Corporate Income Tax Electronic Filing Waiver Request

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CORPORATE INCOME TAX
ELECTRONIC FILING WAIVER REQUEST
If you are unable to make the necessary changes to file and pay electronically, request a temporary
waiver by completing this form.
Corporation Name: ________________________________________________________
Corporation FEIN: _________________________________________________________
Corporation Mailing Address: ________________________________________________
________________________________________________________________________
________________________________________________________________________
Contact Name: ___________________________________________________________
Contact Phone Number: ____________________________________________________
Contact Email Address: _____________________________________________________
Waiver is needed for:
____Electronic Return Filing
____Electronic Payment Submission
Reason for Request: _______________________________________________________
________________________________________________________________________
________________________________________________________________________
Waiver Requested Until (enter date):___________________________________________
Fax your request to:
(804) 367-3015 or
Mail your request to:
Virginia Department of Taxation
Waiver Requests
PO Box 27423
Richmond, VA 23261

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