Form F-7004 — Florida Tentative Income/Franchise Tax Return and Application for Extension of Time to File Return

Florida Tentative Income / Franchise Tax
Return and Application for Extension of Time to File Return
R. 01/17
TC
Florida Department of Revenue - Corporate Income Tax Taxable year end: Type of federal return to be filed (Mark "X" in one box only) 1065 1120S Sign here: ____Date:
Tentative tax due
(See reverse side)

# FEIN US DOLLARS CENTS

Make checks payable to and mail to: Florida Department of Revenue, 5050 W Tennessee St, Tallahassee FL 32399-0135

# YD YDMM

Name
Address
City/St
ZIP
Under penalties of perjury, I declare that I have been authorized by the above-named taxpayer to make this application, and that to the best of my knowledge and belief the statements herein are true and correct:
You must write within the boxes.
Write your numbers as shown and enter one number per box.
If typing, type through the boxes. 0123456789(example) (example)
Rule 12C-1.051
Florida Administrative Code
Effective 01/17
Florida Tentative Income / Franchise Tax
Return and Application for Extension of Time to File Return
R. 01/17
TC
Florida Department of Revenue - Corporate Income Tax Taxable year end:

# FEIN YD YDMM

Name
Address
City/St
ZIP
You must write within the boxes.
Write your numbers as shown and enter one number per box.
If typing, type through the boxes. 0123456789(example) (example)
Rule 12C-1.051
Florida Administrative Code
Effective 01/17
Florida Tentative Income / Franchise Tax
Return and Application for Extension of Time to File Return
R. 01/17
TC
Florida Department of Revenue - Corporate Income Tax Taxable year end:
FEIN
Make checks payable to and mail to: Florida Department of Revenue, 5050 W Tennessee St, Tallahassee FL 32399-0135

# YD YDMM

Name
Address
City/St
ZIP
You must write within the boxes.
Write your numbers as shown and enter one number per box.
If typing, type through the boxes. 0123456789(example) (example)
Rule 12C-1.051
Florida Administrative Code
Effective 01/17
01 23456789
01 23456789
01 23456789
Sign here: ____Date: Tentative tax due
(See reverse side)
US DOLLARS CENTSUnder penalties of perjury, I declare that I have been authorized by the above-named taxpayer to make this application, and that to the best of my knowledge and belief the statements herein are true and correct:
Make checks payable to and mail to: Florida Department of Revenue, 5050 W Tennessee St, Tallahassee FL 32399-0135 Sign here: ____Date: Tentative tax due (See reverse side) US DOLLARS CENTSUnder penalties of perjury, I declare that I have been authorized by the above-named taxpayer to make this application, and that to the best of my knowledge and belief the statements herein are true and correct:
All other federal returns to be filed
Type of federal return to be filed
(Mark "X" in one box only)
1065 1120S
All other federal returns to be filed
Type of federal return to be filed
(Mark "X" in one box only)
1065 1120S
All other federal returns to be filed
9100 0 20239999 0002005030 9 3999999999 0000 2
9100 0 20239999 0002005030 9 3999999999 0000 2
9100 0 20239999 0002005030 9 3999999999 0000 2

A. If applicable, state the reason you need the extension:

B. Type of federal return filed: __
Contact person for questions: __
Telephone number: (_) _
Contact person email address: __
When to file — File this application on or before the original due date of the taxpayer's corporate income tax or partnership return. Do not file before the end of the tax year.
To file online go to www.floridarevenue.com
Penalties —If you are required to pay tax with this application, failure to pay all taxes due will void any extension of time and subject the taxpayer to penalties and interest. There is also a penalty for a late-filed return when no tax is due.
Signature — A person authorized by the taxpayer must sign Florida Form F-7004.
They must be: an officer or partner of the taxpayer; a person currently enrolled to practice before the Internal Revenue Service (IRS); or an attorney or Certified Public Accountant qualified to practice before the IRS under Public Law 89-332.
The Florida Form F-7004 must be filed - To receive an extension of time to file your Florida return, Florida Form F-7004 must be timely filed, even if you have already filed a federal extension request. A federal extension by itself does not extend the time to file a Florida return.
An extension for Florida tax purposes may be granted, even though no federal extension was granted. See Rule 12C-1.0222, F.A.C., for information on the requirements that must be met for your request for an extension of time to be valid.
Information for Filing Florida Form F-7004 F-7004
R. 01/17
Extension of Time Request Florida Income/
Franchise Tax Due

