Application For Extension Of Time To File Form printable pdf download

Application For Extension Of Time To File Form

APPLICATION FOR EXTENSION OF TIME TO FILE

VILLAGE OF GERMANTOWN, OHIO INCOME TAX RETURN

TYPE OF RETURN:

Individual

Corporate

Partnership

Sole Proprietorship

______________________________________

_______________________________

Name

Social Security Number

______________________________________

_______________________________

Address

Federal Employee ID Number

______________________________________

City, State and Zip Code

I request an extension of time to file the Village of Germantown Income Tax Returns for

the above named individual/corporation, etc., until ____________________ for the tax year

beginning ______________________ and ending ___________________.

1. Does this application also cover subsidiaries to be included in a consolidated return?

(If yes, complete Section 2 below.)

2. Provide Name, Address and Federal Employee Identification Number or Social Security

Number of each member of the affiliated group.

3. The above named individual/corporation, etc., has received an extension of the Federal

Income Tax filing date to ______________________. (Attach copy of Federal Extension)

(Date)

4. Signature – Under penalties of perjury, I declare that I have been authorized by the above

named individual/corporation, etc., to make this application for extension, and that to the best

of my knowledge and belief, the statements made here are true, correct and complete.

____________________________________

__________________________________

Signature

Name & Title

____________________________________

Date

Application For Extension Of Time To File Form