City of Springdale
APPLICATION FOR EXTENSION OF TIME TO FILE INCOME TAX RETURN AND
STATEMENT IN LIEU OF TENTATIVE TAX RETURN
File in DUPLICATE with:
PHONE: (513) 346-5715
Make check or money order payable to:
Springdale Tax Commission
FAX: (513) 346-5756
Springdale Tax Commission
11700 Springfield Pike
Please include:
Springdale, Ohio
This extension must be filed on or
Self addressed stamped envelope to
45246
before the original due date of the
ensure proper return of approved
return.
extension
1. Taxpayers Name:
3. Federal ID#:
2a. Address:
4. Springdale ID#:
2b. City:
2c. State:
2d. Zip Code:
5a. I request an extension of time to file the Springdale income tax return of the taxpayer named above for:
Calendar year ending December 31, ___________
Fiscal year beginning _________________________ , __________ and ending ______________________, __________
5b. If this tax year is for less than 12 months, check reason:
Initial return
Change in accounting period
Final return
Consolidated return to be filed
6. Original Due Date of Return:
7. Previous Extension Granted To:
8. Extension Requested To:
9. Estimated total taxable income
9.
10. Tax rate 1.5%
10.
11. Estimated tax due
11.
12. Credits:
a. Overpayment credited from
12a.
prior year
b. Amount previously paid on
12b.
current estimate
c. Total credits
12c.
13. Balance due
13.
This extension of time to file the Springdale income tax return for the year stated above is hereby requested for the