Form Ct-1120si Ext - Application For Extension Of Time To File Connecticut S Corporation Information And Composite Income Tax Return - 2000

STATE OF CONNECTICUT

CT-1120SI EXT

FORM CT-1120SI EXT

DEPARTMENT OF REVENUE SERVICES

2000

PO Box 2967

Hartford CT 06104-2967

Application for Extension of Time to File Connecticut

S Corporation Information and Composite Income Tax Return

(Rev. 12/00)

IMPORTANT! Refer to Instructions on Reverse before Completing this Application

Name of Corporation

Federal Employer ID Number

<

TAXPAYER

Date Received (FOR DEPARTMENT USE ONLY)

Number and Street

PO Box

<

(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 INTEREST AND PENALTIES 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, 2001, to file Form CT-1120SI, Connecticut S Corporation Information and Composite

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Income Tax Return, for calendar year 2000, or until _____________________ for taxable 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 Return,

H

H

for calendar year 2000, or taxable year beginning ______________, 2000, 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 2000. (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 2000 estimated Connecticut S corporation composite income tax payments and any

1999 overpayment credited to 2000 ...................................................................................................................... 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 “2000 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

Preparer’s SSN or PTIN

Keep a copy

of this

Firm Name and Address

Federal Employer ID Number

return for

your records.

Telephone Number

(

)