Form 1027 - Application For Automatic Extension Of Time To File Delaware Individual Income Tax Return

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DELAWARE
FORM 1027
TAX YEAR__________
DO NOT WRITE OR STAPLE IN THIS BOX
(REV. CODE 001)
APPLICATION FOR AUTOMATIC EXTENSION OF TIME TO
FILE DELAWARE INDIVIDUAL INCOME TAX RETURN
NOTE: PREPARE THIS FORM IN DUPLICATE. FILE THE ORIGINAL WITH THE DIVISION OF REVENUE, STATE OF DELAWARE ON OR BEFORE THE DUE
DATE AND PAY THE AMOUNT SHOWN ON LINE 6 BELOW. ATTACH THE DUPLICATE TO YOUR DELAWARE PERSONAL INCOME TAX RETURN.
NAME (IF JOINT RETURN, GIVE FIRST NAMES AND INITIALS OF BOTH)
LAST NAME
YOUR SOCIAL SECURITY NUMBER
PLEASE
PRINT
PRESENT HOME ADDRESS (NUMBER & STREET, INCLUDING APT. NUMBER OR RURAL ROUTE)
SPOUSE’S SOCIAL SECURITY NUMBER
OR
TYPE
CITY, TOWN OR POST OFFICE
STATE
ZIP CODE
AN AUTOMATIC EXTENSION OF TIME UNTIL AUGUST 15, 19_____ IS HEREBY REQUESTED IN WHICH TO FILE DELAWARE PERSONAL INCOME TAX
RETURN FOR THE CALENDAR YEAR 19_____ (OR IF A FISCAL YEAR RETURN UNTIL ______________________________, 19_____ FOR THE TAXABLE
YEAR BEGINNING______________________________, 19_____ AND ENDING ______________________________, 19_____).
1.
TOTAL INCOME TAX LIABILITY YOU EXPECT TO OWE FOR 19_____.....................................................................................
1
2.
DELAWARE INCOME TAX WITHHELD...................................................................................
2
3.
TAX YEAR 19_____ ESTIMATED TAX PAYMENTS (INCLUDE PRIOR YEARS OVERPAYMENT
3
ALLOWED AS CREDIT).........................................................................................................
4.
OTHER PAYMENTS AND CREDITS........................................................................................
4
5.
TOTAL (ADD LINES 2, 3, AND 4)..........................................................................................................................................
5
BALANCE DUE (SUBTRACT LINE 5 FROM LINE 1). PAY IN FULL WITH THIS APPLICATION............................BALANCE DUE' '
6.
6
SIGNATURE AND VERIFICATION
IF PREPARED BY TAXPAYER: UNDER PENALTY OF PERJURY, I DECLARE THAT TO THE BEST OF MY KNOWLEDGE AND BELIEF, THE STATEMENTS MADE
HEREIN ARE TRUE AND CORRECT.
YOUR SIGNATURE
DATE
SPOUSE’S SIGNATURE
DATE
(IF FILING JOINTLY, BOTH MUST SIGN EVEN IF ONLY ONE HAD INCOME)
IF PREPARED BY SOMEONE OTHER THAN TAXPAYER: UNDER PENALTIES OF PERJURY, I DECLARE THAT TO THE BEST OF MY KNOWLEDGE AND BELIEF,
THE STATEMENTS MADE HEREIN ARE TRUE AND CORRECT, THAT I AM AUTHORIZED BY THE TAXPAYER
TO PREPARE THIS APPLICATION, AND THAT I AM:
A MEMBER IN GOOD STANDING OF THE BAR OF THE HIGHEST COURT OF (SPECIFY JURISDICTION)...
A CERTIFIED PUBLIC ACCOUNTANT DULY QUALIFIED TO PRACTICE IN (SPECIFY JURISDICTION)........
A PERSON ENROLLED TO PRACTICE BEFORE THE INTERNAL REVENUE SERVICE
A DULY AUTHORIZED AGENT HOLDING A POWER OF ATTORNEY WITH RESPECT TO FILING AN EXTENSION OF TIME. (THE POWER OF
ATTORNEY NEED NOT BE SUBMITTED UNLESS REQUESTED)
A PERSON STANDING IN CLOSE PERSONAL BUSINESS RELATIONSHIP TO THE TAXPAYER, WHO IS
UNABLE TO SIGN THIS APPLICATION BECAUSE OF ILLNESS, ABSENCE, OR OTHER GOOD CAUSE.
MY RELATIONSHIP TO THE TAXPAYER AND THE REASON WHY THE TAX PAYER IS UNABLE TO
SIGN THIS APPLICATION ARE:........................................................................................................
YOUR SIGNATURE
DATE
SEE INSTRUCTIONS ON REVERSE SIDE
MAKE CHECK PAYABLE AND MAIL TO: DELAWARE DIVISION OF REVENUE, 820 N. FRENCH STREET, WILMINGTON, DE 19899

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