Form 7004 Application for Automatic Extension of Time to File Cert

Form

7004

Application for Automatic Extension of Time To File Certain
Business Income Tax, Information, and Other Returns

(Rev. December 2012)

Department of the Treasury
Internal Revenue Service

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Identifying number

Name

Print
or
Type

OMB No. 1545-0233

File a separate application for each return.
Information about Form 7004 and its separate instructions is at www.irs.gov/form7004.
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Number, street, and room or suite no. (If P.O. box, see instructions.)

City, town, state, and ZIP code (If a foreign address, enter city, province or state, and country (follow the country’s practice for entering
postal code)).

Note. File request for extension by the due date of the return for which the extension is granted. See instructions before completing this form.
Part I
Automatic 5-Month Extension
1a Enter the form code for the return that this application is for (see below) .
Application
Form
Application
Is For:
Code
Is For:
09
31

Form 1065
Form 8804

Part II

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Form
Code
04
05

Form 1041 (estate other than a bankruptcy estate)
Form 1041 (trust)

Automatic 6-Month Extension

b Enter the form code for the return that this application is for (see below) .
Application
Form
Application
Is For:
Code
Is For:
01
02
03
06
07
08
10
11
12
34
15
16
17
18
19

Form 706-GS(D)
Form 706-GS(T)
Form 1041 (bankruptcy estate only)
Form 1041-N
Form 1041-QFT
Form 1042
Form 1065-B
Form 1066
Form 1120
Form 1120-C
Form 1120-F
Form 1120-FSC
Form 1120-H
Form 1120-L
Form 1120-ND
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Form
Code
20
21
22
23
24
25
26
27
28
29
30
32
33
35
36

Form 1120-ND (section 4951 taxes)
Form 1120-PC
Form 1120-POL
Form 1120-REIT
Form 1120-RIC
Form 1120S
Form 1120-SF
Form 3520-A
Form 8612
Form 8613
Form 8725
Form 8831
Form 8876
Form 8924
Form 8928

If the organization is a foreign corporation that does not have an office or place of business in the United States,
check here . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ▶
If the organization is a corporation and is the common parent of a group that intends to file a consolidated return,
check here . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ▶
If checked, attach a statement, listing the name, address, and Employer Identification Number (EIN) for each member
covered by this application.

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Part III
4
5a

All Filers Must Complete This Part

If the organization is a corporation or partnership that qualifies under Regulations section 1.6081-5, check here .
The application is for calendar year 20 , or tax year beginning
, 20
, and ending

b Short tax year. If this tax year is less than 12 months, check the reason:
Change in accounting period
Consolidated return to be filed
Tentative total tax .

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6

7

Total payments and credits (see instructions) .

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7

8

Balance due. Subtract line 7 from line 6 (see instructions) .

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For Privacy Act and Paperwork Reduction Act Notice, see separate Instructions.

, 20

Initial return
Final return
Other (see instructions-attach explanation)

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Cat. No. 13804A

Form 7004 (Rev. 12-2012)