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DIRECTIONS FOR APPLYING FOR EXTENSION OF TIME TO FILE

All extension requests must be made on or before the date for filing the return, and for good cause

shown, the Administrator may extend the time for filing such returns for a period not to exceed six (6)

months, or to the last day of the month following the month of any extension granted by the Federal

Internal Revenue Service.

In cases where extensions have been granted by the Internal Revenue Service, automatic or other,

an automatic extension shall be granted by the Administrator upon receipt of written notification on

or before the due date of the return not to exceed six (6) months, or to the last day of the month

following the month of any extension granted by the Federal Internal Revenue Service.

Information returns, schedules and statements needed to support tax returns are to be filed within the

time limits set forth for filing the tax returns and made a part thereof. If automatic extension is requested,

in cases where extension has been granted by the Internal Revenue Service, attach copy of said

extension and return to the Regional Income Tax Agency.

NO STATEMENT OF RECEIPT OR ACKNOWLEDGEMENT IS REQUIRED TO BE GIVEN BY THIS

AGENCY. IF REPLY IS REQUESTED, ENCLOSED STAMPED, SELF-ADDRESSED ENVELOPE

AND COPY OF EXTENSION APPLICATION WITH REQUEST.

SECTION 1: ATTACH A COPY OF FEDERAL EXTENSION

The above named is hereby requesting an extension of time until (mm/dd/yy) _____________________

in which to file the municipal income tax return for the calendar year ______________ or other taxable

year beginning (mm/dd/yy) ____________________ and ending (mm/dd/yy) _____________________.

Please state in detail the reason the extension is needed (if for subsidiaries – list name, address, and

employer identification number). ________________________________________________________

__________________________________________________________________________________.

SECTION 2: MUST BE COMPLETED BY ALL

Payment requirement: In cases where a balance is due on the annual return, the entire amount of

estimate balance is due at the time the extension is filed. (Note: No penalty will be assessed in those

cases in which the return is filed and the final tax paid within the period as extended, provided all other

filing and payment requirements of the Ordinance have been met.) You MUST distribute estimated tax

from Line1 below on Pg. 1 of Form 20, Section 5. If additional space is needed, attach a schedule.

(1) Estimated tax for taxable year

$ _________________________.00

(2) Less payments of estimated tax

$ _________________________.00

(3) Balance due

$ _________________________.00

SECTION 3: DOES NOT HAVE TO BE COMPLETED IF FEDERAL EXTENSION ATTACHED

Verification: Taxpayer – Under penalties of perjury, I declare that to the best of my knowledge and

belief, the statements made herein are true and correct.

Signature: __________________________________________________ Date: __________________

Preparer other than taxpayer – Under penalties of perjury, I declare that to the best of my knowledge and

belief, the statements made herein are true and correct, that I am authorized by the taxpayer to prepare

this application.

Signature of preparer: ________________________________________ Date: ___________________

Form 20 - Declaration Of Estimated Municipal Tax On Net Profits And / Or Application For Extension Of Time To File Page 2