Form 120ext - Arizona Application For Automatic Extension Of Time To File Corporation, Partnership, And Exempt Organization Returns - 2013
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1Application for Automatic Extension of Time to File
ARIZONA FORM
120EXT
2013
Corporation, Partnership, and Exempt Organization Returns
For the
calendar year 2013 or
fiscal year beginning
M M D D
2 0 1 3 and ending
M M D D Y Y Y Y
.
Name
Employer Identification Number (EIN)
Address – number and street or PO Box
Business Telephone Number (with area code)
City, Town or Post Office
State
ZIP Code
REVENUE USE ONLY. DO NOT MARK IN THIS AREA.
88
Check if this is the first tax return filed under this name and EIN.
A
Check if name and/or address has changed.
B
Check if EIN has changed. List prior number:
C
81 PM
66 RCVD
Check type of return to be filed:
120
120A
120S
99T
99
165
S corporations and Partnerships: Use Form 204 to request an extension of time to file a composite return for nonresident individual
shareholders or nonresident individual partners on Form 140NR.
All applications for an extension of time to file must be
An Arizona extension cannot be granted for more than
postmarked on or before the original due date of
six months beyond the original due date of the return.
the return, unless the original due date falls on Saturday,
Arizona will accept a valid federal extension for the same
Sunday, or a legal holiday. In that case, the application
period of time covered by the federal extension.
The
must be postmarked on or before the business day
federal extension for partnerships is five months.
following such Saturday, Sunday, or legal holiday.
CHECK ONE BOX:
Extension Date
Taxable Year Ending
Form 120, Form 120A, Form 120S, Form 99T, Form 99:
This is a request for an automatic six-month extension until .................................
M M D D Y Y Y Y M M D D Y Y Y Y
Form 165 only:
M M D D Y Y Y Y M M D D Y Y Y Y
This is a request for an automatic five-month extension until ..............................
A federal extension will be used to file this tax return. This form is being used to transmit the Arizona extension payment.
EXTENSION PAYMENT COMPUTATION (Forms 120, 120A, 120S and 99T only)
00
1 Tax liability for the taxable year. See instructions ..................................................................................... 1
00
2 Less estimated tax payments .................................................................................................................... 2
00
3 Balance of Tax: line 1 less line 2 ............................................................................................................. 3
00
4 Enter amount of payment enclosed .....................................................................PAYMENT ENCLOSED. 4
• Make check payable to:
Arizona Department of Revenue and include EIN on payment.
• Mail application and payment to:
Arizona Department of Revenue, PO Box 29085, Phoenix, AZ 85038-9085.
• Mail application without payment to:
Arizona Department of Revenue, PO Box 29079, Phoenix, AZ 85038-9079.
The taxpayer will be liable for the extension underpayment
underpayment penalty are not subject to the late payment
penalty if at least 90 percent of the tax liability disclosed
penalty prescribed by A.R.S. § 42-1125(D).
Interest
by the return has not been paid by the original due
accrues on any additional tax due from the original due
date of the return. Taxpayers subject to the extension
date of the return until paid.
Under penalties of perjury, I declare that I have examined this form, including accompanying schedules and statements, and to the
Declaration
best of my knowledge and belief, it is true, correct, and complete; and that I am authorized to prepare this form.
Please
Sign
SIGNATURE OF OFFICER OR AGENT
DATE
TITLE
Here
PRINTED NAME
BUSINESS PHONE (with area code)
AGENT’S TIN
Print
ADOR 10340 (13)
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