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03 Mail This Form With Remittance Payable To: 03
DELAWARE DIVISION OF REVENUE Delaware Division of Revenue
04 FORM 1100-T – DELAWARE CORPORATE TENTATIVE TAX RETURN P.O. Box 830, Wilmington, DE 19899-0830 04
05 ACCOUNT NUMBER VERIFY BUSINESS FEIN CALENDAR OR FISCAL YEAR ENDING DUE ON OR BEFORE VOUCHER 05
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Check Here If A
12 Request For BALANCE DUE FROM LINE 5 OF WORKSHEET 12
Change Form Is
13 Being Filed ( OF ESTIMATED TAX FOR THE YEAR) 13
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15 $ 15
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17 *DF62315019999* 17
18 DF62315019999 18
CHANGES MUST BE MADE ON THE REQUEST FOR CHANGE FORM.
19 CHECK THE BOX IF YOU ARE FILING A CHANGE FORM. 19
20 TELEPHONE NUMBER DATE 20
21 EMAIL ADDRESS 21
X
22 AUTHORIZED SIGNATURE Iadeclaretrue, correctunderandpenaltiescompleteof perjuryreturn.that this is 22
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