Income Tax Return Form - Extension Request - City Of Springsboro

Income Tax Return Form - Extension Request - City Of Springsboro - 2010

2010 EXTENSION REQUEST

CITY OF SPRINGBORO

INCOME TAX RETURN

• Submit copy of Federal Extension with this form.

• Payment of tax due for 2010 (if applicable):

$_________________________________________

• Payment for the first quarter estimate of 2011 (if applicable):

$_________________________________________

• An extension of time to file extends the due date for filing the return only. Payment in full must be

made or extension may be disallowed.

• Please Complete:

Taxpayer Name:_______________________________________________________________

Account Number:______________________________________________________________

Address:_____________________________________________________________________

Social Security Number:________________________________________________________

Signature of Taxpayer:__________________________________________________________

Date:________________________________________________________________________

EXTENSION FORM MUST BE COMPLETED AND RETURNED BY

APRIL 18, 2011, FOR AN EXTENSION TO BE GRANTED. BE SURE TO

INCLUDE FULL PAYMENT OF TENTATIVE TAX DUE, COPY OF FEDERAL

EXTENSION REQUEST AND/OR THIS FORM.

Income Tax Return Form - Extension Request - City Of Springsboro - 2010