Florida Department of Revenue — Corporate Income Tax
F-1120ES
R. 01/03
Declaration/Installment of Florida Estimated Income/Franchise and/or
Installment #_____
Emergency Excise Tax for Taxable Year Beginning on or After January 1, 2003
0 1 2 3 4 5 6 7 8 9
0123456789
You must write within the boxes.
If typing, type through the boxes. (example)
(example)
Write your numbers as shown and enter one number per box.
FEIN
Taxable
year end
Estimated tax payment
Name
(See reverse side)
Address
US DOLLARS
CENTS
City/St/ZIP
Check here if you transmitted
Office use
funds electronically
only
Make checks payable and mail to:
FLORIDA DEPARTMENT OF REVENUE
5050 W TENNESSEE ST
TALLAHASSEE FL 32399-0135
9999090999999990000200503300039999999990999904