Form E-6 - Request For Indiana Corporate Estimated Quarterly Income Tax Returns

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INDIANA DEPARTMENT OF REVENUE
Form
Request for Indiana Corporate Estimated Quarterly
E-6
State Form 49102
Income Tax Returns (Form IT-6)
(R5 / 8-12)
Document Locator Number
Federal Identification Number
Indiana Taxpayer Identification Number
Location
Check If This Is for a New Estimated Account
Check if new address
A. Name of Corporation or Organization
A
B. Street
B
C. City
C
D. State
D
E. ZIP Code
E
F. Indiana County
F
H. Tax Year Ending (month & year)
H
Month
Year
If you are remitting a payment with this
form, indicate quarter and amount paid:
$
Quarter
Amount
(Enter 1, 2, 3, 4, or 5)
Make check payable
(in U.S. funds) to
Indiana Department of Revenue
Check one option below - Request for preprinted Corporate Income Tax IT-6 returns
P. Enter next starting quarter needed:
P
1
2
3
4
No returns needed, explain:
Signature
Telephone
Title
Date
Mail the completed Form E-6 to: Indiana Department of Revenue, Tax Administration,
PO Box 7228, Indianapolis, IN 46207-7228

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