Form W4768 - Application For Extension Of Time To File A Wisconsin Estate Tax Return (W706)
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1Application for Extension of Time to File a
Mail to:
Form
W4768
Wisconsin Department of Revenue
Wisconsin Estate Tax Return (W706)
PO Box 8904
Madison, WI 53708-8904
For Estates of Resident and Nonresident Decedents When
Telephone No. (608) 266-2772
Date of Death Is On or After October 1, 2002
Part I
Identification
Decedent's first name and middle initial
Decedent's last name
Date of death
Name of executor
Name of application filer (if other than the executor)
Decedent's social security number
Address of executor (number, street, and room or suite no.)
Estate tax return due date Estate federal ID number (EIN)
City, state and zip code
County of Jurisdiction
Part II
Maximum Extension of Time to File Is 6 Months
Extension date requested
You must attach your written statement to explain in detail why it is impossible or impractical to
file a reasonably complete return within 9 months after the date of the decedent's death.
Part III
Payment to Accompany Extension Request
1 Amount of Wisconsin estate tax estimated to be due . . . . . . . . . . . . . . . . . . . . . . . . .
1
2 Advance payment (Complete Form 401T in duplicate and attach to this form.) . . . . .
2
3 Balance due . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3
Part IV
Signature and Verification
If filed by executor –
Under penalties of perjury, I declare that I am an executor of the estate of the above-named decedent and that to the best
of my knowledge and belief, the statements made herein and attached are true and correct.
Executor's signature
Date
Telephone Number
If filed by someone other than the executor –
Under penalties of perjury, I declare that to the best of my knowledge and belief, the statements made herein and attached
are true and correct, that I am authorized by the executor to file this application, and that I am (check box[es] that applies):
A member in good standing of the bar of the highest court of (specify jurisdiction)
A certified public accountant duly qualified to practice in (specify jurisdiction)
A person enrolled to practice before the Internal Revenue Service
A duly authorized agent holding a power of attorney. (Attach copy of Power of Attorney, Form A-222)
Filer's signature (other than the executor)
Date
Telephone Number
HT-010 (R. 12-05)
Wisconsin Department of Revenue
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