Form Ba: Rs1 - Agreement Extending Period Of Limitation For Assessment Or Refund
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1
2State of Alabama
BA: RS1
3/2012
Department of Revenue
RESET
Montgomery, Alabama 36132
( )
Agreement Extending Period of Limitation
For Assessment or Refund
FOR INSTRUCTIONS SEE REVERSE SIDE • SIGN AND RETURN ALL COPIES
Taxpayer’s Name and Address:
SSN / FEIN:
Spouse’s SSN:
(If applicable)
Taxable Period(s):
As provided in Code of Alabama 1975, the taxpayer and the Alabama Department of Revenue hereby consent
and agree as follows:
The amount of _____________________________ tax(es) / penalty / interest due from, or refund due to, the
(type of tax)
taxpayer under the provisions of the Code of Alabama 1975, for the tax period(s) indicated, may be
assessed or claimed at any time on or before
________________________________ , 20______ ;
except that the Department may also enter an assessment of income or estate taxes at any time prior to
the expiration of one year from the date the Department is notified or otherwise learns of a final determi-
nation by the Internal Revenue Service of the taxpayer’s liability for federal income or estate taxes for the
concurrent period(s); and the taxpayer may file a claim for refund at any time prior to the expiration of
one year from the date the federal changes become final.
For the Individual Taxpayer
Signature of Taxpayer
or Representative ____________________________________________________ Date ________________________
Spouse’s Signature ___________________________________________________ Date ________________________
(If applicable)
If you are an attorney or agent of the taxpayer(s), you may sign this consent provided the action is specifically
authorized by a power of attorney. If the power of attorney was not previously filed with the Alabama
Department of Revenue, please include it with this form.
For the Corporate Taxpayer
Alabama Department of Revenue
_______________________________________________
By ____________________________________________
(Signature)
(Corporate name)
_______________________________________________
_______________________________________________
(Officer or Representative printed name)
(Representative printed name)
By _____________________________________________
Title ______________________________ Date__________
(Signature)
Title _______________________________ Date__________
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