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Form In-151 - Vermont Application For Extension Of Time To File Form In-111 Vt Individual Income Tax Return - 2012

VT DeparTmenT of Taxes

*121511199*

po Box 1779

montpelier VT 05601-1779

(866) 828-2865 or (802) 828-2865

* 1 2 1 5 1 1 1 9 9 *

Application for Extension of Time

2012

form

to File Form IN-111

IN-151

VermonT

VT Individual Income Tax Return

2012

Complete this application if you are unable to file your _________ Vermont Income Tax Return

April 15, 2013

before the due date of ______________________ .

Taxpayer’s social security number

spouse’s or CU partner’s social security number

Taxpayer’s Last Name

First Name

Initial

Spouse’s or CU Partner’s Last Name

First Name

Initial

mailing address (number and street, including rural route)

City, Town, or Post Office

State

Zip Code

2013

2012

I request an automatic six-month extension of time to October 15, ________ to file my ________ Vermont Income Tax Return.

NOTE: An extension of time to file the VT individual income tax return does NOT apply to Homestead Declaration

and Property Tax Adjustment Claim (Form HS-122), or Renter Rebate Claim (Form PR-141). These

forms must be filed by their specific due dates.

TAX CALCULATION WORKSHEET

Use this worksheet to determine if you may owe tax.

An extension only allows additional time to file the Vermont income tax return and avoids a late filing penalty. If tax is due,

interest and late payment penalty accrue from the original due date of the return to the date of payment.

2012

1. Estimated ________ individual income tax liability. . . . . . . .1.

(year)

2. Previous payments. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2.

3. Amount of tax paid with extension . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.

PAYMENT OPTIONS

Filing by paper:

Make checks payable to Vermont Department of Taxes and mail with this form to the address above.

On-line payment: Go to VTPay on our website at to pay by credit card and select the “Estimated Payment”

option. (There is a convenience fee for payments over $200.)

5454

Form IN-151

rev. 10/12

Form In-151 - Vermont Application For Extension Of Time To File Form In-111 Vt Individual Income Tax Return - 2012

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