California Form 1115 - Request For Consent For A Water'S-Edge Re-Election - 2013

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Request for Consent for a Water’s-Edge
TAXABLE YEAR
CALIFORNIA FORM
20
1115
Re-Election
Fill out the form completely. Do not change the method of filing until the Franchise Tax Board has approved this request.
Corporation name
Key California corporation number
Address (suite, room, or PMB no.)
City
State
ZIP Code
Part I Effective Dates
/
/
Enter the taxable year ending date of the taxpayer’s last filed water’s-edge tax return: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(mm/dd/yyyy)
/
/
Enter the beginning date of the water’s-edge re-election: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(mm/dd/yyyy)
Part II Basis to Request a Water’s-Edge Re-Election. See instructions .
Explain the basis for the request to re-elect water’s-edge . Attach additional sheets if necessary .
Part III List of Taxpayers Requesting Water’s-Edge Re-Election. Attach additional sheets if necessary .
Taxpayer’s name
California corporation number
FEIN
Signature
I attest to the belief that the water’s-edge re-election is permitted by law and to the accuracy of factual statements .
Under penalties of perjury, I declare that I have examined this form, including accompanying schedules and statements, and to the best of my knowledge,
it is true, correct, and complete .
____________________________________________________ ______________________________________ _________________
Signature of officer
Title
Date
(
)
_______________________________________________________________ ______________________________________________
Print or type name of person to contact
Telephone
THIS FORM MUST BE FILED SEPARATELY FROM THE TAX RETURN
FTB 1115
2013
7181133
C1

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