Form Al-4267 - Application For Extension Of Time To File City Of Albion Tax Returns printable pdf download

Form Al-4267 - Application For Extension Of Time To File City Of Albion Tax Returns

(Rev. 7-01)

Tax Year ______

APPLICATION for EXTENSION OF TIME TO FILE

AL-4267

CITY OF ALBION TAX RETURNS

An extension of time to file is not an extension of time to pay. DO NOT file this form if you will show a refund on your return.

PART 1: IDENTIFICATION. Please print or type. (See instructions on back.)

Federal Employer ID No., or TR No. (If unknown, complete line 3.)

Check ONLY ONE box. File a separate request for each tax.

Individual Tax Return

Corporate Tax Return

Enter your Social Security No.

If filing jointly, spouse's number.

Fiduciary Return

Partnership Tax Return

Taxpayer's name and address (if different from item 4).

Your mailing address.

Type

Address

Here

PART 2: COMPUTATION AND PAYMENT OF TAX DUE

.00

Total annual tax liability for the year

Payments made to date (include estimated tax payments, amounts

.00

carried forward and if an individual taxpayer, include withholding)

.00

Credits (if any)

.00

Add lines 7 and 8

.00

10.

Estimated balance due. Subtract line 9 from line 6

10.

.00

11.

Amount paid with this request

11.

Make your check/money order payable to the "City of Albion."

PART 3: EXTENSION REQUEST

12.

Tax year ends on:

Extension date ends on:

, 20

13.

Check this box if you attached your federal extension.

14.

Reason for extension:

15.

If Albion has previously granted you an extension for this tax year, attach a copy of the approved extension and check here.

• Make your check or money order payable to "City of Albion."

• Write the type of tax and your FEIN or Social Security number on the payment.

• Mail to: City of Albion, Income Tax Division, 112 West Cass St., Albion, Michigan 49224-0900

I declare, under penalty of perjury, that the information in this application,

I declare, under penalty of perjury, that this application

and attachments is true and complete to the best of my knowledge.

is based on all information of which I have knowledge.

I authorize Albion to discuss my application

Do not discuss

Preparer Signature, Address, Phone and ID No.

and attachments with my preparer.

with my preparer.

Filer's Signature

Date

Spouse's Signature

Date

Form Al-4267 - Application For Extension Of Time To File City Of Albion Tax Returns

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