Form Inc 251 - Application For Extension Of Filing Time/prepayment Of Individual Income Tax

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TENNESSEE DEPARTMENT OF REVENUE
APPLICATION FOR EXTENSION OF FILING TIME/PREPAYMENT OF INDIVIDUAL INCOME TAX
Beginning:
ACCOUNT NUMBER
YOUR SSN:
INC
Taxable
Year
Ending:
251
SPOUSE'S SSN:
FEIN:
(If filing jointly, include the first name, middle initials, and last names of both spouses.)
The statutory due date of the return is the fifteenth
day of the fourth month commencing after the end
Name: _________________________________________________________
of the taxpayer's year.
Make your check payable to the Tennessee
Spouse’s Name: _________________________________________________
Department of Revenue for the amount on Line 4 and
mail to:
Address: _______________________________________________________
Tennessee Department of Revenue
Andrew Jackson State Office Bldg.
City: ________________________________ State: _____ Zip: __________
500 Deaderick Street
Nashville, TN 37242
Should you need assistance, please contact the
Please provide the county and city (if within an incorporated municipality) of the taxpayer’s legal residence
Taxpayer and Vehicle Services Division by calling
on the lines below.
our statewide number at 1-800-342-1003 or (615)
County ____________________________________________________________
253-0600. You may file the INC 251 through the
internet at
City _______________________________________________________________
APPLICATION FOR EXTENSION OF FILING TIME: Check the box to the left to appy for a six-month extension of filing time to file the
Individual Income Tax Return. If a payment is made with this request, complete Lines 1 through 4 below. An extension shall be granted provided
thateither this form or a copy of the taxpayer’s federal extension request is attached to the return filed on or before the extended due date. Interest
willaccrue on unpaid tax from the original due date of the return until the date paid. No penalty will accrue with a valid extension. If the return is not
filed with payment of the tax due by the extended due date, penalty will accrue as though no extension had been granted.
PREPAYMENT OF TAX: Check the box to the left if using this form to make a prepayment of individual income tax for the taxable year shown
above. Enter the amount of payment on Line 4 below.
CHECK THE APPLICABLE BOX:
Married Filing
Married Filing Separately
Limited
Liability
Single
(enter spouse's SSN above)
Trust
Partnership
Company
Estate
Jointly
WRITE NUMBERS LIKE THIS
ROUND TO THE NEAREST DOLLAR
00
1.TOTAL TAXABLE INCOME (Dividend Income plus interest income....................................... (1)
{
$1,250 if single or married filing separately
00
2.SUBTRACT EXEMPTION
............................(2)
$2,500 if married filing jointly
00
3.AMOUNT SUBJECT TO TAX (Line 1 less Line 2)...................................
(3)
00
4. EXTENSION PAYMENT/PREPAYMENT (See instructions on reverse)
(4)
RV-R0003601
FOR OFFICE
Taxpayer's Signature
Spouse's Signature
Date
USE ONLY
(
)
Tax Preparer's Signature
Date
Telephone
Preparer's Address
City
State
Zip

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