Form F-851 Fillable Corporate Income/Franchise Tax Affiliations Schedule R.01/13
(all forms fillable on Windows, Mac, Android tablets, and iPad using Adobe Reader XI)

5050 W Tennessee St Contact Us Facts on Tax a quarterly publication Florida Department of Revenue For Calendar Year Other taxable year beginning and ending Proposed rules notices of rule development workshops and more Signature of Officer Date Tallahassee FL 32399 0112 Tax Information Publications (TIPs) Taxpayer Services Mail Stop 3 2000 Title Telephone Number Under penalties of perjury I declare that I have examined the above information and statements and they are true correct www myflorida com/dor Yes No (Yes/No) (Yes/No) 3 One 7 p m ET at 800 352 3671 Addition Address (Number Street City State and ZIP) Affiliations Schedule and complete to the best of my knowledge and belief for the taxable year as stated above and Florida consolidated groups are identical Report changes to the consolidated group in Part II on the reverse side of this form Attach this schedule box Deletions are any subsidiary members that are no longer included in the consolidated return but were included in last year s return Common parent corporation: composed of the identical component members as the federal consolidated group Only those consolidated group It must be filed by the parent corporation of the consolidated group You may substitute IRS Form 851 if the federal consolidated return to change List all affected corporations and indicate whether they are deletions or additions by checking the correct Corporate Income/Franchise Tax corporations as described in section 1504(a) of the Internal Revenue Code? Deletion Does corporation have Effective 01/13 F 851 federal consolidated group Federal Employer Identification Number (FEIN) Florida Administrative Code Florida Common Parent Corporation Florida Nexus Group Check the box if the Florida consolidated group is different than the Florida nexus subgroup return and have continued to file as a subgroup for Florida corporate Florida: For written replies to tax questions write to: Go to: www myflorida com/dor/list/ income tax purposes should check this box Information forms and tutorials are available on our Internet site: NAICS Code Name and Address of Corporation Name of Corporation Note: Section 220 131 Florida Statutes (F S ) requires the Florida consolidated group to be Page 2 PART I PART II Payroll? Property? R 01/13 Rule 12C 1 051 Sales? Schedule of Consolidated Changes Statement of Affiliation Do the above corporations comprise an affiliated group of Subscribe to our tax publications to receive due date reminders or an e mail when we post: Subsidiary corporation: taxpayers that made a valid election in 1985 under s 220 131(1) F S (1985) to file a consolidated This form must be used by taxpayers filing a Florida consolidated income tax return and is used to report the members of the To find a taxpayer service center near you go to: www myflorida com/dor/contact html to Florida Form F 1120 To speak with a Department representative call Taxpayer Services Monday through Friday 8 a m to Use the schedule below to record any changes that occurred during the tax year that caused the corporations included in the Who must file Florida Form F 851?