Form Ftb 6274a C3 - Extension Request To File Information Returns Electronically
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STATE OF CALIFORNIA
DATA RESOURCES AND SERVICES MS A181
FRANCHISE TAX BOARD
PO BOX 1468
SACRAMENTO CA 95812-1468
Extension Request to File Information Returns Electronically
Firm Name:
Date:
/
/
Mailing Address:
Federal Employer Identification Number:
City/State/ZIP Code:
Waiver Request for
Tax Year: ___________
Contact Name:
Title:
Telephone Number:
.
.
Information Return Filing Extension Requests
We consider 30-day and 90-day information return filing extensions. To request our approval, provide a written explanation
for each return type extension you request.
30-Day Extension
Check the box for each return type extension request and enter your explanation in the text field.
Return Type
Extension Request Explanation
m
1098
m
1099
m
5498
m
W-2G
90-Day Extension
To request a 90-day extension to file 1099-B information returns, check the box and enter your explanation in the text field.
Return Type
Extension Request Explanation
m
1099-B
We approve information return filing extensions only for the Franchise Tax Board. We require the payer/employer to
provide payees/employees with their paper return copies postmarked by the prescribed due dates of May 31 for Internal
Revenue Service Form 5498 and January 31 for all other information returns. If the corresponding due date falls on a
Saturday, Sunday, or legal holiday, we extend the due date to the next business day.
I acknowledge that I examined the information provided on this form, including any accompanying statements. To the
best of my knowledge and belief, it is true, correct, and complete.
Signature:
Title:
Date:
/
/
Fax completed form to: IRPHELP
916.855.5555
Internet and Telephone Assistance
Website:
Go to ftb.ca.gov and search for information returns
Telephone:
916.845.6304
FTB 6274A C3 (REV 02-2012)
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