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FORM N-100A

(REV. 2002)

PAGE 2

6. Where to File.—This form must be submitted to the

taxes not completely paid within 60 days of the prescribed filing date

taxation district in which the taxpayer is required to file its return. Any

of the return.

additional extensions require the filing of a new application.

Late Filing of Return.—You may be charged a penalty of 5% of

MAILING ADDRESSES

the tax due for each month or part of a month that the return is late,

but not more than 25% in the aggregate. If you file a return late,

Oahu District Office

Maui District Office

attach a full explanation with the return.

P.O. Box 1530

P.O. Box 913

Honolulu, Hawaii 96806-1530

Wailuku, Hawaii 96793-0913

To avoid being assessed a penalty when filing your return, be

(808) 587-4242

(808) 984-8500

sure you attach a copy of the approved extension to your completed

TDD/TTY: (808) 587-1418

return at the time of filing.

or 1-800-887-8974

Interest.—Interest is accrued at the rate of

of 1% for

each month or part of a month on unpaid taxes and penalties

Hawaii District Office

Kauai District Office

assessed beginning with the first calendar day after the date

P.O. Box 1377

P.O. Box 1688

prescribed for payments whether or not that first calendar day falls

Hilo, Hawaii 96721-1377

Lihue, Hawaii 96766-5688

on a Saturday, Sunday, or legal holiday.

(808) 974-6321

(808) 274-3456

10. Signature.—Application for an additional extension for

7. How to Fill Out This Form.—Fill in the spaces with the

filing Hawaii partnership, fiduciary, or REMIC tax return must be

name, address, and federal employer I.D. number of the partnership,

individually made and personally signed by a member or general

fiduciary, trust, or REMIC. Enter the date of the end of the tax year,

partner (partnership), by a fiduciary, trustee, or an officer

the date to which you are requesting an extension, and the amount of

representing the fiduciary or trustee (trust), or by a residual holder

your payment in the spaces provided.

filing Form N-66 (REMIC).

If the entity’s address is outside the United States or its

11. Signature by Other than Taxpayer.—Persons who

possessions or territories, enter the information on the line for “City or

may sign for the taxpayer include attorneys, certified public

town, State and ZIP Code” in the following order: city, province or

accountants, or other persons qualified to practice before the IRS,

state, postal code, and the name of the country. Do not abbreviate

or any duly authorized agent with a power of attorney. If the

the country name.

taxpayer cannot sign because of illness, absence, or other good

8. Penalties.—You may be assessed one or both of the

cause, a person in close personal or business relationship to the

following penalties:

taxpayer may sign provided a proper explanation is attached as to

why the taxpayer cannot sign this form. It is not necessary that such

Late Payment of Tax.—Form N-100A does not extend the time for

person hold a power of attorney.

payment of income tax. You may be charged a penalty of 20% of

State in detail why you need an additional extension.

DECLARATION

I declare, under the penalties set forth in section 231-36, HRS, that the statements contained herein are true and correct.

Signature

Date

REASONS FOR REJECTION OF EXTENSION

1. The request was not in this office or mailed on or before the expiration of the automatic 3-month extension for filing the return.

2. Your application cannot be considered because no previous extension of time to file the return was granted.

3. The 6-month limitation has expired. (Extension will be granted for a maximum of 6 months only.)

4. We have NOT approved the application. However, because of your reasons stated above, we have granted a 10-day grace

period from the date shown below or due date of the return including extensions, whichever is later. This 10-day grace period is

considered to be a valid extension of time for purposes of elections otherwise required to be made on timely filed returns.

5. Other:

Form N-100a - Application For Additional Extension Of Time To File Hawaii Return For A Partnership, Trust, Or Remic - 2002 Page 2

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