Form Hw-26 - Application For Extension Of Time To File The Employer'S Annual Return And Reconciliation Of Hawaii

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DO NOT WRITE IN THIS AREA
FORM HW-26
34
(REV. 2003)
STATE OF HAWAII — DEPARTMENT OF TAXATION
APPLICATION FOR EXTENSION OF TIME TO FILE THE
EMPLOYER’S ANNUAL RETURN AND RECONCILIATION OF HAWAII
INCOME TAX WITHHELD FROM WAGES (FORM HW-3)
Please read instructions below before preparing form.
TAXPAYER’S
NAME:
_____________________________________________
BUSINESS
HAWAII WITHHOLDING I.D. NO.
____________________________________
NAME (DBA):
ADDRESS:
_____________________________________________
_____ _____ _____ _____ _____ _____ _____ _____
_____________________________________________
__________________________ZIP CODE +4:__________________
APPLICATION is hereby made for an extension of time to file the employer’s return and reconciliation of Hawaii income tax withheld
from wages (FORM HW-3).
a. For calendar year ending December 31, 20______
b. An extension is requested until ( No more than 2 months. See Instructions below. )
________/ _______/ _______
MO
DAY
YR
c. This extension is necessary for the following reasons (See Instructions below):
___________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________
d. ADDITIONAL TAXES DUE. (If no payment is due, enter “0”.) Attach your check or money order payable to
$
“HAWAII STATE TAX COLLECTOR” in U.S. dollars drawn on any U.S. Bank AND Form VP-1 to Form HW-26.
Write “HW-26”, the tax year, and your Hawaii withholding I.D. No. on your check or money order. ....................
DECLARATION
I declare under the penalties set forth in section 231-36, HRS, that the statements contained herein are true and correct, prepared in accordance with the withholding
provisions of the Hawaii Income Tax Law and the rules issued thereunder.
SIGNATURE OF TAXPAYER OR AUTHORIZED AGENT WITH POWER OF ATTORNEY
DATE
INSTRUCTIONS FOR PREPARATION OF THIS FORM
NOTE: This form may be electronically filed (e-filed) with the Department of Taxation. For more information, go to
1. Extensions will only be granted for periods of 2 months or less.
2. Extensions will only be granted for a good reason (e.g., hospitalization of taxpayer). A full explanation of the reasons you need an extension
must be given.
3. This extension of time to file is NOT AN EXTENSION OF TIME TO PAY. If additional income taxes withheld are due for the year, write the
amount due on line d. Your check or money order for the entire amount, payable to “HAWAII STATE TAX COLLECTOR” in U.S. dollars drawn
on any U.S. bank and Form VP-1, Tax Payment Voucher, must be attached to this form.
4. Submit the completed form to the taxation district with which you are registered ON OR BEFORE THE LAST DAY OF FEBRUARY,
FOLLOWING THE CLOSE OF THE CALENDAR YEAR. Where the business terminates or permanently stops paying wages, the completed
form must be submitted on or before the due date of your final periodic withholding tax return (FORM HW-14). Applications for extensions filed
after the applicable date will not be granted.
5. IMPORTANT — Approved applications for extensions are ONLY valid if all monthly or quarterly periodic returns (FORM HW-14) for the year
have been filed.
6. IMPORTANT— The total period for which extensions will be granted cannot exceed two (2) months.
THIS SPACE FOR DATE RECEIVED STAMP
MAILING ADDRESSES
(Please direct all inquiries and correspondence to the district office with which
you are registered.)
OAHU DISTRICT OFFICE
HAWAII DISTRICT OFFICE
P.O. Box 3827
P.O. Box 937
Honolulu, HI 96812-3827
Hilo, HI 96721-0937
Telephone: 808-587-4242
Telephone: 1-800-222-3229
Toll Free: 1-800-222-3229
MAUI DISTRICT OFFICE
KAUAI DISTRICT OFFICE
P.O. Box 923
P.O. Box 1686
Wailuku, HI 96793-0923
Lihue, HI 96766-5686
34
Telephone: 1-800-222-3229
Telephone: 1-800-222-3229
FORM HW-26

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