Form 504e - Maryland Application For Extension To File Fiduciary Income Tax Return - 2012
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1
2MARYLAND APPLICATION FOR
2012
FORM
504E
EXTENSION TO FILE
FIDUCIARY INCOME TAX
RETURN
OR FISCAL YEAR BEGINNING
2012, ENDING
Federal employer identification number (9 digits)
Name of estate or trust
Name and title of fiduciary
Number and street
For Office Use Only
EC
ME
YE
EC
City or town
State
ZIP code
Tax Payment Worksheet
1. Total income tax liability for 2012 (You may estimate this amount) . . . . . . . . . . . . . . . . . . . . . . . . 1.
Note: You must enter an amount on line 1. If you do not expect to owe tax, enter zero (0).
2. Maryland income tax withheld. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2.
3. 2012 estimated tax payments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3.
4. Other payments and credits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
4.
5. Add lines 2, 3 and 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5.
6. Income tax balance due (Subtract line 5 from line 1).
If line 5 is more than line 1, enter zero (0). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6.
$
TAX PAID WITH THIS EXTENSION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Make checks payable to and mail to:
COMPTROLLER OF MARYLAND
REVENUE ADMINISTRATION DIVISION
110 Carroll Street
Annapolis, Maryland 21411-0001
(Write federal employer identification number on check)
COM/RAD-056
12-49
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