Application For Extension Of Time To File Grand Rapids Income Tax Return printable pdf download

Application For Extension Of Time To File Grand Rapids Income Tax Return

APPLICATION FOR EXTENSION OF TIME

TO FILE GRAND RAPIDS INCOME TAX RETURN

Prepare this form in duplicate. File the original with the Grand Rapids Income Tax Department on or

before the due date for filing a return. Attach the duplicate to your Grand Rapids income tax return.

NAME

ACCOUNT, SOCIAL SECURITY

OR EMPLOYER I.D. NUMBER

NUMBER AND STREET

CHECK TYPE OF RETURN TO

BE FILED:

FORM GR-1040NR

CITY, STATE & ZIP CODE

FORM GR-1040R

FORM GR-1065

FORM GR-1120

FORM GRW-3

REASON FOR EXTENSION REQUEST

The Grand Rapids Income Tax Ordinance limits the extension of time for filing annual returns to

SIX months from the original due date.

A _______ month extension of time until ____________________, 20____, is hereby requested in which

to file the Grand Rapids income tax return of the above for the taxable year beginning

____________________, 20____, and ending ____________________, 20____.

TENTATIVE TAX

THE TAX TENTATIVELY DETERMINED TO BE DUE MUST BE PAID WITH THIS EXTENSION.

Tentative City of Grand Rapids Tax ..................................................... $ ___________

Less:

Estimated income tax payments ..................................................... $ ___________

Other credits .................................................................................. $ ___________

BALANCE DUE (Include payment of this amount with extension) $ ___________

The extension is automatically granted upon payment of the tentative tax balance due.

Failure to pay the tentative tax balance due invalidates the extension request.

Extensions filed without a tentative tax payment will not be accepted or processed.

________________________________________

_________________

Signature of taxpayer, officer or agent

Date

_____________________________________________________________________________________

MAIL TO: GRAND RAPIDS INCOME TAX DEPARTMENT, P.O. BOX 347, GRAND RAPIDS, MI 49501-0347

Revised 04/06/2011

Application For Extension Of Time To File Grand Rapids Income Tax Return