Form Mo-60 Draft - Application For Extension Of Time To File

ADVERTISEMENT

Enclosure Sequence No. 1040-05
FORM
MISSOURI DEPARTMENT OF REVENUE
MO-60
DLN
APPLICATION FOR EXTENSION
OF TIME TO FILE
(REV. 10-2011)
NOTE: INDIVIDUAL INCOME TAX FILERS: IF YOU HAVE AN APPROVED FEDERAL EXTENSION, YOU MAY NOT BE REQUIRED TO FILE THIS FORM. ALSO, YOU MAY
NOT BE REQUIRED TO FILE AN EXTENSION IF YOU DO NOT EXPECT TO OWE ADDITIONAL INCOME TAX OR IF YOU ANTICIPATE RECEIVING A REFUND. SEE
THE INSTRUCTIONS FOR DETAILS. NOTE: The Missouri extension to file a corporate tax return is a separate form. See Form MO-7004.
DEPARTMENT OF
M
M
D
D
Y
Y
LAST NAME, FIRST NAME, INITIAL
REVENUE USE ONLY
SPOUSE’S LAST NAME, FIRST NAME, INITIAL
IN CARE OF NAME (ATTORNEY, GUARDIAN, EXECUTOR, ETC.)
TELEPHONE NUMBER
(__ __ __ ) __ __ __ - __ __ __ __
ADDRESS (INCLUDE APARTMENT NUMBER OR ROUTE NUMBER)
CITY, STATE, ZIP CODE
TYPE OF RETURN / EXTENSION
TAXPAYER IDENTIFICATION NUMBER
(Only one box may be checked below. Separate
(Enter the taxpayer’s social security number or FEIN below.)
request must be made for each return.)
Your Social Security
Mail to:
Number
MISSOURI DEPARTMENT OF REVENUE
P.O. BOX 3400
JEFFERSON CITY, MO 65105-3400
Spouse’s Social Security
Number
Individual Income Tax Return, Form MO-1040
Fiduciary Income Tax Return, Form MO-1041
Federal Employer Identification
Number (FEIN)
Partnership Income Tax Return, Form MO-1065
Note: If filing a composite Form MO-1040, mark individual income
tax return box.
YEAR / DATE OF EXTENSION (If based on federal extension, attach a copy of your federal form.)
Tax Year Beginning
Tax Year Ending
An Extension of Time Until
TAX PAYMENT SCHEDULE —
THIS SCHEDULE MUST BE COMPLETED
(SEE LINE-BY-LINE INSTRUCTIONS ON BACK)
1. Tentative amount of the tax for the taxable year . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1
2. Total payments and credits (see instructions) ................................................................................................................................
2
3. Balance due (Subtract Line 2 from Line 1). Make remittance payable to the MISSOURI DEPARTMENT OF REVENUE
BEFORE MAILING — Write your social security number(s) or FEIN on your check or money order ...........................................
3
=
DEPARTMENT OF REVENUE USE ONLY
Check this box to receive notification that your extension was approved. If this extension is denied, you will receive a denial letter.
DOR USE ONLY
If you pay by check, you authorize the Department of Revenue to process the check electronically. Any check returned unpaid may be presented
again electronically.
Under penalties of perjury, I declare that I have examined this application, and to the best of my knowledge and belief it is true, correct, and complete. Declaration of preparer (other
than taxpayer) is based on all information of which he/she has any knowledge.
SIGNATURE
DATE
PREPARER’S SIGNATURE
DATE
_ _ /_ _ / _ _ _ _
__ __ /__ __ / __ __ __ __
SPOUSE’S SIGNATURE
DAYTIME TELEPHONE
PREPARER’S ADDRESS AND ZIP CODE
FEIN, SSN, OR PTIN
(_ _ _ ) _ _ _ - _ _ _ _
MAILING ADDRESS: MISSOURI DEPARTMENT OF REVENUE, P.O. BOX 3400, JEFFERSON CITY, MO 65105.
MO-60 (10-2011)

ADVERTISEMENT

00 votes

Related Articles

Related forms

Related Categories

Parent category: Financial
Go
Page of 2