Extension Request Form - Golf Manor Tax Department

6450 Wiehe Road • Golf Manor, OH 45237 • 513-531-7491 • 513-531-4404 FAX

GOLF MANOR TAX DEPARTMENT

Extension Request Form

Name:

________________________________________________________________

Address:

________________________________________________________________

Phone:

_______________________ Email:

_______________________________

SSN:

________________________________________________________________

Filing Status:

____ Single

____ Joint

Amount Due:

______________________

I request an extension of time until ______________________ to file the Village of Golf Manor income tax return of the

individual(s) named above for calendar year 20_____.

Reason for extension: ___________________________________________________________

Signature:

___________________________________________ Date: _____________

Signature:

___________________________________________ Date: _____________

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Parent category: Financial