Form Ct-1041 Ext - Application For Extension Of Time To File Connecticut Income Tax Return For Trusts And Estates - 2004

ADVERTISEMENT

2004
FORM CT-1041 EXT
State of Connecticut
Department of Revenue Services
Application for Extension of Time to File
CT-1041 EXT
(Rev. 12/04)
Connecticut Income Tax Return for Trusts and Estates
IMPORTANT! PLEASE READ INSTRUCTIONS ON REVERSE BEFORE COMPLETING THIS APPLICATION
Name of Trust or Estate
Federal Employer Identification Number
__ __
__ __ __ __ __ __ __
Name and Title of Fiduciary
DRS USE ONLY
TAXPAYER
– 20
(Please Type
Address of Fiduciary
Number and Street
PO Box
Decedent’s Social Security Number (For Estates Only)
or Print)
__ __ __
__ __
__ __ __ __
City, Town, or Post Office
State
ZIP Code
This is not an extension of time to pay your tax. You must include payment of any tax due or penalty and interest may apply (see instructions). However, if you
expect to owe no additional Connecticut income tax for the 2004 taxable year, after taking into account any Connecticut income tax withheld or estimated
Connecticut income tax payments you made, or both, and you requested an extension of time to file your 2004 federal income tax return, you are not required
to file Form CT-1041EXT.
I request a six-month extension of time to October 15, 2005, to file my Connecticut Income Tax Return for Trusts and Estates
for calendar year 2004, or until ______________________ , ______ , for fiscal year ending
________________________ , ______ .
I have requested a federal extension on either federal Form 2758, Application for Extension of Time to File Certain Excise, Income, Information, and
Other Returns, or federal Form 8736, Application for Automatic Extension of Time to File U.S. Return for a Partnership, REMIC, or for Certain Trusts,
for calendar year 2004 or fiscal year beginning __________________ , _______ and ending __________________ , ________ .
Yes
No
If No, the reason for the Connecticut extension is ______________________________________________________________________
___________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________
YOU WILL BE NOTIFIED ONLY IF YOUR EXTENSION REQUEST IS DENIED.
1. Total Connecticut income tax liability for 2004 (You may estimate this amount)
Note: An amount must be entered on Line 1. If you do not expect to owe income tax, enter
00
1
“0.” ......
00
2. Connecticut income tax withheld ................................................................................................................. 2
3. 2004 estimated Connecticut income tax payments including any 2003
00
overpayments credited to 2004 .................................................................................................................... 3
00
4. Add Line 2 and Line 3 ................................................................................................................................... 4
5. Connecticut income tax balance due (Subtract Line 4 from Line 1). Pay in full with this form.
00
If Line 4 is greater than Line 1, enter
5
“0.” .........................................................................................................
Commissioner of Revenue Services.
Make check or money order payable to:
Write the Federal Employer Identification Number of the trust or estate and “2004 Form CT-1041 EXT” on the check or money order.
Department of Revenue Services
Mail to:
PO Box 2934
Hartford CT 06104-2934
DECLARATION: I declare under penalty of law that I have examined this return (including any accompanying schedules and statements) and, to the best of my knowledge
and belief, it is true, complete, and correct. I understand the penalty for willfully delivering a false return to DRS is a fine of not more than $5,000, or imprisonment for not
more than five years, or both. The declaration of a paid preparer other than the taxpayer is based on all information of which the preparer has any knowledge.
Signature of Fiduciary or Officer Representing Fiduciary
Date
Telephone Number
Sign Here
(
)
Paid Preparer’s Signature
Date
Preparer’s PTIN or SSN
Keep a copy
of this
Firm’s Name and Address
Federal Employer Identification Number
form for
your records
Telephone Number
(
)

ADVERTISEMENT

00 votes

Related Articles

Related forms

Related Categories

Parent category: Financial
Go