Form 1138 - Extension Of Time For Payment Of Taxes By A Corporation Expecting A Net Operating Loss Carryback

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1138
Extension of Time for Payment of Taxes by a
Form
Corporation Expecting a Net Operating Loss Carryback
OMB No. 1545-0135
(Rev. December 2011)
Department of the Treasury
(Under Section 6164 of the Internal Revenue Code)
Internal Revenue Service
Name
Employer identification number
Number, street, and room or suite no. If a P.O. box, see instructions.
City or town, state, and ZIP code
1
Ending date of the tax year of the expected net operating loss (NOL)
2 Amount of expected NOL
$
3
Reduction of previously determined tax attributable to the expected NOL carryback
(see instructions—attach schedule)
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4
Ending date of the tax year immediately preceding the tax year of the expected NOL
5
Give the reasons, facts, and circumstances that cause the corporation to expect an NOL.
6
Amount for which payment is to be extended:
a Enter the total tax shown on the return, plus any amount assessed as a deficiency, interest, or
penalty (see instructions) .
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6a
b Enter amounts from line 6a that were already paid or were required to have been paid, plus refunds,
credits, and abatements (see instructions) .
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6b
c Subtract line 6b from line 6a. Do not enter more than the amount on line 3 above. This is the amount
of tax for which the time for payment is extended
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6c
Sign
Under penalties of perjury, I declare that I have examined this form, including any accompanying schedules and statements, and
to the best of my knowledge and belief it is true, correct, and complete.
Here
Keep a copy of
this form for
Signature of officer
Date
Title
your records.
1138
For Paperwork Reduction Act Notice, see instructions.
Form
(Rev. 12-2011)
Cat. No. 17250W

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