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FORM N-101A

(REV. 2015)

PAGE 2

10. How to Claim Credit for Payment Made With This Form.—

Failure to Pay Tax After Filing Timely Return – The penalty for

failure to pay the tax after filing a timely return is 20% of the tax

Show the amount paid with this form on Form N-11, line 40; Form

unpaid within 60 days of the prescribed due date. The 60-day period

N-13, line 29; or Form N-15, line 57.

is calculated beginning with the prescribed due date even if the

If you and your spouse jointly file Form N-101A but later file

prescribed due date falls on a Saturday, Sunday, or legal holiday.

separate returns for 2015, you can enter the total amount paid

8. Interest.—Interest at the rate of 2/3 of 1% per month or part of

with Form N-101A on either of your separate returns. Or you and

a month shall be assessed on unpaid taxes and penalties beginning

your spouse can divide the payment in any agreed amounts. Also

with the first calendar day after the date prescribed for payment,

enter the social security numbers (or ITINs) of both spouses on the

whether or not that first calendar day falls on a Saturday, Sunday,

separate Form N-11, N-13, or N-15.

or legal holiday.

If you and your spouse each filed a separate Form N-101A but

9. How to Complete Form.––Print your name, address, and

later file a joint return for 2015, enter the total paid with both Forms

social security number in the space provided. If you are filing a joint

N-101A on the appropriate line of your joint return. Also enter the

return, print your spouse’s name and social security number in the

social security numbers (or ITINs) of both spouses on Form N-11,

space provided. If you have a foreign address, enter the complete

N-13, or N-15.

country name in the space provided. If you are an alien and were

Line-by-Line Instructions for Worksheet

issued an individual taxpayer identification number (ITIN) by the

IRS, enter your ITIN. If you applied for an ITIN but the IRS has not

Line 1.—Enter the amount of income tax you expect to owe for

yet issued the ITIN, write “ITIN Applied For” in the space above the

2015. If you do not expect to owe tax, enter zero (0). Be sure to

box where you enter your name.

estimate the amount correctly. If you underestimate this amount,

Print the date your tax year ends and the amount of your payment.

you may be charged a penalty as explained earlier under Penalties.

Detach the voucher where indicated. Submit only the voucher

Line 4.—Enter other payments and credits that you expect to

portion of this form with your payment.

show on Form N-11, N-13, or N-15.

Make your check or money order payable in U.S. dollars to “Hawaii

Line 6.—Round the amount to the nearest dollar. You must pay

State Tax Collector” and attach it to the front of Form N-101A. Make

the amount shown on line 6. An extension of time to file your income

sure your name and address appear on your check or money order.

tax return does not extend the time to pay your income tax. Also,

Please write your social security number, daytime phone number,

any payment made with this extension does not exempt you from

and “2015 Form N-101A” on it. Do not send cash.

the penalty assessed for underpaying estimated taxes for 2015.

You may use the worksheet below to determine the amount of

your income tax balance due.

WORKSHEET

1 Total income tax liability on your income tax return

for 2015 (You may estimate this amount) ........................................1

Note: You must enter an amount on line 1.

If you do not expect to owe tax, enter zero (0)

2 Hawaii income tax withheld .............................................................2

3 2015 estimated tax payments (include 2014

overpayment allowed as a credit) ....................................................3

4 Other payments (see Instructions) ..................................................4

5 Total (add lines 2, 3, and 4) .............................................................5

6 Income tax balance due (line 1 minus line 5). (Whole dollars only) ........................6

Form N-101a - Application For Automatic Extension Of Time To File Hawaii Individual Income Tax Return - 2015 Page 2

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