Form 20-Ext - Net Profit Estimated Income Tax And/or Extension Of Time To File Page 2

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Fed. ID #:
Phone #:
SECTION 2: EXTENSION OF TIME TO FILE
If your business has requested or received an extension to file your federal income tax return, your Net Profit
municipal income tax return is extended as well. It is not necessary to file a copy of your federal extension with
RITA by the annual filing due date. Attach a copy of the federal extension when filing your Net Profit municipal
income tax return on or before the extended due date.
If you have not requested or received a federal income tax filing extension, you may receive a six-month
extension for filing your Net Profit municipal income tax return by checking the box below, and submitting this
th
request on or before the filing due date of either April 18, 2017, or the 15
day of the fourth month following the
taxpayer’s fiscal year-end.
An extension to file the annual return is not an extension to pay - the tax owed is still due by the annual filing
due date. Please complete Section 3 to pay the tax due for the applicable tax year.
If you have a copy of your federal extension, you do NOT have to fill out this section. Check this box if you
have NOT requested or received a federal extension and you are requesting a 6 month extension to file for
the tax year ending _________.
SECTION 3: EXTENSION PAYMENT
Tax Year Ending _____________
1. Anticipated Tax Balance Due on Net Profit Annual Return
$
.00
(Extension paym ent)
2. Distribute Tax Balance Due (if additional space is needed, attach a schedule)
Note: Do not include estim ated tax paym ents, see Section 1 for
Estim ated Tax Com putation and Paym ents
Municipality:
Am ount:
$
.00
$
.00
$
.00
$
.00
$
.00
$
.00
$
.00
3. Total Tax Balance distribution from Line 2 (Line 3 m ust equal Line 1)
.00
SECTION 4: VERIFICATION
Taxpayer – Under penalties of perjury, I declare that to the best of my knowledge and belief, the statements
made herein are true and correct.
Signature:
Date:
Preparer other than taxpayer – Under penalties of perjury, I declare that to the best of my knowledge and
belief, the statements made herein are true and correct, that I am authorized by the taxpayer to prepare this
Declaration and/or Extension.
Signature of Preparer:
Date:
Printed Name of Preparer:
May RITA discuss this Declaration/Extension with the preparer above?
Yes
No
Mail to:
REGIONAL INCOME TAX AGENCY
P.O. BOX 94582
CLEVELAND, OH 44101-4582
Page 2

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