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2023 Scannable Alternative Forms Examples
Alternative F-7004 form changes
Note: Refer to the 2023 Alternative Forms Requirements Guide for barcode and OCR line specifications.
1. Coupon Section:
a) Line 55, Column A: Changed tax year end from 2021 ‘ to ’ 2022‘ .’
b) OCR Line:
• Changed Vendor ID portion from ‘82xx’ to ‘83xx’.
• Changed Applied Date portion from ‘ 2021 ’ to ‘ 2022’.
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Florida Tentative Income / Franchise Tax Return Company ID Here
F-7004
and Application for Extension of Time to File Return R. 01/17
Rule 12C-1.051
Florida Administrative Code
Effective 01/17
Information for Filing Florida Form F-7004 F-7004
When to file - File this application on or before the original due date of the taxpayer’s A. If applicable, state the reason you need the extension: R. 01/17
corporate income tax or partnership return. Do not file before the end of the tax year. ______________________________________________________________________
To file online go to www.floridarevenue.com ______________________________________________________________________
Penalties - If you are required to pay tax with this application, failure to pay will void B. Type of federal return filed:_______________________________________________
any extension of time and subject the taxpayer to penalties and interest. There is also Contact person for questions: ____________________________________________
a penalty for late-file return when no tax is due. Telephone number: (________) ___________________________________________
Signature - A person authorized by the taxpayer must sign Florida Form F-7004. They Contact Person email address: ___________________________________________
must be an officer or partner of the taxpayer; a person currently enrolled to practice
before the Internal Revenue Service (IRS); or attorney or Certified Public Accountant
qualified to practice before the IRS under Public Law 89-332.
The Florida Form F-7004 must be filed - To receive an extension of time to file your Extension of Time Request Florida Income/Franchise
Tax Due
Florida return, Florida Form F-7004 must be timely filed, even if you have already filed
a federal extension request. A federal extension by itself does not extend the time to 1. Tentative amount of Florida tax for the taxable year 1.
file a Florida return.
An extension for Florida tax purposes may be granted, even though no federal 2. LESS: Estimated tax payments for the taxable year 2.
extension was granted. See Rule 12C-1.0222, F.A.C., for information on the 3. Balance due — You must pay 100% of the tax 3.
requirements that must be met for your request for an extension of time to be valid. tentatively determined due with this extension request.
Transfer the amount on Line 3 to Tentative tax due on reverse side.
Make checks payable and mail to:
FLORIDA DEPARTMENT OF REVENUE, 5050 W TENNESSEE STREET, TALLAHASSEE FL 32399-0135
Florida Department of Revenue - Corporate Income Tax Company ID Here
Florida Tentative Income / Franchise Tax Return F-7004
and Application for Extension of Time to File Return R. 01/17
Name FDOR - Corporate Test FEIN
Address 5050 W Tennessee Street Taxable Year End ___/___
City/State/ZIP Tallahassee, FL 32399-0141 FILING STATUS Partnership____ S-corporation___
All other federal returns to be filed ___
Tentative Tax Due $
Under penalties of perjury, I declare that I have been authorized by the above named taxpayer to make this application, that to the best of my knowledge
and belief the statements herein are true and correct:
Sign Here: ______________________________________________________ Date: _____________________________
012345678901234000 000000000000000000 000000000000000000 000000000000000000000000
112345678901234000 000000000000000000 000000000000000000 000000000000000000000000
202212318901234000 000000000000000000 000000000000000000 000000000000000000000000
000000000000000000 000000000000000000 000000000000000000 000000000000000000000000
101234567890123000 000000000000000000 000000000000000000 000000000000000000000000
000000000000000000 000000000000000000 000000000000000000 000000000000000000000000
000000000000000000 000000000000000000 000000000000000000 000000000000000000000000
000000000000000000 000000000000000000 000000000000000000 012345678901234
83XX 0 20221231 0002005030 5 3012345678 0000 9
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