Share4868 Order Form Application for Automatic Extension of Time To File Individual Income Tax Return HiddenOrder Number Part I: Identification1. Your First Name(Required) Your Last Name(Required) Email(Required) State(Required)-- Select One State --AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingAddress(Required) Street Address City ZIP Code 2. Your social security number or ITIN number(Required) 3. Spouse's social security number or ITIN number Part II: Individual Income Tax4. Estimate of total tax liability5. Total year's payments6. Balance Due. Substract line 5 from line 47. Amount you're paying8. If you're "out of the country" and a U.S. citizen or resident, Check here 9. If you file Form 1040-NR and didn't receive wages as an employee subject to U.S. income tax withholding Check here PhoneThis field is for validation purposes and should be left unchanged. Δ
