APPLICATION FOR EXTENSION OF TIME
TO FILE MUSKEGON HEIGHTS INCOME TAX RETURN
NOTE: Complete entire form. File with the Muskegon Heights Income Tax Department on or
before the due date for filing a return. When the form is filed, it may be assumed that the
extension is automatically granted unless otherwise notified. Attach to your Muskegon Heights
Income Tax Return.
SECTION A
NAME
SOCIAL SECURITY OR FEDERAL ID NUMBER
ADDRESS & STREET
TYPE OF RETURN TO BE FILED
_____ Form MH-1040R
CITY STATE & ZIP CODE
_____ Form MH-1040NR
_____ Form MH-1120
_____ Form MH-1065
SECTION B
Reason for extension request:
SECTION C
A 2-month extension of time until ___________________20___, is here by requested in which to file the Muskegon
Heights Income Tax Return of the above for the taxable year beginnings
________________________, 20____, and ending ____________________, 20____.
**Where an extension greater than two months (or additional extension) is requested please use Sections D and E
below.
SECTION D
Where an extension of greater than two months is requested, the tax tentatively determined to be due must be paid
by the last day of the second month. The Uniform 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 until __________________, 20_____, is hereby requested in which to file the
Muskegon Heights Income Tax Return of the above for taxable year beginning
_______________________, 20_____, and ending ______________________,20____.
SECTION E
Tentative Tax
1. Tentative City of Muskegon Heights Tax
_____________________________
2. Less:
a. Payments of Declaration of Estimated Muskegon Heights Income Tax: ____________________________
b. Other credits
____________________________
3. BALANCE DUE
____________________________
____________________________________________
__________________________________
Signature of Taxpayer, Officer or Agent
Date
MAIL TO:
MUSKEGON HEIGHTS INCOME TAX, 2724 PECK STREET, MUSKEGON HTS., MI 49444