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Get and Sign Agent Qualification and Verification of Experience Form Florida 2012-2022
Incorporated
City or town, state, and ZIP code
D Check applicable box if an election
has been made under section(s):
(2)
(3)
Name change
(4)
Address change
953(c)(3)(C)
Amended return
1
2
3
Taxable income (Schedule A, line 37) . . . . . . . . . . . . .
Taxable investment income for electing small companies (Schedule B, line 21) .
Check if a member of a controlled group (attach Schedule O (Form 1120)) . .
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Income tax
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