RV-R0011001 (12/22)
TENNESSEE DEPARTMENT OF REVENUE
2022 Franchise and Excise Tax Return
Tax Year Beginning Account Number Check all that apply:
FAE
a) Amended return
170
Tax Year Ending FEIN
b) Final return
c) Public Law 86-272 applied to excise tax
NAICS SOS Control Number
d) Taxpayer has made an election to
calculate net worth per the provisions of
Tenn. Code Ann. §67-4-2103(g)-(i)
Legal Name
e) Taxpayer has filed the prescribed form
to revoke its election made per Tenn.
Code Ann. §67-4-2103(g)-(i)
Mailing Address f) Annualized income installment method
for quarterly estimates election
g) Manufacturer single sales factor election
City
h) Revoke manufacturer single sales factor
election
i) Taxpayer has filed for federal extension
State ZIP Code
Date Tennessee operations began (see instructions)
Schedule A ‑ Computation of Franchise Tax Round to the nearest dollar
1. Total net worth Schedule F1, Line 5 or Schedule F2, Line 3 ....................................................................................... (1) ______________________________________
2. Total real and tangible personal property from Schedule G, Line 15 ........................................................................ (2) ______________________________________
3. Franchise tax (25¢ per $100 or major fraction thereof on the greater of Lines 1 or 2; minimum $100) .............(3) ______________________________________
Schedule B ‑ Computation of Excise Tax
4. Income subject to excise tax from Schedule J, Line 36 ................................................................................................ (4) ______________________________________
5. Excise tax (6.5% of Line 4) .............................................................................................................................................. (5) ______________________________________
6. Recapture of tax credit (Schedule T, Line 13) and additional excise tax on certified distribution sales .............. (6) ______________________________________
7. Total excise tax due (add Lines 5 and 6) ....................................................................................................................... (7) ______________________________________
Schedule C ‑ Computation of Total Tax Due or Overpayment
8. Total franchise and excise taxes (add Lines 3 and 7) ............................................................. (8) ______________________________________
9. Total credit from Schedule D, Line 9 (cannot exceed Schedule C, Line 8) ........................... (9) ______________________________________
10. Net tax (subtract Line 9 from Line 8; if Line 9 exceeds Line 8, enter zero here) ................ (10) ______________________________________
11. Total payments from Schedule E, Line 7 ................................................................................. (11) ______________________________________
12. Penalty (see instructions) ......................................................................................................... (12) ______________________________________
13. Interest (see instructions) .............................................................................................................................................(13) ______________________________________
14. Penalty on estimated franchise and excise tax payments .......................................................................................(14) ______________________________________
15. Interest on estimated franchise and excise tax payments ......................................................................................(15) ______________________________________
16. Total amount due (overpaid) (add Lines 10, 12, 13, 14, and 15, subtract Line 11) ................................................(16) ______________________________________
If overpayment reported on Line 16, complete A and/or B below:
A. Credit to next year’s tax $ ______________________________________ B. Refund $ _______________________________
Under penalties of perjury, I declare that I have examined this report, and to the best of my knowledge
Power of Attorney - Check YES if this taxpayer's and belief, it is true, correct, and complete.
signature certifies that this tax preparer has
the authority to execute this form on behalf Taxpayer's Signature Date Title
of the taxpayer and is authorized to receive
and inspect confidential tax information Tax Preparer's Signature Preparer's PTIN Date Telephone
and to perform any and all acts relating to
respective tax matters. Preparer's Address City State ZIP Code
YES Preparer's Email Address
FOR OFFICE USE ONLY