APPLICATION FOR EXTENSION OF TIME TO FILE
BUSINESS EARNINGS TAX RETURN (FORM E-234)
(Application does not extend time to pay)
GREGORY F.X. DALY, COLLECTOR OF REVENUE, CITY OF ST. LOUIS
FOR OFFICE USE ONLY
Self-Employed
Partnership
Corporation
Check type
(Business and
of Business:
Professional Persons)
Name of Taxpayer:
FEIN or SSN: (See instruction 4)
Trade Name:
Address:
City, State & Zip Code:
Telephone No.:
I request a 6-month extension of time until _________________ 20 ____ , to file the Earnings Tax Form E-234 for
the taxpayer named above for
calendar year ____ or
tax year beginning _____________20_____, and
ending _____________20_____.
If you do not pay the amount of tax due by the regular due date, you will owe interest. You may also be charged
penalties. See instructions 8 and 9.
If this tax year is for less than 12 months, check reason, (See Instruction 6)
Initial return
Final return
Change in accounting period
Other (explain)
A PAYMENT OF 100% OF YOUR ESTIMATED TAX DUE FOR THE CURRENT TAX YEAR IS REQUIRED WITH THIS
REQUEST. MAKE CHECK PAYABLE TO: GREGORY F.X. DALY, COLLECTOR OF REVENUE. (See Instruction 8 & 9).
AMOUNT PAID WITH THIS EXTENSION REQUEST .................................................................................. $ ____________
Taxpayer’s Signature
Type or Print Name
Title
Date
ONLY TAXPAYERS WHOSE EXTENSION HAS BEEN REJECTED WILL BE NOTIFIED.
FAILURE TO PAY AT LEAST 90% OF THE ACTUAL TAX DUE WILL RESULT IN
PENALTIES BEING ASSESSED FROM THE ORIGINAL DUE DATE (See Instruction 9).
FOR OFFICE USE ONLY
Your application for extension of time to file is granted until ................................................20 ........ . Interest accrues
on unpaid tax at the rate of 12 percent a year during the period of any extension. (See Instruction 8).
Your extension has been rejected for the following reasons:
We cannot grant your extension request due to the following Earnings and/or Payroll Expense Tax
delinquency(s) indicated on the attached “Statement of Tax Delinquency”.
We cannot grant your extension request due to Personal Property Tax delinquency for account
number
. Please contact (314) 622-4108 for assistance with resolving this
delinquency.
If the requirement causing this rejection is satisfied within 10 days, your request may be resubmitted
or you may contact our office at (314) 622-4248.
Approval Date
Reject Date
Extension Section - Earnings Tax Division
Form E-8
(Rev. 11/12)