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10 Par ishes in which proper t y is located
11 Name and address of registered agent
1a Per iod covered:
1b Fiscal month
2 FEI number
3 Incor porated in state of:
4 Name and address of for mer owner (If this corporation is successor to an existing business)
5 Name and address of parent cor poration if applicable
6a Pr incipal place of business
6b Telephone number
7a Pr incipal Louisiana office location (street address city state zip code)
7b Telephone number
8a Date Louisiana char ter issued (mm/dd/yyyy)
8b Louisiana char ter number (issued by Louisiana Secretary of State)
9a Date business began in Louisiana (mm/dd/yyyy)
9b Nature of business operation
Add the amounts calculated for each penalty and print the total amount of penalties The combined amount of delinquent
Add the total penalty and interest due to the franchise tax amount of $10 00 and enter the total on Line 15 Make payment to
amount of interest here
and complete Declaration of preparer (other than taxpayer) is based on all information of which he has any knowledge
as a representative of the firm or corporation preparing the return This verification is not required if the return is prepared by a regular
assets are owned or any business operations are conducted until a Certificate of Dissolution is issued by the Louisiana Secretary of State
Baton Rouge LA 70821 9011
be transmitted on or before the next business day in order to avoid penalty and interest
business day in order to avoid penalty and interest
Calculate Delinquent Filing Penalty for failure to file a return timely The penalty for failure to file a return on time except when
Calculate Delinquent Payment Penalty for failure to pay the tax in full by the date the return is required by law to be filed The
CASH 15 $
charter in Louisiana is authorized to do actually does business in Louisiana or uses any part of its capital or plant in Louisiana Example
Cit y
continues
Corporation franchise tax for domestic corporations continues to accrue and must be filed on Form CIFT 620 regardless of whether any
Corporation franchise tax for foreign corporations continues to accrue and must be filed on Form CIFT 620 as long as the corporation
Corporation Franchise Tax Initial Return
Date (mm/dd/yyyy)
December 31 2013 The next franchise return would be due on or before April 15 2014 and must be filed on Form CIFT 620 If the fiscal
Department is unable to provide a specific rate Refer to the Tax Rate Schedule (R 1111) for monthly interest rates that apply
Describe the nature of the business operations in Louisiana
DO NOT SEND
due dates are as follows: The tax of ABC accrued on March 21 2013; its initial return and payment of $10 00 tax would be due on or before
Enter the charter number assigned to this corporation by the Louisiana Secretary of State
Enter the city and state of the principal place of business Enter the telephone number on line 6b
Enter the date (month day year) the Louisiana charter was issued
Enter the date (month day year) this corporation began business in Louisiana
Enter the Federal Employer s Identification Number for the corporation
Enter the month your accounting period closes The month should match the period ends date on Line 1a
Enter the name and address of the registered agent for this corporation as recorded with the Louisiana Secretary of State
Enter the parishes in Louisiana where corporate property is located
Enter the period covered by this initial franchise tax return The period begins on the date the charter is filed with the Secretary
Enter the primary Louisiana office location Provide a physical address of the primary location: street address city state and
Enter the state where the corporation was originally incorporated
Enter the telephone number
Every new corporation subject to franchise tax must file an initial return and pay the initial tax of $10 00 This return is due on or before
exercises its charter does business or owns or uses any part of its capital or plant in Louisiana and in the case of a qualified corporation
failure is due to a reasonable cause is 5 percent of the tax for each 30 days or fraction thereof during which the failure to file
filing and delinquent payment penalties cannot exceed 25 percent
For Office Use Only
Form R 1111 is available on the LDR s website at www revenue louisiana gov Calculate the interest amount and print the
franchise return would be due on or before October 15 2013 and must be filed on Form CIFT 620 Delinquent returns and payments must
full time employee of the taxpayer The telephone number of the preparer should also be furnished
I declare under the penalties for filing false returns that this return has been examined by me and is to the best of my knowledge and belief true correct
If the corporation is a subsidiary of another corporation enter the name and address of the parent corporation
If the corporation is the successor to an existing business (i e through a merger or the incorporation of an existing entity
include applicable penalty and interest If the due date falls on a holiday or weekend the return must be transmitted on or before the next
Individual or fir m signature of preparer Date (mm/dd/yyyy)
Initial Franchise Tax 12 $ 10 00
Instructions for corporation Franchise Tax Initial Return
Interest (See instructions) 14 $
Interest is due on all items of tax not paid by the due date of the return Because the interest rate varies year to year the
June 15 2013 If ABC adopted a calendar year accounting period this initial payment would cover the period March 21 2013 through
Legal Name
Line 10
Line 11
Line 12
Line 13
Line 14
Line 15
Line 1a
Line 1b
Line 2
Line 3
Line 4
Line 5
Line 6a
Line 7a
Line 7b
Line 8a
Line 8b
Line 9a
Line 9b
Louisiana Depar tment of Revenue
Louisiana Revenue Account Number
Mailing Address
of Revenue Otherwise leave blank
of State or the date of Louisiana qualification or other taxing incidence The period ends on the date the first accounting
officer should be furnished Any person firm or corporation who prepares a taxpayer s return other than the taxpayer must sign the return
Penalt y (See instructions) 13 $
penalty is 5 percent of the tax not paid for each 30 days or fraction thereof during which the failure to pay continues
period closes If books are kept on a calendar year basis the period covered must end on the last day of December If a fiscal
PO Box 91011
R 6906A (1/14)
shown on the charter issued by the Secretary of State For a foreign corporation the tax accrues on the date the corporation exercises its
Signature of officer Title
Signature of verification
State
such as a partnership) enter the name and address of the former business or owner
Telephone
the 15th day of the third month following the month in which the tax accrues If the due date falls on a holiday or weekend the return must
the fifteenth day of the third month following the month in which the tax accrues For a domestic corporation the tax accrues on the date
The initial franchise tax due is $10 00
the Louisiana Department of Revenue Do NoT seND cash
The return must be signed by either the president vice president treasurer or another authorized officer The telephone number of the
This space on the first page of the tax return is to be used only when specifically instructed by the Department
To avoid a penalty this return must be filed with the Department of Revenue P O Box 91011 Baton Rouge LA 70821 9011 on or before
Total Amount Due Make payment to: Louisiana Department of Revenue
until a Certificate of Withdrawal is issued by the Louisiana Secretary of State
year basis is used the period must end on the last day of any month and cannot exceed 12 months
year ending June 30 2013 was adopted the initial return would cover the period from March 21 2013 through June 30 2013 The next
zip code