Form Ri-7004 - Automatic Six Month Extension Request For Ri-1120c, Ri-1120s And Ri-1065 Filers

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EXTENSION REQUEST INSTRUCTIONS
EXTENSION REQUEST:
To be used by a corporation, LLC or partnership for requesting an automatic six (6) month extension of time for
filing Rhode Island Form RI-1120C, RI-1120S or RI-1065.
TO BE EFFECTIVE:
1. Payment of the full amount of the tax reasonably estimated to be due must be submitted with this request.
2. This form must be completed and filed before the date prescribed for payment of the tax.
3. This form must be signed by a person authorized to represent the corporation in this matter.
NOTE:
The extension of time is limited to:
1. The date requested, or
2. The date on which a certificate of good standing is required to be issued, whichever is earlier.
ONLINE PAYMENT
Your extension payment can be made online. For more information, visit:
https://
If you make your payment online, you do not need to send in this extension request form.
STATE OF RHODE ISLAND
RI-7004
AUTOMATIC SIX MONTH EXTENSION REQUEST FOR RI-1120C, RI-1120S AND RI-1065 FILERS
DIVISION OF TAXATION - DEPT #88 - PO BOX 9702 - PROVIDENCE, RI 02940-9702
YOUR COPY
For Calendar Year
Or Taxable Year Beginning
And Ending
DO NOT FILE THIS COPY WITH THE
ESTIMATED TAX
$
0 0
RHODE ISLAND DIVISION OF TAXATION
RI-7004
CURRENT YEAR
NAME
AMOUNT PAID AND
$
0 0
CREDITED TO DATE
FEDERAL EMPLOYER IDENTIFICATION NUMBER
AMOUNT DUE
$
0 0
WITH EXTENSION
I declare, under the penalties of perjury, that this document has been examined by me and,
to the best of my knowledge and belief, is true, and complete.
AMOUNT
$
0 0
ENCLOSED
Key #5
Signature of officer or agent.
STATE OF RHODE ISLAND
RI-7004
AUTOMATIC SIX MONTH EXTENSION REQUEST FOR RI-1120C, RI-1120S AND RI-1065 FILERS
DIVISION OF TAXATION - DEPT #88 - PO BOX 9702 - PROVIDENCE, RI 02940-9702
For Calendar Year
NAME
Or Taxable Year Beginning
And Ending
ADDRESS
ESTIMATED TAX
$
0 0
RI-7004
CURRENT YEAR
CITY, STATE, ZIP CODE
AMOUNT PAID AND
$
0 0
CREDITED TO DATE
FEDERAL EMPLOYER IDENTIFICATION NUMBER
AMOUNT DUE
$
0 0
WITH EXTENSION
I declare, under the penalties of perjury, that this document has been examined by me and,
to the best of my knowledge and belief, is true, and complete.
AMOUNT
$
0 0
ENCLOSED
Key #5
Signature of officer or agent.

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