Form 872n - Nebraska Extension Of Statute Of Limitations Agreement
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Nebraska Extension
FORM
of Statute of Limitations Agreement
872N
• See limitation periods in the table below.
Name
Your Social Security Number
Spouse’s Social Security Number
Street or Other Mailing Address
Nebraska ID Number
City
State
Zip Code
Federal ID Number
Effective Date
Date Agreement Extended to
Tax Categories
Corporate Income Tax
Sales Tax
Income Tax Withholding
Other ______________________
Use Tax
Individual Income Tax
Waste Reduction and Recycling Fee
Other ______________________
Litter Fee
Lodging Tax
The Nebraska Department of Revenue and the taxpayer agree that a notice of deficiency (or the filing of a claim for overpayment) for
the amount of Nebraska and local tax (determined under existing or prior law) in the tax categories listed above, may be mailed at any
time on or before the “date agreement extended to.” A notice of deficiency may include tax periods that could have been included had
a notice of deficiency been issued on the effective date of this agreement.
sign
here
Authorized Signature
Title
Date
Spouse’s Signature (If Married, Filing Jointly Return)
Date
For Nebraska Department of Revenue Use Only
sign
here
Department of Revenue Authorized Signature
Title
Date
Statute of Limitation Periods for Assessment of Tax in the Absence of an Agreement
Statute of Limitation Periods for Various Tax Categories
Return
Sales Tax, Use Tax, Lodging Tax, and
Filing Status
Income Tax*
Income Tax Withholding
Litter Fee
Three years from the last day of the calendar
Three years from the due date
Three years from April 15 of
Timely Filed
month following the period of the deficiency
of the return
the next calendar year
Three years from the filing date
Three years from the filing date
Three years from the filing date
Filed Late
of the return, or the above
of the return
of the return
“Timely Filed” period, whichever is later
Six years from the last day of the calendar
No Return Filed
No limitation period
No limitation period
month following the period of the deficiency
*See next page under Statute of Limitation Periods for situations in which limitation periods may be longer.
Instructions
When and Where to File. A Nebraska Extension of Statute of Limitations Agreement, Form 872N, must be completed
when the taxpayer and the Nebraska Department of Revenue (Department) agree to extend the period of limitation for the
mailing of a notice of deficiency of Nebraska tax, or the filing of a claim for overpayment of tax.
An extension signed on behalf of a flow-through entity will also extend the time allowed for a deficiency determination
against the entity’s partners, shareholders, or members with respect to the entity income received by the partner, shareholder,
or member. The
Nebraska Extension of Statute of Limitations Agreement for Motor Fuels Programs, Form
872-MF, must
be used for all motor fuels tax programs.
Name and Address. An individual must enter his or her name, as entered on the tax return covered by this agreement,
and current address. The spouse’s name must also be entered if this agreement is for Nebraska individual income tax and a
married, filing jointly return was filed for any of the taxable periods being extended.
An organization must enter the organization’s name and business address.
Effective Date. The agreement becomes effective on the later of the following dates:
1. The date entered in the Effective Date box; or
2. The date both the Department and the taxpayer have signed the agreement.
Mail this agreement to: Nebraska Department of Revenue, PO Box 94818, Lincoln, NE 68509-4818
Please retain a copy of this agreement for your records.
8-209-1972 Rev. 2-2017
Supersedes 8-209-1972 Rev. 12-2015
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