Form 101 - Application For Extension Of Time To File A North Dakota Tax Return - 2002

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Form
North Dakota Office Of State Tax Commissioner
Attach copy of
Application for extension of time to file a
101
approved form
North Dakota tax return
to ND return
(income and financial institution tax returns only)
® ® ® ® ®
Did you apply for a federal extension?
If you applied for an extension to file your federal return, you do
not need to use this form—see the instructions for the procedures to follow to have the federal extension recognized.
Part 1
To be completed by Taxpayer
Complete lines 1 through 7 (see instructions to Part 1 on reverse side)
1. Name and address of taxpayer:
3. Taxpayer’s social security number (or FEIN):
_________________________________________________________
______________________________________________________
Name (If a joint return, include both spouses’ names.)
(If a joint return, include both spouses’ numbers.)
_________________________________________________________
4. Tax year of taxpayer:
Address
J
_________________________________________________________
Calendar year ending December 31, 20 ____
Address
J
_________________________________________________________
Fiscal year ending— _____________ ______ ______
City
State
Zip code
Month
Day
Year
Enter below the name and address of the person to whom the
5. An extension is requested to:
processed form should be sent if not to the taxpayer:
______________________________
_______________
_________________
_________________________________________________________
Month
Day
Year
_________________________________________________________
J
This is a request for an additional extension.
_________________________________________________________
6. Reason for needing extension:
2. Type of tax return for which extension
____________________________________________________
is requested:
J
Form ND-1 or Form ND-2 (individual)
____________________________________________________
J
Form 38 (estate or trust)
____________________________________________________
J
Form 58 (partnership)
7. Taxpayer signature:
J
Form 40 (C corporation)
J
______________________________________________
________________
Form 60 (S corporation)
Signature of taxpayer (or authorized representative)
Date
J
Form 35 (financial institution)
______________________________________________
________________
J
Spouse’s signature, if joint return
Date
Other (identify) __________________________________
® ® ® ® ® Do not send any payment with this form — see
Prepayment of tax due
in instructions.
Part 2
To be completed only by the Office of State Tax Commissioner
Reason for rejection:
J
Application was late—
The application must be
postmarked on or before the due date (or previously granted
extended due date) of the tax return.
J
No reason for extension provided—
An extension is
granted only for good cause. No reason for needing the
extension was stated in the application.
J J J J J
J
Granted
_________________________
_______________
No good cause—
After reviewing the reason for needing an
Authorized initials
Date
extension, we do not find good cause for an extension. (Note:
An inability to pay is not good cause for an extension.)
J
Multiple taxpayers or returns—
More than one
taxpayer or type of return was identified on the application. A
separate application must be filed for each taxpayer or type of
return.
J
No signature—
The application must be signed by the
taxpayer. If married filing joint return, both spouses must sign.
J J J J J
Rejected
J
_________________________
_______________
Other ___________________________________
Authorized initials
Date
_________________________________________
_________________________________________
28215 (Revised October 2002)

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