Forsyth County Tax Administration Extension Request

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JOHN BURGISS, RES
MICHAEL D. POLLOCK
Assessor / Collector
Deputy Assessor/Collector
ASSESSOR’S OFFICE
COLLECTOR’S OFFICE
(336) 703-2300
(336) 703-2300
FAX: (336) 727-2369
FAX: (336) 727-2369
PO Box 757
PO Box 82
Winston-Salem, NC 27102
Winston-Salem, NC 27102
FORSYTH COUNTY TAX ADMINISTRATION
EXTENSION REQUEST
NAME: _________________________________________________________
ABSTRACT NUMBER: _________________________________________________
(Abstract number appears on your business personal property listing form in the upper left hand
corner)
Please complete the following:
NAME: _______________________________________________________________________
MAILING ADDRESS:
_____________________________________________________________________________
_____________________________________________________________________________
PHYSICAL BUSINESS ADDRESS IN FORSYTH COUNTY:
_____________________________________________________________________________
_____________________________________________________________________________
If this request is for more than one account, please attach a list of business
names, addresses and account numbers for each account for which an
extension is requested.
Reason for requesting an extension: ________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
North Carolina General Statute 105-307 states that an extension may be granted “for good cause
shown”. Extensions cannot be granted beyond April 15.
EXTENSION DATE REQUESTED: ____________________________________
This form must be completed and submitted within the regular listing period in order for the filing
date to be extended.
EXTENSION REQUESTED BY: __________________________________________________
TITLE:_______________________________________________________________________
DATE: ____________________ PHONE:___________________________________________
Mail: P O Box 757 Winston-Salem, NC 27102
Email: Businesslistinghelp@forsyth.cc

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