Form 504 - Application For Extension Of Time To File An Oklahoma Income Tax Return - 2012

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Application for Extension
504
2
of Time to File an Oklahoma Income Tax Return
0
(This is NOT an extension of time for payment of tax)
1
2
2012
For the year January 1 - December 31, or other taxable year beginning
,
ending
,
.
Your Social
INDIVIDUALS: Your first name, middle initial and last name
Security Number:
Spouse’s Social
INDIVIDUALS: If joint return, spouse’s first name, middle initial and last name
Security Number:
CORPORATIONS: Corporate, Partnership, Trust or Estate Name
CORPORATIONS, PARTNERSHIPS, TRUSTS, ESTATES:
Present address (number and street, including apartment number or rural route)
Federal
Employer
Identification
City, State and Zip
Number:
Important:
Extension is valid only if 90% of the tax liability is paid by the original due date.
An Extension of Time to File with the IRS has been granted to:
DATE ________________________
Extension of Time to File with the Okla. Tax Commission is requested to:
DATE ________________________
If requesting a total of more than 6 months for corporations or more than 5 months for partnerships, estates or trusts,
please state reason here: ________________________________________________________________________
Amount you are
Signature
Under penalty of perjury, I declare the information contained in this document, attachments and schedules are true and
correct to the best of my knowledge and belief.
paying:
.
(from line 7)
Your Signature (* If corporation, partnership, estate, or trust, see below)
Date
Paid Preparer’s Signature
$
Date
Spouse’s Signature (if filing jointly, BOTH must sign even if only one had income)
Date
* If corporation, partnership, estate, or trust (officer, partner, member or fiduciary signature is required)
This is NOT an extension of time for payment of tax!!
Application for Extension of Time
to File an Oklahoma Income Tax Return Worksheet
The bottom portion of this form is a worksheet to compute your payment. Please retain for your
records. Enter the total from line 7 of the worksheet on the coupon above. Return the top portion
with your payment, if applicable.
Oklahoma Income Tax Computation
00
1. Total income tax liability (you may estimate this amount) .........................................
1
Note: You must enter an amount on line 1. If you do not expect to owe tax, enter zero.
00
2. Oklahoma income tax withheld ...............................................
2
3. Estimated tax payments (include prior year overpayment
00
allowed as a credit) .................................................................
3
4. Other payments and credits you expect to claim
00
on your return .........................................................................
4
00
5. Add lines 2, 3 and 4 ..................................................................................................
5
00
6. Income tax balance due (subtract line 5 from line 1) ................................................
6
7. Amount you are paying. (Enter here and on the coupon above) ...........................
00
7
Important: Extension is valid only if 90% of the tax liability is paid by the original due date

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