Form Fae 183 - Franchise And Excise Tax Annual Exemption Renewal
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1
2TENNESSEE DEPARTMENT OF REVENUE
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FRANCHISE AND EXCISE TAX ANNUAL EXEMPTION RENEWAL
ACCOUNT NUMBER
Beginning:
FEIN:
FAE
Exemption
183
Period
Ending:
DUE DATE:
Send this renewal to:
Tennessee Department of Revenue
Andrew Jackson State Office Building
500 Deaderick Street
Nashville, TN 37242
Should you need assistance, please contact the
NAME
Taxpayer Services Division by calling our statewide
number at 1-800-342-1003 or (615) 253-0600.
ADDRESS
IMPORTANT
If this entity no longer meets the requirements
for exemption, a completed franchise and
excise tax return (FAE170) must be filed by the
CITY
ZIP
STATE
15th day of the 4th month following the close of
the taxable period.
INSTRUCTIONS
1.
Check the box next to the applicable exemption type certifying the limited liability company, limited partnership, limited liability partnership
or business trust continues to meet the exemption requirements.
2.
Complete the appropriate schedule on page 2 of this form. Attach additional schedule as instructed.
3.
Sign and date the form.
MN
- Complete Schedule A on page 2 and a Disclosure of Activity form.
Family-Owned Non-Corporate Entity
HI
- Complete Schedule B on page 2 and a Disclosure of Activity form.
Farming/Personal Residence
HI
- Complete Schedule C on page 2 and Certification LP or LLC Providing Affordable Housing.
Affordable Housing
HI
- Complete Schedule D on page 2.
Venture Capital Fund
HI
- Complete Schedule E on page 2.
Diversified Investment Fund
HI
- Complete Schedule F on page 2.
Obligated Member Entity
HI
- Complete Schedule G on page 2.
Asset-Backed Securitization (REMIC/FASIT)
HI
- Complete Schedule H on page 2.
Security 3rd Party Indebtedness
HI
- Complete Schedule I on page 2.
Facilities Owned by the Armed Forces
Under penalty of perjury, I declare that the above-named entity continues to meet the requirements for
exemption under the applicable provisions of Tenn. Code Ann. Section 67-4-2008.
MMMMMMN
FOR OFFICE
USE ONLY
Taxpayers Signature
Title
Date
(
)
Telephone
Email
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