Application For Extension Of Time To File A Income Tax Return

Application For Extension Of Time To File A Income Tax Return - City Of Lapeer

CITY OF LAPEER

TAX YEAR ___________

APPLICATION FOR EXTENSION OF TIME

TO FILE A LAPEER CITY INCOME TAX RETURN

Prepare this form in duplicate. File the original with the Lapeer City Income Tax Department on or

before the due date for filing a return. Attach the duplicate to your city income tax return.

Name

Social Security Number

Address (Street number and name)

Mark type of return to be filed

Form L-1040

City, State & Zip Code

Form L-1120 or L-1120S

Form L-1065

Reason for extension request

The City Income Tax Ordinance limits the extension of time for filing annual returns to SIX months

from the original due date.

A _______ month extension of time is hereby requested in which to file the income tax return of the

above named taxpayer. The extended due date of the return is the last day of _______________, 2______

TENTATIVE TAX RETURN

THE TENTATIVE TAX BALANCE DUE MUST BE PAID WITH THIS EXTENSION.

Tentative Tax (Estimate total tax liability)............................................ $ ___________

Less:

Estimated income tax payments..................................................... $ ___________

Other credits .................................................................................. $ ___________

BALANCE DUE (Line 1 less lines 2a and 2b) .................................. $ ___________

(Include payment of this amount with extension)

The extension is automatically granted upon payment of the tentative tax balance due.

Failure to pay the tentative tax balance due invalidates the extension request.

An extension filed without a payment will not be accepted.

________________________________________

_________________

Signature of taxpayer, officer or agent

Date

_____________________________________________________________________________________

.................................................................... MAIL TO: City of Lapeer Income Tax Department

576 Liberty Park

Lapeer MI 48446

Application For Extension Of Time To File A Income Tax Return - City Of Lapeer