Arizona Application for Filing Extension

Application for Filing Extension
Arizona Form 204
DO NOT STAPLE ANY ITEMS TO THE RETURN.

Arizona Form

204

Application for Filing Extension
For Individual Returns Only

FOR
CALENDAR YEAR

2023

For the calendar year 2023 or fiscal year beginning M M D D 2 0 2 3 and ending M M D D 2 0 Y Y .

1
1
2
3
94

Your First Name and Middle Initial

Last Name

Spouse’s First Name and Middle Initial (if filing joint)

Last Name

Current Home Address - number and street, rural route
City, Town or Post Office

Apt. No.
State

ZIP Code

Enter
your
SSN(s).

66

Your Social Security Number

Spouse’s Social Security No.

95. Filing Status. Must be the same as Form 140, 140A, 140EZ, 140 PTC, 140ET, 140NR, 140PY
95a
Married filing joint return
95c
Head of Household
95b
Married filing separate return 95d
Single

REVENUE USE ONLY. DO NOT MARK IN THIS AREA.

88

Your Daytime Phone (with area code):

Resident Personal Income Tax Forms – Check only one box:

	140	
	140A	 	140EZ	 	140PTC	 	140ET
	Part-Year Resident Personal Income Tax, Form 140PY
	Nonresident Personal Income Tax, Form 140NR
	Nonresident Composite, Form 140NR

81 PM

80 RCVD

Filing Form 204 will also provide an automatic 6-month extension for your Small Business
Income tax return (Form 140-SBI, Form 140NR-SBI or Form 140PY-SBI). Do not file Form
204-SBI unless you are making an extension payment for your Small Business tax return.
See Form 204-SBI for more information. Use Form 204-SBI to make this payment.

All extension requests must be postmarked on or before
the original due date of the return, unless the original due
date falls on a weekend or legal holiday. In that case, your
request must be postmarked on or before the business
day following the weekend or legal holiday. If you are a
calendar year filer, your request for a 2023 filing extension
must be postmarked on or before April 15, 2024.

An Arizona extension cannot be granted for more than
six months beyond the original due date of the return.
Arizona will grant an automatic six-month extension to
individuals filing Forms 140, 140A, 140EZ, 140NR, 140PY,
140PTC, or 140ET. Arizona will accept a valid federal
extension for the period covered by the federal extension.
This includes the automatic six‑month individual federal
filing extension.

Fiscal Tax Year Ending
Return Due Date
CHECK ONE BOX:
 Individual Calendar Year Filers:
This is a request for an automatic 6-month filing extension...................................
October 15, 2024

 Individual Fiscal Year Filers:

Enter taxable year end date and 6-month extended due date...............................

 A federal extension will be used to file this tax return.

MM D D Y Y Y Y MM D D Y Y Y Y

This form is being used to transmit the Arizona extension payment.

	1	 Tax liability for 2023. You may estimate this amount....................................................................................... 	 1
00
	2	 Arizona income tax withheld during 2023.......................................................................	 2
00
	3	 Arizona estimated tax payments for 2023......................................................................	 3
00
	4	 Credits you will claim on your 2023 return. See Arizona Form 301 for a list of credits..	 4
00
	5	 Add lines 2 through 4........................................................................................................................................ 	 5
00
	6	 Balance of Tax: Subtract line 5 from line 1..................................................................................................... 	 6
00
	7	 Enter amount of payment enclosed with this extension.......................................... PAYMENT ENCLOSED 	 7
00
	 •	 Make check payable to Arizona Department of Revenue; write your SSN, Form 204 and tax year on your payment.
	•	
Include your payment with this form.
	•	
For Nonresident Composite returns, write “Composite 140NR” on payment and include the taxable year end and entity’s EIN.
•	 IMPORTANT: If you are filing under a federal extension but are making an Arizona extension payment by credit card
or electronic payment, do not mail Form 204 to us. We will apply your extension tax payment to your account.
•	 If you are sending a payment with this request, mail to Arizona Department of Revenue,
PO Box 29085, Phoenix, AZ 85038-9085.
•	 If you are not sending a payment with this request, mail to Arizona Department of Revenue,
PO Box 52138, Phoenix, AZ 85072-2138.
ADOR 10576 (23)

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