Form Ri-4768 - Application For Automatic 6 Month Extension Of Time To File Rhode Island Estate Tax

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RI-4768
Application for Automatic 6 Month Extension of Time to File Rhode Island Estate Tax
Date of death
Decedent’s first name and middle initial
Decedent’s last name
NAME AND
ADDRESS
Name of executor
Name of application filer (if other than the executor)
Decedent’s social security number
Form Type
Address of executor
Estate tax return due date
RI-100
RI-100A
City, town or post office
State
ZIP code
Domicile of decedent (town, state and zip code)
Daytime telephone number
PAYMENT TO ACCOMPANY EXTENSION REQUEST
1.
Amount of Rhode Island estate taxes estimated to be due...................................................................................................
1.
2.
Amount enclosed with application .........................................................................................................................................
2.
ADDITIONAL EXTENSION
Requested Extension Date
If you are an executor out of the country applying for an extension of time to file in excess of 6 months, check here and
enter requested extension date. Also, you must attach a statement explaining in detail why it is impossible or impractical
to file Form RI-100 or RI-100A by the due date.
SIGNATURE AND VERIFICATION
If filed by executor: Under penalties of perjury, I declare that I am an executor of the estate of the above-named decedent and that to the best of my
knowledge and belief, the statements made herein and attached are true and correct.
Executor’s signature
Date
Title
If filed by someone other than the executor: Under penalties of perjury, I declare that to the best of my knowledge and belief, the statements made
herein and attached are true and correct, that I am authorized by an executor to file this application, and that I am:
(Check applicable box(es))
A member in good standing of the bar of the highest court of (specify jurisdiction) _________________________________
A certified public accountant duly qualified to practice in (specify jurisdiction) ______________________________
A licensed public accountant in (specify jurisdiction) ______________________________
A person actively enrolled to practice before the Internal Revenue Service.
A duly authorized agent holding a power of attorney. (Unless requested, the power of attorney does not need to be submitted.)
Filer’s signature (other than the executor)
Date
Filer’s name - please print
Filer’s phone number
Filer’s address
City or town
State
ZIP code
A DEATH CERTIFICATE MUST BE ATTACHED TO FORM RI-4768
WHEN REQUESTING AN EXTENSION.
RI-4768
11/27/2012

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