Form G-39 - Application For Extension Of Time To File The General Excise/use Tax Annual Return And Reconciliation - 2008

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FORM G-39

(REV. 2008)

STATE OF HAWAII — DEPARTMENT OF TAXATION

Clear Form

APPLICATION FOR EXTENSION OF TIME TO FILE

THE GENERAL EXCISE/USE TAX ANNUAL

RETURN AND RECONCILIATION (FORM G-49)

Please read instructions below before preparing form.

TAXPAYER’S

NAME

________________________________________________

BUSINESS

HAWAII TAX I.D. No.

NAME (DBA)

__________________________________________

ADDRESS

________________________________________________

____ ____ ____ ____ ____ ____ ____ ____

____ ____

: ___ ___ ___ ___

________________________________________________

LAST 4 DIGITS OF YOUR FEIN OR SSN

APPLICATION is hereby made for an extension of time to file the general excise and use tax annual return and reconciliation (Form G-49):

a. For:

b. An extension is requested until:

(No more than 3 months. See Instructions below.)

calendar year ending December 31, 20 ______

fiscal year ending

________ /_______ /_______

DAY

c. Were you previously granted an extension of time to file this return?

Yes

If yes, previous extension was granted to

________/ _______/ _______

DAY

d. This extension is necessary for the following reasons (see instructions below):

____________________________________________________________________________________________________________________

e. ADDITIONAL TAXES DUE. (If no payment is due, enter “0”.) Attach your check or money order payable to

“HAWAII STATE TAX COLLECTOR” in U.S. dollars drawn on any U.S. Bank AND Form VP-1 to Form G-39.

Write “G-39”, the tax year, and your Hawaii Tax I.D. No. on your check or money order. Mail to:

HAWAII DEPARTMENT OF TAXATION, P. O. BOX 1425, HONOLULU, HI 96806-1425

Form G-39 can be filed and payment made electronically at

DECLARATION

I declare under the penalties set forth in section 231-36, HRS, that the statements contained herein are true and correct, prepared in accordance with the provisions

of the General Excise and Use Tax Laws and the rules issued thereunder.

SIGNATURE OF TAXPAYER, PARTNER OR MEMBER, OFFICER, OR DULY AUTHORIZED AGENT

DATE

DAYTIME PHONE NUMBER: (

)

INSTRUCTIONS

NOTE: This form may be electronically filed (e-filed) with the Department of Taxation. For more information, go to:

1. Extensions will only be granted for 3 months or less. See 6 below if additional extensions are needed.

2. Extensions will only be granted for a good reason (e.g., hospitalization of taxpayer). A full explanation of the reasons you need an extension must be given.

3. This extension of time to file is NOT AN EXTENSION OF TIME TO PAY. If additional general excise and use taxes are due for the year, write the amount due

on line e. Your check or money order for the entire amount, payable to “HAWAII STATE TAX COLLECTOR” in U.S. dollars drawn on any U.S. bank and Form

VP-1, Tax Payment Voucher, must be attached to this form.

4. Submit the completed form to the Hawaii Department of Taxation ON OR BEFORE THE ORIGINAL DUE DATE OF THE RETURN. Applications for

extensions filed after that date will not be granted.

5. IMPORTANT — Approved applications for extensions are valid ONLY IF all monthly, quarterly, or semiannual periodic returns (Form G-45) for the year have been filed.

6. ADDITIONAL extensions of time to file the general excise/use tax annual return and reconciliation beyond the initial 3-month period may be requested by

completing this form and submitting it to the Hawaii Department of Taxation before the expiration of the initial 3-month extension.

7. IMPORTANT — The total period for which extensions will be granted cannot exceed six (6) months.

THIS SPACE FOR DATE RECEIVED STAMP

MAILING ADDRESS

HAWAII DEPARTMENT OF TAXATION

P.O. Box 1425

Honolulu, HI 96806-1425

Telephone: 808-587-4242

Toll Free: 1-800-222-3229

FORM G-39