Vt Form Est-195 - Application For Extension Of Time To File Vermont Estate Tax Return
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1Vermont Department of Taxes
133 State Street
Montpelier, VT 05633-1401
*171951100*
Phone: (802) 828-6880
Application for Extension of Time
VT Form
EST-195
* 1 7 1 9 5 1 1 0 0 *
to File Vermont Estate Tax Return
• File this application on or before the due date of the Vermont Estate Tax Return.
• With the filing of this application, you are granted an automatic six month extension of time to file the tax return.
Decedent’s Information
Decedent’s Last Name
First Name
Initial
Decedent’s Social Security Number
Domicile of Decedent - City
State
ZIP Code
Date of Death
-
Executor’s Information
Name of Executor
Daytime telephone number
Name of application filer (If other than the executor)
Estate tax return due date
Address of Executor (number, street, and room or suite number)
City
State
ZIP Code
-
Payment to accompany extension request
Enter all amounts in whole dollars.
1. Estimated tax liability . . . . . . . . . . . . . . . . . 1. ________________________ .
2. Previous payments . . . . . . . . . . . . . . . . . . . . 2. ________________________ .
3. Amount of TAX DUE with this application (Subtract Line 2 from Line 1) . . . . . . . . .3._________________________ .
Make check payable to VERMONT DEPARTMENT OF TAXES and mail it with this application to:
Vermont Department of Taxes
133 State Street
Montpelier, VT 05633-1401
An extension of time to file a Vermont estate tax return does not extend the time for paying the tax. Any tax due and unpaid by
the original due date will bear interest and penalty at the statutory rate. Returns filed after the due date without an authorized
extension are subject to a late filing fee. The interest rate is set annually by the Commissioner of Taxes in accordance with
32 V.S.A. § 3108.
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Form EST-195
(formerly ES-164)
5454
Rev. 10/17
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