Form F-1122 Fillable Authorization and Consent of Subsidiary Corporation to be Included in a Consolidated Income and Emergency Excise Tax Return R.01/13
(all forms fillable on Windows, Mac, Android tablets, and iPad using Adobe Reader XI)
(Parent)
For Calendar Year
Other taxable year beginning and ending
Under penalties of perjury I declare the subsidiary corporation named above has authorized me to sign this form on
(a) The common parent corporation named above to
(b) The common parent corporation (or if it fails the
1 Date incorporated 2 Federal Employer Identification Number
3 Place incorporated
4 Name of Common Parent Corporation 5 Federal Employer Identification Number
Authorization and Consent of Subsidiary Corporation to be
City State ZIP
consents to and agrees to be bound by the terms of
consolidated return must be made by the affiliated
designee) to make a consolidated income tax return
Effective 01/13
Executive Director of the Department of Revenue or a
F 1122
Florida Administrative Code
for the taxable year for which this form is filed
group
Included in a Consolidated Income Tax Return
initial authorization to be included in the Florida consolidated income tax return
its behalf and I have examined this form and the information contained in it is to the best of my knowledge and belief
make a consolidated income tax return on its behalf
on its behalf for each future taxable year for which a
privilege of joining in the making of a consolidated
R 01/13
return with the common parent corporation therefore
Rule 12C 1 051
section 220 131 Florida Statutes and Rule 12C 1 0131
Signature
Signature of Officer / Authorized Person Phone Number
Street Address
The subsidiary corporation authorizes:
The subsidiary corporation in consideration of the
This form is only required to be attached to the Florida Form F 1120 for a subsidiary s
Title Date
true correct and complete
