Form N-101a - Application For Automatic Extension Of Time To File Hawaii Individual Income Tax Return - 2012 Page 2

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FORM N-101A
(REV. 2012)
PAGE 2
extend the time to pay taxes. If you do not pay the amount due by the
You may use the worksheet below to determine the amount of your
prescribed due date, you will owe interest. You may also be charged
income tax balance due.
10. How to Claim Credit for Payment Made With This Form.—
penalties.
7. Penalties.—Late Filing of Return – The penalty for failure to file a
Show the amount paid with this form on Form N-11, N-13, or N-15;
return on time is assessed on the tax due at a rate of 5% per month, or
line 40, 29, or 56 respectively.
part of a month, up to a maximum of 25%.
If you and your spouse file a joint Form N-101A for 2012 but do not
Failure to Pay Tax After Filing Timely Return – The penalty for failure
file a joint income tax return for 2012, you may claim the total automatic
to pay the tax after filing a timely return is 20% of the tax unpaid within
extension tax payment on your separate return or on your spouse’s
60 days of the prescribed due date. The 60-day period is calculated
separate return or you may divide it in any agreed amounts. Be sure
beginning with the prescribed due date even if the prescribed due date
to enter the social security numbers (or ITINs) of both spouses on the
falls on a Saturday, Sunday, or legal holiday.
separate Form N-11, N-13, or N-15 return.
8. Interest.—Interest at the rate of 2/3 of 1% per month or part of a
If you and your spouse file separate Forms N-101A for 2012 and you file
month shall be assessed on unpaid taxes and penalties beginning with
a joint income tax return for 2012, enter on Form N-11, N-13, or N-15; line
the first calendar day after the date prescribed for payment, whether or
40, 29, or 56 respectively, the sum of the amounts paid on the separate
not that first calendar day falls on a Saturday, Sunday, or legal holiday.
Forms N-101A. Also enter the social security numbers (or ITINs) of both
9.
How to Complete Form.––Print your name, address, and
spouses in the spaces on Form N-11, N-13, or N-15.
social security number in the space provided. If you are filing a joint
Line-by-Line Instructions for Worksheet
return, print your spouse’s name and social security number in the
space provided. If you have a foreign address, enter the complete
Line 1.—Enter the amount of income tax you expect to owe for 2012.
country name in the space provided. If you are an alien and were
If you do not expect to owe tax, enter zero (0). Be sure to estimate the
issued an individual taxpayer identification number (ITIN) by the
amount correctly. If you underestimate this amount, you may be charged
IRS, enter your ITIN. If you applied for an ITIN but the IRS has not
a penalty as explained earlier under Penalties.
yet issued the ITIN, write “ITIN Applied For” in the space above the
Line 4.—Enter other payments and credits that you expect to show on
box where you enter your name.
Form N-11, N-13, or N-15.
Print the date your tax year ends and the amount of your payment.
Line 6.—Round the amount to the nearest dollar. You must pay the
Detach the voucher where indicated. Submit only the voucher portion
amount shown on line 6. An extension of time to file your income tax return
of this form with your payment.
does not extend the time to pay your income tax. Also, any payment made
Make your check or money order payable in U.S. dollars to “Hawaii State
with this extension does not exempt you from the penalty assessed for
Tax Collector” and attach it to the front of Form N-101A. Make sure your
underpaying estimated taxes for 2012.
name and address appear on your check or money order. Please write
your social security number, daytime phone number, and “2012 Form
N-101A” on it. Do not send cash.
WORKSHEET
1 Total income tax liability on your income tax return
for 2012 (You may estimate this amount) ........................................1
Note: You must enter an amount on line 1.
If you do not expect to owe tax, enter zero (0)
2 Hawaii income tax withheld .............................................................2
3 2012 estimated tax payments (include 2011
overpayment allowed as a credit) ....................................................3
4 Other payments (see Instructions) ..................................................4
5 Total (add lines 2, 3, and 4) .............................................................5
6 Income tax balance due (line 1 minus line 5). (Whole dollars only) ........................6

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