Form Gr-7004 - Application For Automatic Extension Of Time To File Certain Business Income Tax, Information And Other Returns

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GR-7004
GRAND RAPIDS
2012 RET EXT
2012 CRP PEX
APPLICATION FOR AUTOMATIC EXTENSION OF TIME TO FILE CERTAIN
2012 CRP CEX
BUSINESS INCOME TAX, INFORMATION AND OTHER RETURNS
This application is for:
Form GR-1041
Form GR-1065
Form GR-1120
Name of Taxpayer
Taxpayer's FEIN:
Taxpayer s FEIN:
File on or Before:
4/30/2013 or the last day of the fourth month after the end of the tax year or short tax year
$
Payment:
Payment Method:
Make payment by check or money order payable to "City of Grand Rapids." DO NOT SEND CASH.
Write the corporation's FEIN, daytime phone number and "2012 GR-7004" on check or money order.
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To pay by credit card or direct debit, see income tax website,
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Address for Payment:
Grand Rapids Income Tax Department
PO Box 109
Grand Rapids MI 49501-0109
Instructions:
An extension to file does not extend the due date to pay tax. Tax paid late will be assessed late fees.
Line 1: Enter the total tax liability you expect to report on your 2012 Grand Rapids income tax return.
Line 2: Enter the total payments that you expect to report on your 2012 Grand Rapids income tax return, not
including the extension payment reported on line 3 of this form.
Filing date: The income tax ordinance limits an extension to SIX months from the original due date.
Related Information:
Federal extension: Filing a federal extension (Form 7004) with the Internal Revenue Service does not grant an
extension of time to file a Grand Rapids income tax return.
Payment:
Payment:
An extension is automatically granted upon payment of the balance due (line 3); failure to pay the balance due
An extension is automatically granted upon payment of the balance due (line 3); failure to pay the balance due
invalidates the extension request; an extension filed without a payment will not be accepted.
Interest and penalty will be assessed on taxes paid late even if an extension of time to file is granted.
Penalty may be waived by the Income Tax Administrator if the tax paid by the original due date is not understated
by more than 5% of tax or the taxpayer can show that the failure to pay on time was due to reasonable cause.
Taxpayer Records:
Amount Paid:
Check Number:
Date Mailed:
Date Mailed:
Revised: 12/26/2012
KEEP TOP PORTION FOR YOUR RECORDS. SEND BOTTOM PORTION WITH YOUR PAYMENT
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DETACH HERE
Revised: 12/26/2012
GRAND RAPIDS
2012 RET EXT
GR-7004
2012 CRP PEX
APPLICATION FOR AUTOMATIC EXTENSION OF TIME TO FILE CERTAIN
2012 CRP CEX
BUSINESS INCOME TAX, INFORMATION AND OTHER RETURNS
NACTP #
This application is for:
Form GR-1041
Form GR-1065
Form GR-1120
EFIN #
The application is for calendar year 2012, or tax year beginning _______________, 20____, and ending _______________, 20____
Name of trust, estate, partnership or corporation
FEIN
Address (Number and street)
Suite. no.
Address line 2 (P.O. Box address for mailing use only)
Mail to:
Grand Rapids Income Tax Department
PO Box 109
City, town or post office
State Zip code
Grand Rapids MI 49501-0109
.00
1. Estimate of total tax liability for 2012
.00
2. Total 2012 payments and credits
.00
3. Balance due (Line 1 less line 2)

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