Form N-101a - Application For Automatic Extension Of Time To File Hawaii Individual Income Tax Return - 2015

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STATE OF HAWAII –– DEPARTMENT OF TAXATION
FORM
APPLICATION FOR AUTOMATIC EXTENSION
N-101A
OF TIME TO FILE HAWAII INDIVIDUAL INCOME TAX RETURN
(REV. 2015)
2015
(NOTE: References to “married”, “unmarried”, and “spouse” also means
“in a civil union”, “not in a civil union”, and “civil union partner”, respectively.)
About this Form
Internet Filing—Form N-101A can be filed and payment
made electronically through the State’s Internet portal. For more
Form N-101A is designed for electronic scanning that permits
information, go to tax.hawaii.gov/eservices/.
faster processing with fewer errors. To avoid delays:
1. Purpose of Form N-101A.— Use this form to make a tax
1. Print amounts only on those lines that are applicable.
payment if you will have a balance due when you file Form N-11,
2. Use only a black or dark blue ink pen. Do not use red ink,
N-13, or N-15.
pencil, felt tip pens, or erasable pens.
Federal Form 4868, Application for Automatic Extension of Time
3. Because this form is read by a machine, please print your
To File U.S. Individual Income Tax Return, may not be used in lieu
numbers inside the boxes like this:
of Form N-101A.
2. How to Obtain Tax Forms.—To request tax forms and
1 2 3 4 5 6 7 8 . 9 0
publications by mail, you may call 808-587-4242 or toll-free 1-800-
222-3229.
4. Do NOT print outside the boxes.
Tax forms are available on the Department of Taxation’s website
5. Do NOT use dollar signs, commas, slashes, dashes or
at tax.hawaii.gov.
parenthesis in the boxes.
3. When to File.—File Form N-101A by April 20, 2016. If you are
6. Do not photocopy this form.
filing a fiscal year return, file Form N-101A by the due date of your
General Instructions
return (twentieth day of the fourth month following the close of the
taxable year). If the due date falls on a Saturday, Sunday or legal
You are granted an automatic 6-month extension of time to file
holiday, file by the next regular workday.
Form N-11, N-13, or N-15. You don’t need to file an application to
4. Where to File.—This form must be submitted to:
request the extension. The automatic 6-month extension is granted
if the following requirements are met:
Hawaii Department of Taxation
• On or before April 20, 2016, 100% of the properly estimated
P.O. Box 1530
tax liability is paid;
Honolulu, Hawaii 96806-1530
• The tax return is filed on or before the expiration of the
5. Where to Call for Information.—You may get information by
6-month extension period;
calling the following:
• The tax return is accompanied by full payment of any tax not
Telephone
already paid; and
808-587-4242
• You are not bound by a court order to file a tax return on or
or 1-800-222-3229
before the prescribed due date.
Telephone for the hearing impaired
808-587-1418
Properly estimated tax liability means you made a bona fide and
or 1-800-887-8974
reasonable attempt at the time the extension was submitted to
locate and gather all of the necessary information to make a proper
6. Filing Your Tax Return.—You may file your tax return any time
estimate of tax liability for the taxable year. If you did not file Form
before the extension expires. But remember, Form N-101A does
N-101A, you are considered to have submitted the extension on
not extend the time to pay taxes. If you do not pay the amount due
April 20, 2016.
by the prescribed due date, you will owe interest. You may also be
charged penalties.
If you must make a tax payment to meet the requirement that
100% of the properly estimated tax liability is paid on or before April
7. Penalties.—Late Filing of Return – The penalty for failure to
20, 2016, you must file Form N-101A with your payment.
file a return on time is assessed on the tax due at a rate of 5% per
month, or part of a month, up to a maximum of 25%.
DETACH HERE
Form
Tax Year
(Rev. 2015)
STATE OF HAWAII — DEPARTMENT OF TAXATION
DO NOT WRITE OR STAPLE IN THIS SPACE
2015
N-101A
APPLICATION FOR AUTOMATIC EXTENSION OF TIME TO
FILE HAWAII INDIVIDUAL INCOME TAX RETURN
DO NOT SUBMIT A PHOTOCOPY OF THIS FORM
JGB151
o
First time filer
Your Social Security Number
Your first name
M.I.
Last name
If joint return, spouse’s first name
M.I.
Last name
Spouse’s Social Security Number
Present mailing or home address (Number and street, including rural route)
Apartment Number
Tax Year Ending (MM DD YY)
City, town, or post office
State
Postal/ZIP Code
Country
For office use only
Amount of Payment
MAIL THIS VOUCHER WITH CHECK OR MONEY ORDER
PAYABLE TO “HAWAII STATE TAX COLLECTOR.” Write your
social security number, daytime phone number, and “2015
Form N-101A” on your check or money order.

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