Form 1041me-Ext - Extension Payment Voucher For Fiduciary Income Tax - 2012
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1STATE OF MAINE
2012
99
EXTENSION PAYMENT VOUCHER
1041ME-EXT
for FIDUCIARY INCOME TAX
*1109600*
Pay electronically using Maine EZ Pay at and eliminate the
need to fi le 1041ME-EXT or mail this completed form to make your extension payment.
NAME OF ESTATE OR TRUST
ESTATE/TRUST EIN
NAME AND TITLE OF FIDUCIARY OR TRUSTEE
FIDUCIARY SSN OR EIN (do not enter / or -)
ADDRESS OF FIDUCIARY (NUMBER and STREET)
.00
CITY
STATE
ZIP CODE
AMOUNT OF PAYMENT
Mail with check or money order payable to “TREASURER, STATE OF MAINE” to:
Maine Revenue Services, P.O. Box 9101, Augusta, ME 04332-9101.
DO NOT STAPLE OR TAPE CHECK TO YOUR FORM. DO NOT CUT FORM. DO NOT SEND PHOTOCOPIES OF FORMS.
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