Form F-1120x - Amended Florida Corporate Income/franchise Tax Return Page 2

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F-1120X

R. 01/13

Page 2

Correct amount

As originally reported or as adjusted

(Attach amended schedules)

11. Tax due

Check here if paying FL AMT

12. Credits against the tax

13. Total income/franchise tax due

14. Penalty and interest

(attach Florida Form F-2220 and/or schedule)

15. Total of Lines 13 and 14

16. a) Estimated payments _____________________

b) Tentative payment ___________________

Total

c) Tax paid with or after return _______________

➤

17. a) Credit __________________________________

b) Refund _____________________________

Total

if any shown on last return, or as later adjusted

➤

18. Total payments (Line 16 minus Line 17)

19. Total amount due or overpayment (Line 15 minus Line 18). Enter on payment coupon, also.

20. Credit: Enter amount of overpayment credited to ______ estimated tax here and on payment coupon.

Year

21. Offset: Enter amount of overpayment to be offset.

22. Refund: Enter amount of overpayment to be

refunded

here and on payment coupon.

Contact person: ________________________________ Telephone number: ( ________ ) ________________________

Part II — Explanation of changes to income, deductions, credits, etc. Attach separate sheet if needed. To

expedite processing, please indicate if this tax year has been previously audited by the Department; include

the service notification (audit) number.

Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct,

and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge.

Sign here

Title

Signature of officer (must be an original signature)

Date

Preparer

Preparer’s Tax

Preparer’s

check if self-

Identification

Paid

signature