Form 355-7004 - Corporate Extension Worksheet

Rev. 10/02

Massachusetts

Form 355-7004

Department of

Corporate Extension Worksheet

Revenue

Tentative Return

1 Estimated amount of tax for the taxable year (must be at least minimum tax) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

2 Advance and/or estimated payments made (if any) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

3 Tax due with this application. Subtract line 2 from line 1. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

Payment in full of the tax due must be made with the extension request for it to be considered valid. If at least 50% of the tax due or the minimum tax (whichever

is greater) for the taxable year is not paid, the extension is null and void. Penalties for a late return will be assessed from the original due date of the return.

General Information

Who May File Form 355-7004?

How Long Is the Period of Extension?

All domestic and foreign business, manufacturing or security cor-

An automatic six-month extension is granted upon the proper filing

porations eligible to file Forms 355, 355U, 355S, 355SC or 355SBC

of this form. An extension for a period longer than six-months

may use this application to request either an automatic six-month

may be granted if good cause exists; it requires the written approval

extension of time to file their return or an extension of time to file for

of the Commissioner before it becomes effective. The Commissioner

more than six-months. Taxpayers filing Form 355U must file this form

may terminate this extension at any time by mailing a notice of termi-

electronically. Corporations that file corporate returns other than those

nation to the corporation or to the person who requested the exten-

listed, such as insurance companies, financial institutions, public utili-

sion for the corporation. The notice will be mailed at least 10 days

ties, urban redevelopment companies, etc., must use Form 355-7004

prior to the termination date designated in the notice.

Misc. Form 355-7004 also acts as the required tentative return.

Who May Sign?

When Should Form 355-7004 Be Filed?

Form 355-7004 must be signed by the treasurer or assistant trea-

This application must be filed on or before the 15th day of the third

surer of the corporation or by a person authorized by the corpora-

month after the close of the taxable year, calendar or fiscal.

tion to do so. An application signed by an unauthorized person will

be considered null and void. If a return is filed after the original due

Must a Payment Be Submitted with This Form?

date based on a void extension, interest and penalties will be as-

Yes. The full payment of tax reasonably estimated to be due must

sessed back to the original due date.

accompany this form. If at least 50% of the tax due or the minimum

Keep this worksheet with your records. Do not submit it with Form

tax (whichever is greater) for the taxable year is not paid, the exten-

355-7004. Mail the completed application to: Massachusetts De-

sion is null and void. If filing Form 355U, payments may be allocated

partment of Revenue, PO Box 7025, Boston, MA 02204.

to subsidiaries when Schedule CG is filed.

Note: Under certain circumstances, if a payment is not required to

Will Interest and Penalties Be Due?

be submitted with the extension request, the requirement to file the

An extension of time to file a corporation tax return does not extend

extension may be waived. For further information, see TIR 06-21.

the due date for payment of the tax. Interest will be charged on any

tax not paid on or before the original due date. Any tax not paid within

Corporations with $100,000 or more in receipts or sales must submit

the extended period is subject to a penalty of 1% per month, up to a

their extension request, as well as any accompanying payment, elec-

maximum of 25%, from the extended due date.

tronically. Also, any corporation making an extension payment of

$5,000 or more must make the payment using electronic means. For

further information, see TIR 04-30.

DETACH HERE

Massachusetts

Form 355-7004

Application for Corporate Extension — 2012

Department of Revenue

Federal Identification number

Is the corporation incorporated in Massachusetts?

Period end date

Amount enclosed

Yes

Business name

Type of extension being applied for

a. Automatic six-month

b. Extension until:

Mailing address

City/Town

State

Zip

Sign here. Under penalties of perjury, I declare that to the best of my knowledge and belief this return and enclosures are true, correct and complete.

Signature of officer or agent

Signature of paid preparer

Date

Employer Identification number of paid preparer

Social Security number or PTIN of paid preparer

2012 0167 104