Form Ft 1120-Fi - 2002 Corporation Franchise Tax Report For Financial Institutions
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4Mail with remittance to: Treasurer of State of Ohio, P.O. Box 27, Columbus, Ohio 43216-0027
REVISED
Tax Year
OHIO
2002
FT 1120-FI
Corporation Franchise Tax Report for Financial Institutions
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EPARTMENT
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NLY
2001
Based upon calendar year 2001 or other taxable year beginning ____________________, _____ and ending ____________________,
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If this is an amended report, check the box (if the amended report reflects a refund, attach Form FT-REF).
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Corporation Name
HIO
RANCHISE
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Address (Check box below if you are not receiving forms at the proper mailing address.)
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HIO
HARTER OR
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City
State
Zip Code
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EDERAL
MPLOYER
DENTIFICATION
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Statutory Agent
Corporate Officers
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Check the box if both the below-reported statutory agent and the address
Check the box if all the below-reported corporate officers are the same as
are the same as were reported on the 2001 franchise tax report.
were reported on the 2001 franchise tax report.
First Name
Middle Initial
Last Name
Name
President
Street Address
Secretary
City
State
Zip Code
Treasurer
Schedule A — Computation of Franchise Tax
Whole Dollars Only
_________________
1.
00
1. Net value of stock (from Schedule E, line 7 or, if applicable, from Schedule F, line 6) .........................
_________________
2.
2. Apportionment ratio (from Schedule D-1, line 4 or Schedule D-2) .......................................................
_________________
3.
00
3. Taxable value (line 1 x line 2) .................................................................................................................
_________________
00
4.
4. Tax on net worth basis (.013 x line 3, but not less than $50) ................................................................
_________________
5.
00
5. Total nonrefundable credits (from Schedule A-1, line 7) .......................................................................
_________________
6.
00
6. Amount due after nonrefundable credits (line 4 minus line 5, but not less than $50) .........................
_________________
7.
00
7. Overpayment carryforward from 2001 ....................................................................................................
_________________
8.
00
8. Estimated payments made in tax year 2002: E __________, ER __________, EX __________ ...
_________________
00
9.
9. New jobs refundable credit (attach Department of Development certificate of verification) .................
_________________
10.
00
10. Total payments and refundable credits (add lines 7, 8 and 9) ..............................................................
_________________
11.
00
11. Tax due (line 6 minus line 10) ................................................................................................................
_________________
00
12.
12. Interest __________, Penalty __________, Total interest and penalty .................................................
_________________
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13.
00
13. Balance due (make payable to Ohio Treasurer of State). Check box if payment made by EFT
....
_________________
14.
00
14. Overpayment ..........................................................................................................................................
_________________
15.
00
15. Amount of line 14 to be credited to tax year 2003 estimated tax ...........................................................
16.
00
16. Amount of line 14 to be refunded ...........................................................................................................
Declaration/Signatures (An officer or managing agent of the corporation must sign this declaration. )
I declare under penalties of perjury that this report (including any accom-
of or opposition to a political party, a candidate for election or nomination
panying schedule or statement) has been examined by me and to the
to public office, or a political action committee, legislation campaign fund,
best of my knowledge and belief is a true, correct and complete return
or organization that supports or opposes any such candidate or in any
and report and that this corporation has not, during the preceding year,
manner used any of its money for any partisan political purpose what-
except as permitted by section 3517.082, 3599.03 and 3599.031 of the
ever, or for reimbursement or indemnification of any person for money or
Ohio Revised Code, directly or indirectly paid, used or offered, con-
property so used.
sented, or agreed to pay or use any of its money or property for or in aid
Date
Signature of officer or managing agent
Title
Date
Signature of preparer other than taxpayer based on
Title
all information of which preparer has knowledge
Do Not Write Below
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