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