Year Beginning

, and Ending

________________________

___________

________________________

___________

Common Parent Corporation (or Designated Connecticut Parent)

The common parent corporation (or designated Connecticut parent) named below hereby revokes the election to ﬁ le a

Combined Corporation Business Tax Return or a Unitary Corporation Business Tax Return, which was submitted on behalf

of itself and its Connecticut taxpayer afﬁ liates for the income year

. This revocation is irrevocable for the ﬁ ve

__________

succeeding income years.

Name of common parent corporation (or designated Connecticut parent)

Connecticut Tax Registration Number

Print name of authorized ofﬁ cer

Signature of authorized ofﬁ cer

Federal Employer ID Number

Title

Daytime telephone number

Date

(

)

Afﬁ liated Corporation

The afﬁ liated corporation named below revokes its election to ﬁ le a Combined Corporation Business Tax Return or a Unitary

Corporation Business Tax Return with the common parent corporation (or designated Connecticut parent) named above.

This revocation is irrevocable for the ﬁ ve succeeding income years.

Name of afﬁ liate

Connecticut Tax Registration Number

Address (number, street, city or town, state, and ZIP code)

Federal Employer ID Number

State of incorporation

Date incorporated

Type of business

Current status (active/inactive)

Print name of authorized ofﬁ cer

Signature of authorized ofﬁ cer

Title

Daytime telephone number

Date

(

)

Complete a separate revocation of election for each afﬁ liate revoking its election to ﬁ le as part of a combined or unitary

Connecticut corporation business tax return.

Mail Form CT-1120CC-R to:

Department of Revenue Services

PO Box 2937

Hartford CT 06104-2937

Form Ct-1120cc-R - Revocation Of Election And Consent To File Combined Corporation Business Tax Return

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