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Form Ba-403 - Application For Extension Of Time To File Vermont Corporate/business Income Tax Return 2000

*004031199*

Vermont Department of Taxes

109 State Street

Montpelier, VT 05609-1401

* 0 0 4 0 3 1 1 9 9 *

Application for Extension of Time to File

2000 VERMONT

Vermont Corporate/Business Income Tax Return

h File this application on or before the due date of the Vermont

Corporate Income Tax Return (Form CO-411) or Vermont

Name of corporation/entity

Business Income Tax Return (Form BI-471) if a tax payment

is due or if an extension of time to file with Vermont is being

Last name of person authorized to sign this application

First Name

Initial

requested without having a federal extension.

Mailing address (Street number or PO Box/Street/Suite or Room number)

h An extension of time to file a federal return automatically

extends the time to file with Vermont. However, at least the

City or Town

State

Zip Code + 4

minimum tax is due on the original due date for an extension

to be valid. Include a photocopy of the federal extension

Check here if name or address has changed

request when filing the Vermont return.

FOR PROPER CREDIT, INDICATE FEDERAL TAX RETURN TO BE FILED (CHECK BOX):

c 1120/1120A

c 1120S

c 1065/1065-A

c Other (specify) ______________

PAYMENTS CANNOT BE PROPERLY CREDITED WITHOUT THESE ENTRIES

TAXPAYER

INFORMATION:

Federal I.D. Number

Year

Month

Vermont Business Account Number

Calendar or

fiscal year ending

Month

Day

Year

Initial return

Final return

Change in accounting period

Other

1. Estimated tax liability

○

2. Previous payments

○

3. AMOUNT OF TAX DUE WITH THIS APPLICATION: Subtract Line 2 from Line 1

○

Vermont Department of Taxes

Vermont Department of Taxes, 109 State Street, Montpelier, VT 05609-1401.

Signature of Officer or Agen

Date

Title

Daytime telephone

Sign

number (optional)

Here

Date

Check if

Preparer’s Social Security No. or PTIN

Preparer’s

self-employed

Paid

signature

Preparer’s

Firm’s name (or yours

Use Only

EIN

if self-employed) and

address

ZIP Code

Form BA-403

Form Ba-403 - Application For Extension Of Time To File Vermont Corporate/business Income Tax Return 2000

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