Form Sf- 4868 - Application For Auto Extension Of Time To File Springfield Income Tax Return
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1Print Form
Application fo
r A
uto
Ext
ens n f i
io o T me
SF- 4868
To File Springfield Income Tax Return
Year
Last Name
First name, initial, spouse's name and initial
Social Security number
PLEASE
TYPE OR Number and Street
Spouse's Social Security number
PRINT
State
Zip Code
City or Town
Employer ID number
Alabama
EXTENSION IS
INDIVIDUAL
CORPORATION
PARTNERSHIP
ESTATE
REQUESTED FOR:
CALENDAR YEAR FILER
FISCAL YEAR FILER
Prepare this form in duplicate. File the original with the Springfield Income Tax Department on or before the due date for
INSTRUCTIONS:
filing your return (if you wish to have an approved copy, you must enclose a stamped per-addressed envelope.) Attach
the duplicate to your Springfield Income Tax Return when filed.
INDIVIDUAL
When form SF-4868 is timely filed, an automatic extension will be granted for individual returns until August 30th of the
year the return is due. The tentative tax must be paid with this application for extension.
RETURNS
When an extension of greater than four months is requested, the tax tentatively determined to be due must be paid by
the last day of the fourth month. The uniform City Income Tax Ordinance limits the extension of time for filing annual
CORPORATIONS
returns to six months from the due date.
PARTNERSHIPS
ESTATES
A
month extension of time for filing until
is hereby requested in which to file the Springfield Tax Return as
indicated above for the calendar year
or the fiscal year beginning
and ending
.
TENTATIVE TAX COMPUTATION:
1 Tentative City
of Springfield Income T
ax
$
2 Less:
a. City
Income T
ax
W thheld
i
$
b. Estimated Tax Paid to Springfield
$
c. Other Credits
$
d. Total Credits (add lines a, b and c)
$
3 Balance Due (line 1 less line 2d)
$
ANY BALANCE DUE MUST BE PAID WITH THIS APPLICATION
SIGNATURE AND VERIFICATION:
Under penalties of perjury, I declare that I have examined this form, including accompanying schedules and statements and to
the best of my knowledge and belief, it is true, correct, and complete; if prepared by someone other than the taxpayer, I am
authorized to prepare this form.
Signature of taxpayer:
Date
Signature of spouse:
(if filing jointly, both must sign)
Date
Signature of preparer:
Date
MAIL TO: SPRINGFIELD INCOME TAX DEPARTMENT, 601 AVENUE A, SPRINGFIELD, MI 49037-7774
(Make checks payable to: City of Springfield)
Your request for an Extension is:
APPROVED
DENIED
By:
By:
Finance Director
Date
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