Form N-101a - Application For Automatic Extension Of Time To File Hawaii Individual Income Tax Return - 2012

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STATE OF HAWAII –– DEPARTMENT OF TAXATION
FORM
APPLICATION FOR AUTOMATIC EXTENSION
N-101A
OF TIME TO FILE HAWAII INDIVIDUAL INCOME TAX RETURN
(REV. 2012)
2012
(NOTE: References to “married”, “unmarried”, and “spouse” also means
“in a civil union”, “not in a civil union”, and “civil union partner”, respectively.)
About this Form
If you must make an additional payment of tax on or before April 20,
2013 in order to meet the condition requiring payment of 100% of the
The Form N-101A has been redesigned for electronic scanning that
properly estimated tax liability, you must file Form N-101A with your
permits faster processing with fewer errors. In order to avoid unnecessary
payment.
delays caused by manual processing, taxpayers should follow the
Internet Filing—Form N-101A can be filed and payment made
guidelines listed below:
electronically through the State’s Internet portal. For more information, go
1. Print amounts only on those lines that are applicable.
to
2. Use only a black or dark blue ink pen. Do not use red ink,
1. Purpose of Form N-101A.—Use this form if you are making a tax
pencil, or felt tip pens.
payment toward the balance due with the filing of Form N-11, N-13, or
N-15.
3. Because this form is read by a machine, please print your
You are not required to sign Form N-101A.
numbers inside the boxes like this:
Federal Form 4868, Application for Automatic Extension of Time To
1 2 3 4 5 6 7 8 . 9 0
File U.S. Individual Income Tax Return, may not be used in lieu of Form
N-101A.
4. Do NOT print outside the boxes.
2. How to Obtain Tax Forms.—To request tax forms and publications
by mail, you may call 808-587-4242 or toll-free 1-800-222-3229.
5. Do NOT use dollar signs, commas, slashes, dashes or
Tax forms are also available on the Internet. The Department of
parenthesis in the boxes.
Taxation’s site on the Internet is:
6. Photocopying of this form could cause delays in processing
3. When to File.—File Form N-101A by April 20, 2013. If you are filing
your payment.
a fiscal year return, file Form N-101A by the due date of Form N-11, N-13,
or N-15. If the due date falls on a Saturday, Sunday or legal holiday, file
General Instructions
by the next regular workday.
You are not required to file Form N-101A (or any other form) to request
The due date is normally April 20 for calendar year taxpayers and the
an automatic 6-month extension of time to file Form N-11, N-13, or N-15.
twentieth day of the fourth month following the close of the taxable year
The 6-month extensions are automatically granted unless an additional
for fiscal year taxpayers.
tax payment must be made. As long as the following conditions are met,
You may file Form N-11, N-13, or N-15 any time before the 6-month
you are deemed to have made an application for the 6-month extension
period ends.
to file an income tax return on the prescribed due date:
4. Where to File.—This form must be submitted to:
• On or before April 20, 2013, 100% of the properly estimated
tax liability is paid;
Hawaii Department of Taxation
• The tax return is filed on or before the expiration of the
P.O. Box 1530
Honolulu, Hawaii 96806-1530
6-month extension period;
• The tax return is accompanied by full payment of any tax not
5. Where to Call for Information.—You may obtain information by
calling the following:
already paid; and
• You are not bound by a court order to file a tax return on or
Telephone
before the prescribed due date.
808-587-4242
or 1-800-222-3229
Properly estimated tax liability means the taxpayer made a bona fide
Telephone for the hearing impaired
and reasonable attempt at the time the extension was submitted to locate
808-587-1418
and gather all of the necessary information to make a proper estimate
or 1-800-887-8974
of tax liability for the taxable year. Individuals not filing Form N-101A are
deemed to have submitted the extension on April 20 for purpose of this
6. Filing Your Tax Return.—You may file your tax return any time
condition.
before the extension expires. But remember, Form N-101A does not
DETACH HERE
Form
Tax Year
(Rev. 2012)
STATE OF HAWAII — DEPARTMENT OF TAXATION
DO NOT WRITE OR STAPLE IN THIS SPACE
N-101A
2012
APPLICATION FOR AUTOMATIC EXTENSION OF TIME TO
FILE HAWAII INDIVIDUAL INCOME TAX RETURN
DO NOT SUBMIT A PHOTOCOPY OF THIS FORM
JGF121
Your Social Security Number
Your first name
M.I.
Last name
If joint return, spouse’s first name
M.I.
Last name
Spouse’s Social Security Number
Present mailing or home address (Number and street, including rural route)
Apartment Number
Tax Year Ending (MM DD YY)
City, town, or post office
State
Postal/ZIP Code
Country
For office use only
Amount of Payment
MAIL THIS VOUCHER WITH CHECK OR MONEY ORDER
PAYABLE TO “HAWAII STATE TAX COLLECTOR.” Write your
social security number, daytime phone number, and “2012
ID NO 01
Form N-101A” on your check or money order.

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