Instructions For Connecticut S Corporation Information And Composite Income Tax Return Form Ct-1120si - 1999 Page 23

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CT-1120SI EXT
STATE OF CONNECTICUT
FORM CT-1120SI EXT
1999
DEPARTMENT OF REVENUE SERVICES
(Rev. 12/99)
Application for Extension of Time to File Connecticut
S Corporation Information and Composite Income Tax Return
IMPORTANT! PLEASE READ INSTRUCTIONS ON REVERSE BEFORE COMPLETING THIS APPLICATION
Name of Corporation
Federal Employer ID Number
<
TAXPAYER
Address
Number and Street
PO Box
Date Received (FOR DEPARTMENT USE ONLY)
<
(Please Type
or Print)
City, Town or Post Office
State
Zip Code
Connecticut Tax Registration Number
<
THIS IS NOT AN EXTENSION OF TIME TO PAY YOUR TAX.
YOU MUST INCLUDE PAYMENT IF ANY TAX IS DUE OR PENALTIES AND INTEREST MAY APPLY. (see instructions)
AN EXTENSION GRANTED BY THE INTERNAL REVENUE SERVICE DOES NOT AUTOMATICALLY EXTEND THE CONNECTICUT FILING DATE.
I request a six-month extension of time, to October 15, 2000, to file Form CT-1120SI, Connecticut S Corporation Information and Composite
<
Income Tax Return for calendar year 1999, or until _______________________ for fiscal year ending
____________________________.
This extension is not an extension to file Form CT-1120S, S Corporation Business Tax Return. Form CT-1120S EXT, Application for
Extension of Time to File S Corporation Business Tax Return is used for that purpose.
A federal extension has been requested on federal Form 7004, Application for Automatic Extension of Time to File Corporation Income Tax
r
r
Return, for calendar year 1999, or fiscal year beginning ______________, 1999, and ending _____________, _____.
YES
NO
If NO, the reason for the Connecticut extension is: ...........................................................................................................................................................
........................................................................................................................................................................................................................................
........................................................................................................................................................................................................................................
........................................................................................................................................................................................................................................
–– YOU WILL BE NOTIFIED ONLY IF THE EXTENSION REQUEST IS DENIED ––
1. Total Connecticut S corporation composite income tax liability for 1999. (You may estimate this amount) ............. 1
NOTE: An amount must be entered on Line 1. If no tax is due, enter zero (0).
2. The sum of 1999 estimated Connecticut S corporation composite income tax payments and any
1998 overpayment credited to 1999 ................................................................................................................... 2
3. Connecticut S corporation composite income tax balance due (Subtract Line 2 from Line 1). Pay in
<
full with this form. If Line 2 is greater than Line 1, enter zero (0) ................................................................
3
Make check or money order payable to: COMMISSIONER OF REVENUE SERVICES
Write the S Corporation’s Federal Employer ID Number and “1999 Form CT-1120SI EXT” on the check or money order.
Mail to:
State of Connecticut
Department of Revenue Services
PO Box 2967
Hartford CT 06104-2967
DECLARATION: I declare under the penalty of false statement that I have examined this application and to the best of my knowledge and
belief it is true, complete, and correct. (The penalty for false statement is imprisonment not to exceed one year or a fine not to exceed
two thousand dollars, or both.) Declaration of the preparer (other than the taxpayer) is based on all information of which the preparer
has any knowledge.
Signature of Corporate Officer
Title
Date
Telephone Number
Sign Here
(
)
Paid Preparer’s Signature
Date
Federal Employer ID Number
Keep a copy
of this
Firm Name and Address
return for
your records

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