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Form 207C EXT

Instructions

Where to File

Use Form 207C EXT, Application for Extension of Time to File

Insurance Premiums Tax Return Captive Insurance Companies,

Make check payable to Commissioner of Revenue Services.

to request a 12-month extension to file your captive insurance

To ensure payment is applied to your account, write

the calendar

companies premiums tax return. Complete this application in

year of the return “2014 Form 207C

EXT” and your Connecticut

blue or black ink only.

Tax Registration Number on the front of your check. Be sure

to sign your check and paper clip it to the front of your return.

Request for Extension

Do not send cash. DRS may submit your check to your bank

A captive insurance company may request a 12-month

electronically.

extension to file its Connecticut tax return provided there is

Mail to: Department of Revenue Services

reasonable cause for the request.

State of Connecticut

To request an extension of time to file Form 207C you must file

PO Box 2990

Form 207C EXT and pay all the tax you expect to owe on or

Hartford CT 06104-2990

before March

1, 2015 of the succeeding calendar

year.

Failure to file or failure to pay the proper amount of tax due will

Form 207C EXT only extends the time to file your tax return.

result in penalty and interest charges. It is to your avantage

Form 207C EXT does not extend the time to pay the amount

to file when your return is due whether or not you are able to

of tax due.

make full payment.

We will notify you only if the extension request is denied.

Signature

Name, Address, and Tax Registration Number

A principal officer of the company must sign this return.

Enter the company’s name, address, Federal Employer

Paid Preparer Signature

Identification Number (FEIN), and Connecticut Tax Registration

A paid preparer must sign and date Form 207C EXT. Paid

Number in the spaces provided.

preparers must also enter their Social Security Number (SSN)

Rounding Off to Whole Dollars

or Preparer Tax Identification Number (PTIN) and their firm’s

You must round off cents to the nearest whole dollar on your

FEIN in the spaces provided.

return and schedules. If you do not round, the Department of

Pay Electronically

Revenue Services (DRS) will disregard the cents.

Visit to use the Taxpayer Service Center

Round down to the next lowest dollar all amounts that include

(TSC) to make a direct tax payment. After

1 through 49 cents. Round up to the next highest dollar all

logging into the TSC, select the Make Payment

amounts that include 50 through 99 cents. However, if you need

Only option and choose a tax type from the drop

to add two or more amounts to compute the amount to enter on

down box. Using this option authorizes DRS to electronically

a line, include cents and round off only the total.

withdraw from your bank account (checking or savings) a

Example: Add two amounts ($1.29 + $3.21) to compute the

payment on a date you select up to the due date. As a reminder,

total ($4.50) to enter on a line. $4.50 is rounded to $5.00 and

even if you pay electronically you must still file your return on

entered on a line.

or before the due date. Tax not paid on or before the due date

will be subject to penalty and interest.

Interest and Penalties

For More Information

In general, interest and penalty apply to any portion of the tax

not paid on or before the original due date of the return. If the

Call DRS during business hours, Monday through Friday:

tax is not paid when due, interest will accrue at the rate of 1%

• 1-800-382-9463 (Connecticut calls outside the Greater

per month or fraction of a month from the original due date of

Hartford calling area only); or

the return until the tax is paid in full.

• 860-297-5962 (from anywhere).

Late Payment Penalty: If tax is due, the penalty for late payment

TTY, TDD, and Text Telephone users only may transmit

is 10% of the tax due or $50, whichever is greater.

inquiries anytime by calling 860-297-4911.

Late Filing Penalty: If no tax is due, the Commissioner of

Forms and Publications

Revenue Services may impose a $50 penalty for the late filing

Visit the DRS website at to download and

of any return or report required by law to be filed.

print Connecticut tax forms and publications.

Form 207C EXT Back

(Rev.

12/15)

P:\Special\AFP\PROD\FORMS\15\Form\Form 207C EXT\Form 207C EXT 20151006.indd

Last Modified 2015107 02:49 PM

Form 207c Ext Draft - Application For Extension Of Time To File Captive Insurance Premiums Tax Return Page 2

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