2011 Application for Extension of Time to File

              Application for Extension of Time
to File an Oklahoma Income Tax Return Worksheet
Oklahoma Income Tax Computation
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1. Total income tax liability (you may estimate this amount)..........................................
Note: You must enter an amount on line 1. If you do not expect to owe tax, enter zero.
2. Oklahoma income tax withheld................................................
3. Estimated tax payments (include prior year overpayment
allowed as a credit)..................................................................
4. Other payments and credits you expect to claim
on your return..........................................................................
5. Add lines 2, 3 and 4...................................................................................................
6. Income tax balance due (subtract line 5 from line 1).................................................
7. Amount you are paying. (Enter here and on the coupon above)............................
Important: Extension is valid only if 90% of the tax liability is paid by the original due date
This is NOT an extension of time for payment of tax!!
The bottom portion of this form is a worksheet to compute your payment. Please retain for your
records. Enter the total from line 7 of the worksheet on the coupon above. Return the top portion
with your payment, if applicable.
INDIVIDUALS: Your first name, middle initial and last name
Present address (number and street, including apartment number or rural route)
City, State and Zip
Your Social
Security Number:
CORPORATIONS: Corporate, Partnership, Trust or Estate Name
Important: Extension is valid only if 90% of the tax liability is paid by the original due date.
An Extension of Time to File with the IRS has been granted to: DATE ________________________
Extension of Time to File with the Okla. Tax Commission is requested to: DATE ________________________
FORM
2011
504
ITE
Signature Under penalty of perjury, I declare the information contained in this document, attachments and schedules are true and
correct to the best of my knowledge and belief.
Spouse’s Signature (if filing jointly, BOTH must sign even if only one had income) Date
Your Signature (* If corporation, partnership, estate, or trust, see below) Date Paid Preparer’s Signature
For the year January 1 - December 31, or other taxable year beginning , ending , .
Federal
Employer
Identification
Number:
Application for Extension
of Time to File an Oklahoma Income Tax Return
If requesting a total of more than 6 months for corporations or more than 5 months for partnerships, estates or trusts,
please state reason here: _________________________________________________________________________
$
Date
Amount you are
paying: (from line 7).
 
* If corporation, partnership, estate, or trust (officer, partner, member or fiduciary signature is required)
(This is NOT an extension of time for payment of tax)
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2011
INDIVIDUALS: If joint return, spouse’s first name, middle initial and last name
CORPORATIONS, PARTNERSHIPS, TRUSTS, ESTATES:
Spouse’s Social
Security Number:
#1695#