Department of Revenue Services
Form CT-1120 EXT
2015
State of Connecticut
Application for Extension of Time to File
PO Box 2974
Hartford CT 06104-2974
Corporation Business Tax Return
(Rev. 12/15)
Complete this form in blue or black ink only. See instructions on reverse.
Enter Income Year Beginning
, 2015, and Ending
,
____________________________________
____________________________________
____________
Corporation name
CT Tax Registration Number
Taxpayer
This return MUST be fi led electronically!
DRS use only
Number and street
PO Box
Please
DO NOT MAIL paper return to DRS.
–
– 20
type
or print.
Federal Employer ID Number (FEIN)
City or town
State
ZIP code
Request for Six-Month Extension to File Form CT-1120, Form CT-1120CR, or Form CT-1120U
Each corporation must submit payment of any tax due or believed to be due with this application for an extension of time to fi le, whether or not
an application for federal extension has been approved. See instructions on reverse.
I request a six-month extension of time, to October 1, 2016, to fi le a Connecticut Corporation Business Tax Return for calendar year
2015
or
until
for fi scal year ending
.
_________________________________________
_________________________________________
A federal extension has been requested on federal Form 7004, Application for Automatic Extension of Time to File Certain Business Income Tax,
Information, and Other Returns, for calendar year 2015, or for fi scal year beginning
, 2015, and
_________________________________________
ending
.
Yes
No
_________________________________________
If No, the reason for the Connecticut extension is _________________________________________________________________________________
_________________________________________________________________________________________________________________________
Are you fi ling Form CT-1120CR?
Yes
No
Are you fi ling Form CT-1120U?
Yes
No
Tentative Return
00
1. Tentative amount of tax due for this income year; minimum tax $250. See instructions. ............................. 1.
2. Surtax: See instructions. .............................................................................................................................. 2.
00
3. Total tax: Add Line 1 and Line 2. Include tax credit recapture, if applicable. ............................................... 3.
00
4. Multiply Line 3 by 49.99% (0.4999) ............................................................ 4.
00
5. Multiply the number of companies included by $250. .................................. 5.
00
00
6. Enter the greater of Line 4 or Line 5. ............................................................................................................ 6.
00
7. Tax credit limitation: Subtract Line 6 from Line 3. ......................................................................................... 7.
00
8. Tax credits: Do not exceed amount on Line 7. .......................................................................................... 8.
00
9. Balance of tax payable: Subtract Line 8 from Line 3. ................................................................................... 9.
00
10. Payment(s) of estimated tax ........................................................................ 10.
00
11. Overpayment from prior year ....................................................................... 11.
00
12. Total payments: Add Line 10 and Line 11. ................................................................................................... 12.
00
13. Balance due with this return: Subtract Line 12 from Line 9. ..................................................................
13.
For income years beginning on or after
Visit the DRS Taxpayer Service
January 1, 2014, Form CT-1120 EXT must
Center (TSC) at to
be fi led and paid electronically.
fi le and pay this return electronically.
Declaration: I declare under penalty of law that I have examined this return (including any accompanying schedules and statements) and, to the best of
my knowledge and belief, it is true, complete, and correct. I understand the penalty for willfully delivering a false return or document to the Department of
Revenue Services (DRS) is a fi ne of not more than $5,000, imprisonment for not more than fi ve years, or both. The declaration of a paid preparer other
than the taxpayer is based on all information of which the preparer has any knowledge.
Corporate offi cer’s name (print)
Corporate offi cer’s signature
Date
May DRS contact the preparer
Sign Here
This return MUST be fi led electronically!
shown below about this return?
Yes
No
Keep a
Title
Telephone number
DO NOT MAIL paper return to DRS.
(
)
See instructions.
copy
of this
Paid preparer’s name (print)
Paid preparer’s signature
Date
Preparer’s SSN or PTIN
return for
your
records.
Firm’s name and address
FEIN
Telephone number
(
)
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