Form 8809-Ex - Request For Extension Of Time To File An Exstars Information Return
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1
28809-EX
Request for Extension of Time To
OMB No. 1545-1733
Form
File an ExSTARS Information Return
OFFICIAL USE ONLY
Determination Date
(January 2014)
(For Form 720-TO or Form 720-CS)
Approved
Denied
Department of the Treasury
Information about Form 8809-EX and its instructions is at
▶
Internal Revenue Service
2. Employer identification number
1. Filer information
Name
Print
Address (number, street, and apt. or suite no.)
Form 637 registration number
or
Type
City
State
ZIP code
Contact name
Telephone number
3. Filing period
4. Type of extension request (check one)
5. Request type (check one)
Form 720-TO
Form 720-CS
Combined filing
Initial
Additional
Note. File this form by the required return due date.
6. Extension request reason: Provide a brief but clear reason for the extension request. The IRS will automatically deny an application for an
extension that is submitted without a reason(s). Use additional sheets if necessary and include your name and employer identification number on
each page. For a combined filing, provide a reason for the extension request for each return.
Under penalties of perjury, I declare that I have examined this form, including any accompanying statements, and, to the best of my knowledge and belief, it is true, correct, and
complete.
Signature
Title
Date
▶
▶
▶
Section references are to the Internal Revenue Code unless
How to file. All requests must include an extension reason. All initial
otherwise noted.
30-day requests will be honored except for those without a reason.
When to file. File this form with the IRS on or before the due date of
Future Developments
the return. If you are requesting an extension of time to file both
Form 720-TO and Form 720-CS, you may use one Form 8809-EX.
For the latest information about developments related to Form
8809-EX and its instructions, such as legislation enacted after they
Extension period. The automatic extension is 30 days from the
were published, go to
original due date. You may request one additional extension of not
more than 30 days by submitting a second Form 8809-EX before
General Instructions
the end of the first extension period (see Line 5, later). Requests for
an additional extension of time to file information returns are not
Purpose of form. Use Form 8809-EX to request a 30-day extension
automatically granted. Generally, the IRS will not grant additional
of time to file an Excise Summary Terminal Activity Reporting
time except in cases of extreme hardship or catastrophic event.
System (ExSTARS) information report (Form 720-TO, Terminal
Operator Report, or Form 720-CS, Carrier Summary Report).
8809-EX
For Privacy Act and Paperwork Reduction Act Notice, see instructions.
Form
(1-2014)
Cat. No. 62959G
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