Form Fr-128 - Extension Of Time To File A Dc Franchise Or Partnership Return Worksheet - 2011

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FR-128 Extension of Time to File a DC Franchise or Partnership Return
Worksheet
ENTER DOLLAR AMOUNTS ONLY
$
.00
1 Total estimated franchise tax liability for the tax period.
1
$
.00
2 Estimated franchise tax payments
2
(include any tax overpayment credit).
$
.00
3 Other payments.
3
$
.00
4 Total payments and credits
4
(add Lines 2 and 3).
$
.00
5
5 Balance due
(Line 1 minus Line 4). Payment in full must be submitted with this
form or your request will be denied. (Note: you will be subject to the failure-to-pay
penalty and interest on any tax due and not paid with this form.)
Detach at perforation and mail the voucher, with payment attached, to the Office of Tax and Revenue, PO Box 679, Washington, DC 20044-0679.
l
2011
FR-128 Extension of Time
Government of the
*111280110002*
District of Columbia
to File a DC Franchise
This is a FILL-IN format. Please do not handwrite
or Partnership Return
any data on this form other than your signature.
Federal Employer I.D. Number
Social Security Number (if self-employed)
OFFICIAL USE ONLY
Vendor ID# 0002
Business Name
Tax period ending MMYY
Business mailing address
City
State
Zip Code +4
A 6-month extension of time to file until _________ 15,
2012, for calendar year 2011, or until ____________, ________, for fiscal year ending ___________,
is requested for the following return:
$
.00
Payment submitted with this form
(fill in one):
D-20
D-30
D-65
l
l
2011 FR-128 P1
Revised 08/11
Extension of Time to File a DC Franchise or Partnership Return
l
2011
FR-128 Extension of Time
Government of the
*111280110002*
District of Columbia
to File a DC Franchise
This is a FILL-IN format. Please do not handwrite
or Partnership Return
any data on this form other than your signature.
Federal Employer I.D. Number
Social Security Number (if self-employed)
OFFICIAL USE ONLY
Vendor ID# 0002
Business Name
Tax period ending MMYY
Business mailing address
City
State
Zip Code +4
A 6-month extension of time to file until _________ 15, 2012, for calendar year 2011, or until ____________, ________, for fiscal year ending ___________,
is requested for the following return:
$
.00
Payment submitted with this form
(fill in one):
D-20
D-30
D-65
l
l
2011 FR-128 P1
Revised 08/11
Extension of Time to File a DC Franchise or Partnership Return

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