Form Ft 2-1n - Initial Domestic Corporation Franchise Tax Return And Permit Application
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FT 2-1N
19
LABAMA
EPARTMENT OF
EVENUE
9/96
Initial Domestic Corporation
______
Franchise Tax Return and Permit Application
(Year Incorporated)
THIS RETURN AND PAYMENT ARE DUE WITHIN 10 DAYS OF INCORPORATION
LEGAL CORPORATION NAME (PLEASE TYPE OR PRINT)
RECEIVING STAMP
STREET ADDRESS
CITY, STATE AND ZIP
(This Space for Use By Alabama Department of Revenue)
ALABAMA FRANCHISE
TAX ACCOUNT NO.
FEDERAL EMPLOYER
(Instructions on reverse side)
IDENTIFICATION NUMBER
(FEIN)
1. County of incorporation . . . . . . . . . . . . . . . . . . . . . . . . . . .
1.
____________________________________________________
2. Date of incorporation . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2.
____________________________________________________
3. Name of registered agent in Alabama. . . . . . . . . . . . . . .
3.
____________________________________________________
FEIN or Social Security No. of registered agent . . . . . .
____________________________________________________
Street address of registered office in Alabama . . . . . . .
____________________________________________________
City, State and Zip . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
____________________________________________________
4. Name of president of corporation. . . . . . . . . . . . . . . . . . .
4.
____________________________________________________
Social Security Number . . . . . . . . . . . . . . . . . . . . . . . . . . .
____________________________________________________
Home Address . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
____________________________________________________
City, State and Zip . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
____________________________________________________
5. Name of secretary of corporation. . . . . . . . . . . . . . . . . . .
5.
____________________________________________________
Social Security Number . . . . . . . . . . . . . . . . . . . . . . . . . . .
____________________________________________________
Home Address . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
____________________________________________________
City, State and Zip . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
____________________________________________________
6. Type of business done in Alabama . . . . . . . . . . . . . . . . .
6.
____________________________________________________
7. Principal place of business in Alabama . . . . . . . . . . . . .
7.
____________________________________________________
8. EXECUTION AND VERIFICATION (Required by Sections 10-2B-16.22 and 40-14-44, Code of Alabama 1975 )
I __________________________________________ the __________________________________ , do hereby swear (or affirm),
(Name of officer)
(Title of officer)
depose, and say that the foregoing statement made to the Department of Revenue for the annual report and the collection of the franchise tax and permit
fee of said corporation, is true, full and correct and also, if a professional corporation, that all the shareholders, at least one director, and the president of
said corporation are qualified persons or otherwise legally authorized to practice his profession in the State of Alabama.
_________________________________________
(______)_________________
(Signature of officer)
(Telephone number)
CHECK THIS BOX IF PAYMENT
MADE THROUGH ELECTRONIC
FUNDS TRANSFER (EFT)
DEPARTMENT USE ONLY
TPR
9. Permit Fee due (from line 22a) . . . . . . . . . . . . . . . . . . . . . .
9.
__________________________
10. Permit Fee penalty due (see instructions) . . . . . . . . . . . .
10.
__________________________
11. Permit Fee interest due (see instructions) . . . . . . . . . . . .
11.
__________________________
TFR
12. Total Permit Fee due (add lines 9, 10, & 11) . . . . . . . . . .
12.
__________________________
13. Franchise Tax due (from line 23e) . . . . . . . . . . . . . . . . . . .
13.
__________________________
14. Franchise Tax penalty due (see instructions) . . . . . . . . .
14.
__________________________
TAR
15. Franchise Tax interest due (see instructions) . . . . . . . . .
15.
__________________________
16. Total Franchise Tax due (add lines 13, 14, & 15) . . . . . .
16.
__________________________
17. Total amount due (add lines 12 & 16) . . . . . . . . . . . . . . . .
17.
18. In accordance with §40-14-43, Code of Alabama 1975 , a portion, 6.65%, of the corporation’s franchise tax payment is distributed
to the Alabama county(ies) in which the corporation owns property. Therefore, in order to accurately distribute the payment to the
proper Alabama county(ies), list below the Alabama county(ies) where the corporation holds title to any property, real and/or
personal, and the assessed value in each county as of October 1. If all property is located in one Alabama county, list the county
and indicate "All" or "100%". (Use attachment if additional space is required.)
COUNTY NAME
ASSESSED VALUE
COUNTY NAME
ASSESSED VALUE
$
$
$
Total Alabama Assessment
Make check payable to Alabama Department of Revenue and mail to:
ALABAMA DEPARTMENT OF REVENUE
DOMESTIC FRANCHISE TAX SECTION
P.O. BOX 327340
MONTGOMERY, AL 36132-7340
WARNING!!! IF THE FRANCHISE TAX IS NOT PAID, THE CORPORATION WILL BE CERTIFIED TO THE SECRETARY OF STATE
FOR ADMINISTRATIVE DISSOLUTION AS REQUIRED BY THE ALABAMA BUSINESS CORPORATION ACT!!!
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