(Mark X in
(Mark X in
(See reverse side)
(See reverse side)
0 1 2 3 4 5 6 7 8 9
0 1 2 3 4 5 6 7 8 9
1 Tentative amount of Florida tax for the taxable year 1
1 Tentative amount of Florida tax for the taxable year 1
2 LESS: Estimated tax payments for the taxable year 2
2 LESS: Estimated tax payments for the taxable year 2
3 Balance due You must pay 100% of the tax
3 Balance due You must pay 100% of the tax
9200 0 20139999 0002005030 9 3999999999 0000 2
9200 0 20139999 0002005030 9 3999999999 0000 2
a federal extension request A federal extension by itself does not extend the time to
a federal extension request A federal extension by itself does not extend the time to
A If applicable state the reason you need the extension:
A If applicable state the reason you need the extension:
Accountant qualified to practice before the IRS under Public Law 89 332
Accountant qualified to practice before the IRS under Public Law 89 332
Address
Address
An extension for Florida tax purposes may be granted even though no federal
An extension for Florida tax purposes may be granted even though no federal
application and that to the best of my knowledge and belief the statements herein are true and correct: Check here if you transmitted
application and that to the best of my knowledge and belief the statements herein are true and correct: Check here if you transmitted
B Type of federal return filed:
B Type of federal return filed:
City/St/ZIP
City/St/ZIP
Contact person for questions:
Contact person for questions:
corporate income tax or partnership return Do not file before the end of the tax year
corporate income tax or partnership return Do not file before the end of the tax year
Corporation Partnership
Corporation Partnership
Effective 01/14
Effective 01/14
Extension of Time Request Florida Income/Franchise
Extension of Time Request Florida Income/Franchise
extension was granted See Rule 12C 1 0222 F A C for information on the
extension was granted See Rule 12C 1 0222 F A C for information on the
F 7004
F 7004
F 7004
failure to pay will void any extension of time and subject the taxpayer to penalties and
failure to pay will void any extension of time and subject the taxpayer to penalties and
file a Florida return
file a Florida return
FILING STATUS
FILING STATUS
Florida Administrative Code
Florida Administrative Code
Florida Department of Revenue Corporate Income Tax
Florida Department of Revenue Corporate Income Tax
Florida return Florida Form F 7004 must be timely filed even if you have already filed
Florida return Florida Form F 7004 must be timely filed even if you have already filed
Florida Tentative Income / Franchise Tax
Florida Tentative Income / Franchise Tax
for a late filed return when no tax is due
for a late filed return when no tax is due
funds electronically
funds electronically
If typing type through the boxes 0123456789 (example) (example)
If typing type through the boxes 0123456789 (example) (example)
Information for Filing Florida Form F 7004 F 7004
Information for Filing Florida Form F 7004 F 7004
interest for failure to file a timely return(s) and pay all taxes due There is also a penalty
interest for failure to file a timely return(s) and pay all taxes due There is also a penalty
M M D D Y Y
M M D D Y Y
Make checks payable to and mail to: Florida Department of Revenue 5050 W Tennessee St Tallahassee FL 32399 0135
Make checks payable to and mail to: Florida Department of Revenue 5050 W Tennessee St Tallahassee FL 32399 0135
one box only)
one box only)
Penalties for failure to pay tax If you are required to pay tax with this application
Penalties for failure to pay tax If you are required to pay tax with this application
practice before the Internal Revenue Service (IRS) or (c) an attorney or Certified Public
practice before the Internal Revenue Service (IRS) or (c) an attorney or Certified Public
R 01/14
R 01/14
R 01/14
requirements that must be met for your request for an extension of time to be valid
requirements that must be met for your request for an extension of time to be valid
Return and Application for Extension of Time to File Return
Return and Application for Extension of Time to File Return
Rule 12C 1 051
Rule 12C 1 051
Sign here: Date:
Sign here: Date:
Signature A person authorized by the taxpayer must sign Florida Form F 7004
Signature A person authorized by the taxpayer must sign Florida Form F 7004
Tax Due
Tax Due
Taxable year end:
Taxable year end:
Telephone number: ( )
Telephone number: ( )
Tentative tax due
Tentative tax due
tentatively determined due with this extension request
tentatively determined due with this extension request
The Florida Form F 7004 must be filed To receive an extension of time to file your
The Florida Form F 7004 must be filed To receive an extension of time to file your
They must be (a) an officer or partner of the taxpayer (b) a person currently enrolled to
They must be (a) an officer or partner of the taxpayer (b) a person currently enrolled to
To file online go to www myflorida com/dor
To file online go to www myflorida com/dor
Transfer the amount on Line 3 to Tentative tax due on reverse side
Transfer the amount on Line 3 to Tentative tax due on reverse side
Under penalties of perjury I declare that I have been authorized by the above named taxpayer to make this
Under penalties of perjury I declare that I have been authorized by the above named taxpayer to make this
US DOLLARS CENTS
US DOLLARS CENTS
When to file File this application on or before the original due date of the taxpayer s
When to file File this application on or before the original due date of the taxpayer s
Write your numbers as shown and enter one number per box
Write your numbers as shown and enter one number per box
You must write within the boxes
You must write within the boxes