Application To Extension Of Time To File Income Tax Return Form - City Of Springdale, South Carolina - Tax Commission Page 2

following reason(s):

Application must be accompanied by a remittance of the balance due.

Under penalties of perjury, I declare that I am the above named taxpayer or that I have been authorized by the

above named taxpayer to make this application, and to the best of my knowledge and belief, the statements made

are true, correct, and complete.

Signature

Title

Date

NOTE: Extension covers only the income tax return. It does not cover the declaration of estimated tax.

The declaration must be filed by the normal due date.

FOR SPRINGDALE TAX COMMISSION USE ONLY

Extension granted to ________________________

Extension denied

Reason(s) for denial:

Request received after due date for filing return.

No payment of tentative taxes received.

No such account name or account number established in Springdale.

Account is not current.

Other: _______________________________________________________________________________________________

By:

Finance Officer / Tax Commissioner

Date

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Parent category: Financial