Arizona Form 120ext - Application For Automatic Extension Of Time To File Corporation, Partnership, And Exempt Organization Returns - 2012

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ARIZONA FORM

Application for Automatic Extension of Time to File

120EXT

2012

Corporation, Partnership, and Exempt Organization Returns

M M D D Y Y Y Y

For the

calendar year 2012 or

ﬁ scal year beginning

and ending

Check box if: This is the ﬁ rst tax return ﬁ led under this name and EIN

Name, address, or EIN has changed

If EIN has changed, list prior number

Employer identiﬁ cation number (EIN)

Name

Please

Business telephone number

Type

Number and street or PO Box

City or town, state, and ZIP code

REVENUE USE ONLY. DO NOT MARK IN THIS AREA.

Check type of return to be ﬁ led:

Form 120

Form 120A

Form 120S

Form 99T

Form 99

Form 165

All applications for an extension of time to ﬁ le must be postmarked on or before the

original due date of the return, unless the original due date falls on Saturday, Sunday, or a

legal holiday. In that case, the application must be postmarked on or before the business

day following such Saturday, Sunday, or legal holiday.

S corporations and partnerships: Use Form 204 to request an extension of time to ﬁ le a composite return for nonresident individual

shareholders or nonresident individual partners on Form 140NR.

AN ARIZONA EXTENSION CANNOT BE GRANTED FOR MORE THAN SIX MONTHS BEYOND THE ORIGINAL DUE DATE OF THE RETURN.

ARIZONA WILL ACCEPT A VALID FEDERAL EXTENSION FOR THE SAME PERIOD OF TIME COVERED BY THE FEDERAL EXTENSION. THE

FEDERAL EXTENSION FOR PARTNERSHIPS IS FIVE MONTHS.

Check one:

Form 120, Form 120A, Form 120S, Form 99T, Form 99: This is a request for an automatic six-month extension of time

until

, to ﬁ le the tax return for the taxable year ending

MM DD YYYY

Form 165 only: This is a request for an automatic ﬁ ve-month extension of time until

, to ﬁ le the tax return

MM DD YYYY

for the taxable year ending

MM DD YYYY

A federal extension will be used to ﬁ le this tax return. This form is being used to transmit the Arizona extension payment.

Extension Payment Computation (For Forms 120, 120A, 120S, and 99T only)

1 Amount of tax for the taxable year. See instructions ........................................................................................................

2 Less estimated tax payments ...........................................................................................................................................

3 Balance of tax - line 1 less line 2 ......................................................................................................................................

4 Enter amount of payment enclosed. See instructions ................................................................ PAYMENT ENCLOSED

Make check payable to:

ARIZONA DEPARTMENT OF REVENUE. Include EIN on Payment.

Send application and payment to:

Arizona Department of Revenue, PO Box 29085, Phoenix AZ 85038-9085

Send application without payment to:

Arizona Department of Revenue, PO Box 29079, Phoenix AZ 85038-9079

THE TAXPAYER WILL BE LIABLE FOR THE EXTENSION UNDERPAYMENT PENALTY IF AT LEAST 90 PERCENT OF THE TAX LIABILITY

DISCLOSED BY THE RETURN HAS NOT BEEN PAID BY THE ORIGINAL DUE DATE OF THE RETURN. TAXPAYERS SUBJECT TO THE EXTENSION

UNDERPAYMENT PENALTY ARE NOT SUBJECT TO THE LATE PAYMENT PENALTY PRESCRIBED BY A.R.S. § 42-1125(D). INTEREST ACCRUES

ON ANY ADDITIONAL TAX DUE FROM THE ORIGINAL DUE DATE OF THE RETURN UNTIL PAID.

SIGNATURE AND VERIFICATION