Arizona Application for Automatic Extension of Time to File Corporation, Partnership, and Exempt Organization Returns

Application for Automatic Extension of Time to File  Corporation, Partnership, and Exempt Organization Returns
Arizona Form 120/165EXT
Arizona Form

Application for Automatic Extension of Time to File
Corporation, Partnership, and Exempt Organization Returns

120/165EXT

2023

S Corporations and Partnerships: Use Form 204 to request an extension of time to file a composite return on Form 140NR for
nonresident individual shareholders or nonresident individual partners.

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 .

 Check this box if this return is based on a 52/53 week taxable year.

Name

Employer Identification Number (EIN)

Address – number and street or PO Box

Business Telephone Number (with area code)

City, Town or Post Office

State

A

	

Check if this is the first tax return filed under this name and EIN.

B

	

Check if name and/or address has changed.

C

	

Check if EIN has changed. Enter prior EIN:

Check type of return to be filed:
 120A	
 99T	

 120	

 99M	

ZIP Code

REVENUE USE ONLY. DO NOT MARK IN THIS AREA.

88

81 PM

 120S	

All applications for an extension of time to file must be
postmarked on or before the original due date of the
return, unless the original due date falls on Saturday, Sunday, or
a legal holiday. In that case, the application must be postmarked
on or before the business day following such Saturday, Sunday,
or legal holiday.

66 RCVD

 165
An Arizona extension for a C corporation cannot be granted for
more than seven months beyond the original due date of the return.
An Arizona extension for a partnership or S Corporation cannot be
granted for more than six months beyond the original due date of
the return. Arizona will accept a valid federal extension for the
same period of time covered by the Arizona extension.

CHECK ONE BOX
Extension Date
Taxable Year Ending
Form
120,
Form
120A,
Form
99T,
or
Form
99M:

This is a request for an automatic seven-month extension until.........................
MM D D Y Y Y Y MM D D Y Y Y Y
 Form 120S, or Form 165:
This is a request for an automatic six-month extension until...............................
MM D D Y Y Y Y MM D D Y Y Y Y
 A federal extension will be used to file this tax return. See instructions if this form is being used to transmit the Arizona extension
payment.
EXTENSION PAYMENT COMPUTATION
1	
2	
3	
4	
5	
	
	
	

Forms 120, 120A, 120S, 99T, or 165 (for partnerships that elected to pay tax at the entity level)

Tax liability for the taxable year: See instructions................................................................................................	
Less estimated tax payments.........................................................................................................................	
Balance of Tax: Subtract line 2 from line 1. Enter the difference.................................................................	
Enter amount of extension payment made electronically. See instructions..........................................................	
Enter amount of payment enclosed with this extension. See instructions.................. PAYMENT ENCLOSED 	
•	 Make check payable to Arizona Department of Revenue and include EIN on payment.
•	 Mail application and payment to:
Arizona Department of Revenue, PO Box 29085, Phoenix, AZ 85038-9085.
•	 Mail application without payment to:
Arizona Department of Revenue, PO Box 29079, Phoenix, AZ 85038-9079.

The taxpayer will be liable for the extension underpayment
penalty if at least 90 percent of the tax liability disclosed by
the return has not been paid by the original due date of the
return.
Taxpayers subject to the extension underpayment
penalty are not subject to the late payment penalty prescribed by
Declaration

Please
Sign

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2	00
3	00
4	00
5	00

A.R.S. § 42‑1125(D).
Interest accrues on any additional
tax due from the original due date of the return until paid.
Taxpayers that have a tax liability of $500 or more for tax
year 2023 must make tax payments by electronic funds
transfer.

Under penalties of perjury, I declare that I have examined this form, including accompanying schedules and statements, and to the
best of my knowledge and belief, it is true, correct, and complete; and that I am authorized to prepare this form.

SIGNATURE OF OFFICER OR AGENT

DATE

TITLE

PRINTED NAME

BUSINESS PHONE (with area code)

Here
ADOR 10340 (23)

Print

AGENT’S TIN