Pass-Through Entity Tax Electronic Filing Waiver Request Form- Virginia Department Of Taxation (2014)

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Pass-Through Entity Tax Electronic Filing Waiver Request
Complete this form to request a waiver if you are unable to file and/or pay your Pass-through Entity
(PTE) tax electronically, or need time to do so. Provide all information.
Waivers may be granted for up to one year. If you need additional time once the waiver period ends,
you must submit a new waiver request.
Pass-Through Entity Information
If you are a Tax Preparer submitting requests for multiple pass-through entities (PTEs), provide your
contact information below and attach a list of all PTEs with the Name and FEIN of each PTE included.
Pass-Through Entity Name: _____________________________________________________
FEIN: _______________________________________________________________________
Mailing Address: ______________________________________________________________
______________________________________________________________
Contact Name: _______________________________________________________________
Phone Number: _______________________________________________________________
Waiver Requested Until (Enter Date): ______________________________________________
Reason for Waiver Request
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
Fax to: (804) 367-3015
OR
Mail to:
Virginia Department of Taxation
Waiver Requests
PO Box 27423
Richmond, VA 23261
Pass-Through Entity Tax Electronic Filing Waiver Request
Rev. 08/2014

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