Form 1100ez - Delaware 2012 Corporation Income Tax Return - 2012

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DO NOT WRITE OR STAPLE IN THIS AREA - REVENUE CODE 0042

FORM 1100EZ

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2012 DELAWARE 2012

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CORPORATION INCOME TAX RETURN

FOR CALENDAR YEAR 2012

EMPLOYER IDENTIFICATION NUMBER

or fiscal year beginning

2012, and ending

2013

Name of Corporation

CHECK APPLICABLE BOX:

Address

INITIAL RETURN

CHANGE OF ADDRESS

EXTENSION ATTACHED

City & State

Zip Code

Date and State of Incorporation

Nature of Business

IF OUT OF BUSINESS, ENTER DATE HERE:

ATTACH COPY OF COMPLETED FEDERAL FORM 1120

CENTS

0 0

Federal Taxable Income (See specific instructions)

0 0

Delaware income taxes deducted in computing Line 1

0 0

Delaware Taxable Income (Add Line 1 and Line 2)

0 0

Tax @ 8.7%

0 0

Delaware tentative tax paid

0 0

Credit carry-over from prior year

0 0

Total payments and credits (Add Line 5 and Line 6)

0 0

If Line 4 is greater than Line 7, enter BALANCE DUE and PAY IN FULL

If Line 7 is greater than Line 4, enter OVERPAYMENT:

0 0

9a.

Total OVERPAYMENT

0 0

9b.

To be REFUNDED

0 0

9c.

To be CREDITED to 2013 Tentative Tax

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. If prepared by a person other than the taxpayer, the declaration is based on all information of which the preparer has any knowledge.

Date

Signature of Officer

Title

Email Address

Date

Signature of individual or firm preparing the return

Address

*DF11112019999*

MAKE CHECK PAYABLE AND MAIL TO: DELAWARE DIVISION OF REVENUE, P.O. BOX 2044, WILMINGTON, DE 19899-2044