Municipal Income Tax Extension Request Form - 2015 printable pdf download

Municipal Income Tax Extension Request Form - 2015

2015 EXTENSION REQUEST FORM

MUNICIPAL INCOME TAX

Alliance, Carrollton, Columbiana, Geneva, Hubbard, Jefferson, Leetonia, Lisbon, Lordstown,

Lowellville, Middlefield, Orwell, Salem, Sebring, Struthers, and Warren will accept this Extension

Request Form in lieu of a copy of the Federal Extension. It must be received by April 15, 2016

(Or by Federal Due Date), the due date of the municipal income tax return.

Canfield, Malvern, Newton Falls, Niles, and Windham only accept a copy of the Federal Extension

which must be received by April 15, 2016, the due date of the municipal income tax return.

For East Palestine’s extension requirements see

FOR MUNICIPALITY OF ____________________________ ACCOUNT NUMBER _________________

SSN __________________________________

EIN ____________________________________

NAME ________________________________________________________________________________

ADDRESS ____________________________________________________________________________

CITY __________________________________ STATE ________ ZIP CODE ____________________

I HEREBY REQUEST AN EXTENSION OF TIME FOR FILING THE MUNICIPAL INCOME

TAX RETURN FOR:

____ CALENDAR YEAR 2015 or ____ FISCAL YEAR ________

Please note: For taxable year 2015 the extended due date for filing the municipal income tax return is the

last day of the month following the month to which the due date of the federal income tax return has been

extended.

CHECK APPROPRIATE LINE AND COMPLETE IF NECESSARY:

_____ Individual 4 month extension to September 15, 2016.

_____ Individual additional extension to November 15, 2016.

_____ Calendar year 3 month Partnership extension to August 15, 2016.

_____ Calendar year 6 month Corporate extension to October 15, 2016.

_____ Fiscal year 6 month Corporate extension to ___________________ _______, __________

I UNDERSTAND THIS IS NOT AN EXTENSION FOR PAYING THE TAX OWED.

________________________________________

Taxpayer Signature

Preparer Signature if other than Taxpayer

TRICOTA/EXT/2015

Municipal Income Tax Extension Request Form - 2015