Form Ar1055 - Request For Extension Of Time For Filing Income Tax Returns

Form Ar1055 - Request For Extension Of Time For Filing Income Tax Returns - 2012

AR1055

ARKANSAS INDIVIDUAL INCOME TAX

REQUEST FOR EXTENSION OF TIME FOR

FILING INCOME TAX RETURNS

Do not file this extension request if you have received an extension of time to file your

Federal Income Tax Return

(See instructions for additional information)

Approved extension to be returned to:

Name and address of taxpayer:

_________________________________________

Primary SSN/FEIN: _________________________

Telephone number: _________________________

Spouse’s SSN: ____________________________

1. Indicate type of return for which extension is being requested:

Individual

Partnership

Fiduciary

Composite

2. Extension requested for the tax year beginning _____________ ,20 ____ and ending ____________,20 __ .

3. State reason for requesting extension of time to file: (REQUIRED)

_____________________________________________________________________________________

File this request in triplicate ON OR BEFORE THE DUE DATE OF RETURN. A request for an extension which is

postmarked AFTER the due date of the tax return will NOT be considered. Attach original copy of the approved

request to Form AR1000F, AR1000NR, or AR1000S when filed and check the box on the front of the return.

NOTE:

Individual income tax returns must be filed and the tax paid on or before the fifteenth (15

) day of the fourth (4

)

month following the close of the tax year (April 15 for calendar year filers). This extension is an agreement by the

Commissioner of Revenue to waive the statutory penalty for delinquency if the return is filed by the extension due

date and the tax, with interest, is paid by the original due date of the return (April 15 for calendar year filers).

Mail to the following address:

Individual Income Tax Section

P.O. Box 3628

Little Rock, AR 72203-3628

FOR TAX SECTION USE

APPROVED

Your payment has been credited to your account.

INCOMPLETE: Complete and return to the address above.

DENIED: Extension request not filed on time.

DENIED: Inability to pay is not a valid reason for requesting an extension.

DENIED: Other ____________________________________________

AR1055 (R 6/13/12)

Form Ar1055 - Request For Extension Of Time For Filing Income Tax Returns - 2012