Form M-4868 - Application For Automatic Six-Month Extension Of Time To File Massachusetts Income Tax Return - 2013

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2013
Form M-4868
Massachusetts
Application for Automatic Six-Month Extension
Department of
of Time to File Massachusetts Income Tax Return
Revenue
For the year January 1–December 31, 2013 or other taxable year beginning
ending
Tentative Return
1 Total tax you expect to owe for 2013 (Form 1, lines 28 and 33 (if applicable); Form 1-NR/PY, lines 32 and 38 (if applicable). . . . 1
2 Massachusetts income tax withheld . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
3 2012 overpayment applied to your 2013 estimated tax (do not enter 2012 refund). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
4 2013 Massachusetts estimated tax payments (do not include amount in line 3) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
5 Credits (see Form 1, lines 29, 30 and 40 through 42; Form 1-NR/PY, lines 33 through 35 and 45 through 47) . . . . . . . . . . . . . . . 5
6 Total. Add lines 2 through 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
7 Amount due. Subtract line 6 from line 1; not less than “0.” Pay in full with this application. Note: If “0,” see below for
information regarding automatic extensions. Payments of $5,000 or more must be made electronically. If you are
making a payment of less than $5,000, you also have the option of filing Form M-4868 electronically. See below for
more information. Be sure to detach Form M-4868 where indicated before mailing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
7
If line 7 is “0” and 100% of the tax due for 2013 has been paid through: withholding; timely estimated payments of tax; credits from your
utomatic Extension Granted if 100% Tax Due is Paid by Tax Return Due Date
2013 return; or a refund from the prior tax year applied to the current year’s tax liability, you are no longer required to file Form M-4868,
Application for Automatic Extension of Time to File Massachusetts Income Tax Return. However, if you do choose to file Form M-4868
in this instance, you must do so electronically, via DOR’s website. See
TIR 06-21
for more information.
If you owe no tax or you are making a payment of $5,000 or more, you are required to file your extension and make any payment electron-
Filing Your Extension Electronically (E-File or via the Web)
ically. If you are making a payment of less than $5,000, you also have the option of filing your extension electronically. If there is a tax due
with your extension, payment can be made through Electronic Funds Withdrawal.
Visit to file via the Web.
Note: Instructions for Form M-4868 are on page 2.
DETACH HERE (if making a payment)
Form M-4868
5
5
Massachusetts
Application for Automatic Six-Month Extension — 2013
Department of Revenue
Social Security number
Spouse’s Social Security number
Period end date
Amount enclosed (from above)
Check which form you plan to file:
Taxpayer’s name
Form 1 Full-Year Resident
Form 1-NR/PY Nonresident/
Taxpayer’s address
City/Town
State
Zip
Part-Year Resident
E-File
Composite
Write your Social Security number(s) on lower left corner of check. Return this voucher with check or money order payable to:
Commonwealth of Massachusetts. Mail to: Massachusetts Department of Revenue, PO Box 7070, Boston, MA 02204.
Sign here. Under penalties of perjury, I declare that to the best of my knowledge and belief this return and enclosures are true, correct and complete.
Your signature
Signature of paid preparer
Date
Employer Identification number of paid preparer
Social Security number or PTIN
01 0 10
1

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