Form Fr-127 - Extension Of Time To File - 2000

FR-127

2000

OFFICIAL USE ONLY

GOVERNMENT OF THE DISTRICT OF COLUMBIA

OFFICE OF THE CHIEF FINANCIAL OFFICER

Extension of Time to File

OFFICE OF TAX AND REVENUE

D.C. INDIVIDUAL INCOME OR FIDUCIARY TAX RETURN

Date Received

Taxable year beginning:

ending:

Last Name

First Name and Initial

Your Social Security No.

Last Name

Spouse’s First Name and Initial (if joint return)

Spouse's Social Security No.

Telephone Number

Number and Street or Rural Route, City, State, Zip

Apt. No.

Home Address (Number and Street)

City

State

Zip

Request for Extension of Time to File. Complete Part I and submit this form with your payment of any tax

PART I.

due as shown on Line 7.

1. A 4-month extension of time until August 15, 2001 for calendar year 2000 or until___________________________________________for a fiscal year return, is hereby

requested to file a District of Columbia (check one)

Individual income tax return, Form D-40EZ

Individual income tax return, Form D-40

Fiduciary income tax return, Form D-41

2. Total income tax liability for 2000 (If none, enter zero (0.) . . . . . . . . . . . . . . . . . . . . . . . . . . .

3. D.C. income tax withheld in 2000 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

4. 2000 estimated tax payment (include any 1999 overpayment shown as a credit to your

2000 estimated tax on your 1999 return, Form D-40) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

5. Other payments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6. Total payments (Add Lines 3, 4 and 5) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

7. Balance due. (Line 2 minus Line 6) You must submit payment in full with this form, or your request will not be accepted.

NOTE: You will be subject to failure to pay penalty and interest on any tax due and not paid with this request . . . . . . . . . . . . . . . . .

PART II. Request for Additional Extension of Time to File. Complete this part and send this form in duplicate, with your

payment of any tax due.

8. An additional extension (not to exceed 2 months) until _________________________________________________________ is hereby requested to file a District of

Columbia (check one):

Individual income tax return, Form D-40EZ

Individual income tax return, Form D-40

Fiduciary income tax return, Form D-41.

State in detail the reason(s) for the request _________________________________________________________________________________________

_________________________________________________________________________________________________________________________

__________________________________________________________________________________________________________________________

__________________________________________________________________________________________________________________________

Taxpayer(s) signature(s) (If signed by another person, see instructions on reverse side.

Date

Telephone No.

NOTICE TO APPLICANT:

Upon consideration of your request an extension of time to file is hereby granted until:______________________________________________

Your request cannot be considered since it was postmarked after the due date of the return. Your return should be filed without further delay.

Careful consideration has been given to the reason(s) and other data submitted with your request but it has been determined that the extension is not

warranted. Your return should be filed by the regular due date or within 10 days of the date entered below on this notice if the end of the 10-day

period is later than the regular due date. Please attach this form to the return to explain any delay in filing.

Your request is denied for failure to state a reason.

Your request is denied since you failed to pay the balance of tax due.

Other: ____________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

__________________________________________________________________________________________________________________________

__________________________________________________________________________________________________________________________

Customer Service Administration (Authorized Signature)

Date

OFFICIAL

USE ONLY