Form Dr-144 - Gas And Sulfur Production Quarterly Tax Return
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10Mail to:
DR-144
Gas and Sulfur Production Quarterly Tax Return
Florida Department of Revenue
R. 07/12
For Year:
5050 W Tennessee St
o
Tallahassee Florida 32399-0150
Check here if amending your return
DOR USE ONLY
POSTMARK OR HAND-DELIVERY DATE
Use black ink. Example A - Handwritten Example B - Typed
0 1 2 3 4 5 6 7 8 9
0123456789
Certificate #
:
Name
FEIN
:
Address
Quarter Ending :
City/St/ZIP
Return Due By :
Late After:
Complete Return Schedules First
Tax Due with Return Calculation
US DOLLARS
CENTS
,
,
11. Gross Tax Due:
............................................................................ $
(from Lines 6 and 10)
12. Payments and Other Credits:
,
,
12a. Credit for Contributions to Nonprofit Scholarship Funding Organizations:
.............................................................................. $
(may not exceed 50% of Line 6)
,
,
12b. Estimated Tax Payments: ............................................................................... $
,
,
12c. Other Credits:
.......................................................................... $
(see instructions)
,
,
13. Total Tax Due: ......................................................................................................... $
,
,
14. Penalty: ................................................................................................................... $
,
,
15. Interest: ................................................................................................................... $
,
,
16. Total Due with Return: ........................................................................................... $
,
,
17. Credit: ...................................................................................................................... $
,
,
18. Refund: ................................................................................................................... $
Under penalties of perjury, I declare that I have read the foregoing and the facts stated in it are true.
___________________________________________________________________________________________________________________________________________
Signature of officer
Title
Phone number
Date
___________________________________________________________________________________________________________________________________________
Signature of preparer
Address of preparer
Phone number
Date
Do Not Detach Coupon
DR-144
Gas and Sulfur Production Quarterly Tax Return
R. 07/12
Enclose your payment coupon and check with your tax return to ensure your account is properly credited.
Return is due on or before the 25
of the second month following the end of the quarter.
th
Quarter
Y
M
M
D
D Y
US DOLLARS
CENTS
Ending
,
,
Total amount due
from Line 16
Check here if you transmitted funds electronically.
,
,
Enter name and address, if not preprinted:
Total credit
from Line 17
,
,
Total refund
Name
from Line 18
Address
City/St
FEIN
Enter FEIN if not preprinted
ZIP
DR-144
Do Not Write in the Space Below.
9100 0 99999999 0012037031 9 3999999999
0000 2
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