Form 355-7004 - Corporate Extension Worksheet - 2012

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Rev. 10/02
Massachusetts
Form 355-7004
Department of
Corporate Extension Worksheet
Revenue
Tentative Return
1 Estimated amount of tax for the taxable year (must be at least minimum tax) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
2 Advance and/or estimated payments made (if any) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
3 Tax due with this application. Subtract line 2 from line 1. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Payment in full of the tax due must be made with the extension request for it to be considered valid. If at least 50% of the tax due or the minimum tax (whichever
is greater) for the taxable year is not paid, the extension is null and void. Penalties for a late return will be assessed from the original due date of the return.
General Information
Who May File Form 355-7004?
How Long Is the Period of Extension?
All domestic and foreign business, manufacturing or security cor-
An automatic six-month extension is granted upon the proper filing
porations eligible to file Forms 355, 355U, 355S, 355SC or 355SBC
of this form. An extension for a period longer than six-months
may use this application to request either an automatic six-month
may be granted if good cause exists; it requires the written approval
extension of time to file their return or an extension of time to file for
of the Commissioner before it becomes effective. The Commissioner
more than six-months. Taxpayers filing Form 355U must file this form
may terminate this extension at any time by mailing a notice of termi-
electronically. Corporations that file corporate returns other than those
nation to the corporation or to the person who requested the exten-
listed, such as insurance companies, financial institutions, public utili-
sion for the corporation. The notice will be mailed at least 10 days
ties, urban redevelopment companies, etc., must use Form 355-7004
prior to the termination date designated in the notice.
Misc. Form 355-7004 also acts as the required tentative return.
Who May Sign?
When Should Form 355-7004 Be Filed?
Form 355-7004 must be signed by the treasurer or assistant trea-
This application must be filed on or before the 15th day of the third
surer of the corporation or by a person authorized by the corpora-
month after the close of the taxable year, calendar or fiscal.
tion to do so. An application signed by an unauthorized person will
be considered null and void. If a return is filed after the original due
Must a Payment Be Submitted with This Form?
date based on a void extension, interest and penalties will be as-
Yes. The full payment of tax reasonably estimated to be due must
sessed back to the original due date.
accompany this form. If at least 50% of the tax due or the minimum
Keep this worksheet with your records. Do not submit it with Form
tax (whichever is greater) for the taxable year is not paid, the exten-
355-7004. Mail the completed application to: Massachusetts De-
sion is null and void. If filing Form 355U, payments may be allocated
partment of Revenue, PO Box 7025, Boston, MA 02204.
to subsidiaries when Schedule CG is filed.
Note: Under certain circumstances, if a payment is not required to
Will Interest and Penalties Be Due?
be submitted with the extension request, the requirement to file the
An extension of time to file a corporation tax return does not extend
extension may be waived. For further information, see TIR 06-21.
the due date for payment of the tax. Interest will be charged on any
tax not paid on or before the original due date. Any tax not paid within
Corporations with $100,000 or more in receipts or sales must submit
the extended period is subject to a penalty of 1% per month, up to a
their extension request, as well as any accompanying payment, elec-
maximum of 25%, from the extended due date.
tronically. Also, any corporation making an extension payment of
$5,000 or more must make the payment using electronic means. For
further information, see TIR 04-30.
DETACH HERE
Massachusetts
Form 355-7004
Application for Corporate Extension — 2012
Department of Revenue
Federal Identification number
Is the corporation incorporated in Massachusetts?
Period end date
Amount enclosed
Yes
No
Business name
Type of extension being applied for
a. Automatic six-month
b. Extension until:
Mailing address
City/Town
State
Zip
Sign here. Under penalties of perjury, I declare that to the best of my knowledge and belief this return and enclosures are true, correct and complete.
Signature of officer or agent
Signature of paid preparer
Date
Employer Identification number of paid preparer
Social Security number or PTIN of paid preparer
2012 0167 104

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