Application For Extension Of Time To File Income Tax Return - City Of Hamtramck - 2005

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2005
City of Hamtramck
2005
APPLICATION FOR EXTENSION OF TIME
TO FILE INCOME TAX RETURN
Prepare this form in duplicate. File the original with the City’s Income Tax Department on or before the due date for
filing a return. Attach the duplicate to your city income tax return.
NAME
TAXABLE PERIOD
Calendar Year_________________________________________
Fiscal Year Ending______________________________________
ADDRESS (STREET NUMBER AND NAME)
TYPE OF RETURN
Corporation
Individual
Partnership
Resident
Estate or Trust
Non-Resident
CITY, STATE & ZIP CODE
Employer Identification Number or
Social Security Number
____________________________________
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 this return is the last day of ______________________, 2006.
TENTATIVE TAX RETURN
THE TENTATIVE TAX BALANCE DUE MUST BE PAID WITH THIS EXTENSION.
1.
Tentative Tax (Estimate total tax liability)……………………………………..
$_____________________
2.
Less:
a.
Estimated income tax payment………………………………………
$_____________________
b.
Other credits……………………………………………………………
$_____________________
3.
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 tentative tax (if
due) could result in penalty for failure to pay.
__________________________________________________
__________________________
Signature of taxpayer, officer or agent
Date
MAIL TO: City of Hamtramck
Income Tax Department
3401 Evaline Avenue
Hamtramck, MI 48212

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