Form Ct-706/709 Ext - Application For Estate And Gift Tax Return Filing Extension And For Estate Tax Payment Extension - 2012

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CT-706/709 EXT

Department of Revenue Services

Form CT-706/709 EXT

PO Box 2978

Calendar Year

Application for Estate and Gift Tax Return Filing

Hartford CT 06104-2978

(Rev. 06/12)

Extension and for Estate Tax Payment Extension

2012



Complete this application in blue or black ink only.

Donor or decedent’s ﬁ rst name and middle initial

Last name

Social Security Number (SSN)

• •





__ __ __

• •

__ __

__ __ __ __

Address

Number and street, apartment number, suite number

PO Box

Federal Employer ID Number (FEIN), if applicable









City, town, or post ofﬁ ce

State

ZIP code

DRS use only

–

– 20







Mailing address (ﬁ rm name if applicable)

Number and street, suite number

PO box



City, town, or post ofﬁ ce

State

ZIP code



Attention, care of, or estate representative (if applicable)



Fiduciary’s name and address

Section 1 – Gift Tax Extension Request

If the donor died during calendar year 2012, skip Section 1 and complete Section 2. Otherwise, complete Section 1 for gift tax purposes only.

By completing Section 1 of this form and ﬁ ling it with the Connecticut Department of Revenue Services (DRS), you are requesting

a six-month extension of time to report your Connecticut taxable gifts for calendar year 2012.

I have requested a federal extension using federal Form 8892, Application for Extension of Time to File Form 709 and/or Payment of

 Yes

 No

Gift/Generation-Skipping Transfer Tax, for calendar year 2012.

_________________________________________________

If No, the reason for the Connecticut extension request is:

1. 2012 Connecticut gift tax liability

You must enter a whole dollar amount. If you do not expect to have a gift tax liability,

enter “0.” ...........................................................................................................................



Section 2 – Estate Tax Extension Request

 __________________ Connecticut Probate Court: ____________________________________

Decedent’s date of death:



By completing Section 2 of this application and ﬁ ling it with DRS, you are requesting an extension of time to ﬁ le Form CT 706/709,

Connecticut Estate and Gift Tax Return, pay Connecticut estate tax, or both.





Extension of Time to File - I request a nine-month extension of time to ﬁ le the decedent’s Form CT-706/709.





Extension of Time to Pay - I request a six-month extension of time to pay the decedent’s Connecticut estate tax. Attach a

statement of reasonable cause.

I have requested a federal extension using federal Form 4768, Application for Extension of Time to File a Return and/or Pay U.S.

 Yes

 No

Estate (and Generation-Skipping Transfer) Taxes.

If No, the reason for the Connecticut extension request is: _________________________________________________________

________________________________________________________________________________________________________

2. 2012 Connecticut estate tax liability

You must enter a whole dollar amount. . .......................................................................... 

Declaration: I declare under penalty of law that I have examined this return (Including any accompanying schedules and statements) and, to the best of my knowledge and

belief, it is true, complete, and correct. I understand the penalty for willfully delivering a false return or document to DRS is a ﬁ ne of not more than $5,000, imprisonment for

not more than ﬁ ve years, or both. The declaration of a paid preparer other than the taxpayer is based on all information of which the preparer has any knowledge.

Donor or ﬁ duciary’s signature

Title

Date

Telephone number

Sign Here

(

)

Keep a

Paid preparer’s or authorized estate representative’s signature

Date

Preparer’s PTIN or SSN Telephone number

copy of