1. Tentative amount of Florida tax for the taxable year 1.
2. LESS: Estimated tax payments for the taxable year 2.
3. Balance due — You must pay 100% of the tax tentatively determined due with this extension request.

3.
Transfer the amount on Line 3 to Tentative tax due on reverse side.
A. If applicable, state the reason you need the extension:

B. Type of federal return filed: __
Contact person for questions: __
Telephone number: (_) _
Contact person email address: __
When to file — File this application on or before the original due date of the taxpayer's corporate income tax or partnership return. Do not file before the end of the tax year.
To file online go to www.floridarevenue.com
Penalties —If you are required to pay tax with this application, failure to pay all taxes due will void any extension of time and subject the taxpayer to penalties and interest. There is also a penalty for a late-filed return when no tax is due.
Signature — A person authorized by the taxpayer must sign Florida Form F-7004.
They must be: an officer or partner of the taxpayer; a person currently enrolled to practice before the Internal Revenue Service (IRS); or an attorney or Certified Public Accountant qualified to practice before the IRS under Public Law 89-332.
The Florida Form F-7004 must be filed - To receive an extension of time to file your Florida return, Florida Form F-7004 must be timely filed, even if you have already filed a federal extension request. A federal extension by itself does not extend the time to file a Florida return.
An extension for Florida tax purposes may be granted, even though no federal extension was granted. See Rule 12C-1.0222, F.A.C., for information on the requirements that must be met for your request for an extension of time to be valid.
Information for Filing Florida Form F-7004 F-7004
R. 01/17
Extension of Time Request Florida Income/
Franchise Tax Due

1. Tentative amount of Florida tax for the taxable year 1.
2. LESS: Estimated tax payments for the taxable year 2.
3. Balance due — You must pay 100% of the tax tentatively determined due with this extension request.

3.
Transfer the amount on Line 3 to Tentative tax due on reverse side.
A. If applicable, state the reason you need the extension:

B. Type of federal return filed: __
Contact person for questions: __
Telephone number: (_) _
Contact person email address: __
When to file — File this application on or before the original due date of the taxpayer's corporate income tax or partnership return. Do not file before the end of the tax year.
To file online go to www.floridarevenue.com
Penalties —If you are required to pay tax with this application, failure to pay all taxes due will void any extension of time and subject the taxpayer to penalties and interest. There is also a penalty for a late-filed return when no tax is due.
Signature — A person authorized by the taxpayer must sign Florida Form F-7004.
They must be: an officer or partner of the taxpayer; a person currently enrolled to practice before the Internal Revenue Service (IRS); or an attorney or Certified Public Accountant qualified to practice before the IRS under Public Law 89-332.
The Florida Form F-7004 must be filed - To receive an extension of time to file your Florida return, Florida Form F-7004 must be timely filed, even if you have already filed a federal extension request. A federal extension by itself does not extend the time to file a Florida return.
An extension for Florida tax purposes may be granted, even though no federal extension was granted. See Rule 12C-1.0222, F.A.C., for information on the requirements that must be met for your request for an extension of time to be valid.
Information for Filing Florida Form F-7004 F-7004
R. 01/17
Extension of Time Request Florida Income/Franchise Tax Due

1. Tentative amount of Florida tax for the taxable year 1.
2. LESS: Estimated tax payments for the taxable year 2.
3. Balance due — You must pay 100% of the tax tentatively determined due with this extension request.

3.
Transfer the amount on Line 3 to Tentative tax due on reverse side.