Application for Automatic Extension of Time To File Certain Business Income Tax, Information, and Other Returns

Application for Automatic Extension of Time To File Certain Business Income Tax, Information, and Other Returns
Business Name*
Legal Business Name registered with the IRS & your State of Incorporation
Business Type*
LLC, S-Corp, C-Corp, Etc...
EIN*
Tax ID # assigned by the IRS
Name*

First Name of Requestor (person completing this form)Last Name of Requestor
SSN*
SSN of Requestor (person completing this request for Extension)
Physical Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Mailing Address if different

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Is the organization a foreign corporation that does not have an office or place of business in the United States?*

YesNo
Is the organization a corporation and is the common parent of a group that intends to file a consolidated return? (If yes, we will need to attach a statement listing the name, address, and employer identification number (EIN) for each member covered by this application.)*

YesNo
Is the organization a corporation or partnership that qualifies under Regulations section 1.608-5?*

YesNoUnsure (We will check)
The application is for calendar year 202 digit yr, or tax year beginning Month, 202 digit yr and ending Month, 2 digit yr .
Short tax year. If this tax year is less than 12 months, check the reason*

Initial returnFinal returnChange in accounting periodConsolidated return to be filedOther See instructions—attach explanationNone of the above
6. Tenative Total Tax
7. TOTAL payments and credits
BALANCE DUE. Subtract line 7 from line 6.
For Privacy Act and Paperwork Reduction Act Notice, see separate instructions.
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