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Form 225 - Application For Extension Of Time To File Large Passenger Vessel (Lpv) Gaming Tax Return

225

Alaska

Application for Extension of Time to File Large

Passenger Vessel (LPV) Gaming Tax Return

This application must be filed no later than the April 15 due date of the return.

Calendar Year

Telephone Number

EIN

SSN

Taxpayer Name

Fax

Mailing Address

City

State

Zip Code

Country (other than U.S.)

Note: This application for extension is valid for up to six months. Your return is due no later than October 15.

This application is not an extension to pay your taxes. Your tax payment is due April 15. A failure to pay

penalty will be assessed if payment is not made by April 15. The penalty is 5% for each 30-day period or

fraction of the period your payment is late, up to a maximum of 25%.

Signature

Print name

Date

The person making this application on behalf of the named business is :

The owner or partner

An officer of the corporation

An agent for the business

Estimated payment included with extension

Amount ______________________________

File your estimated payment online at https://myalaska.state.ak.us/OTIS

If your total payment exceeds $150,000 you are required to pay electronically or by wire transfer.

Check if you are remitting by

OTIS receipt number ________________________

Wire transfer date ________________________

Pay online at

or make check payable to State of Alaska

225

Mail to: Alaska Department of Revenue, PO Box 110420, Juneau AK 99811-0420

0405-225 Rev 10/12

Form 225 - Application For Extension Of Time To File Large Passenger Vessel (Lpv) Gaming Tax Return