Pennsylvania Application for Extension of Time to File

Application for Extension of Time to File
Application for Extension of Time to File (REV-276)
REV-276
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1603610054

Application for
Extension of Time to File

REV-276 EX (07-16)(FI)

PA DEPARTMENT OF REVENUE

2003
EC

OFFICIAL USE ONLY

Print the first two letters of the last name if for a PA-40. Print the first two letters of the name if a PA-41, PA-40NRC, PA-40NRC-AE or PA-20S/PA-65. If PACHECK DIGIT 40NRC, PA-40NRC-AE or PA-20S/PA-65, enter the entity name starting with
the first box of the “Last, Estate, Trust or Entity Name” and continue until you have used all
the space available (if needed). If you do not have enough space for the name, do not use
the address line. If a PA-41, see “Fiduciary Accounts” in the instructions.

Your Social Security Number

OFFICIAL USE ONLY

FC

DO NOT STAPLE

PA-40, PA-41, PA-40NRC, PA-40NRC-AE, PA-20S/PA-65
APPLICATION FOR EXTENSION OF TIME TO FILE
(See reverse for filing instructions. Be sure to answer all questions.)

PLEASE PRINT OR TYPE ALL INFORMATION

Spouse’s Social Security Number

Federal Employer Identification Number

PLEASE WRITE IN YOUR SOCIAL SECURITY, YOUR SPOUSE’S SOCIAL SECURITY, OR EIN NUMBER ABOVE

Last, Estate, Trust or Entity Name

First Name

MI

Spouse’s Last Name - or Name of Trustee for Estate or Trust

Spouse’s First Name

MI

P. O. Box, Apt. No., Suite, Floor, RR No, etc.

Daytime Telephone Number

Fill in the oval if filing in Pennsylvania for the
first time
First Time PA Filer

TYPE OF RETURN
Fill in the oval for the kind of PA Return you will file
PA-40 Individual Tax Return

PA-40NRC Consolidated Nonresident
Tax Return

PA-40NRC-AE Nonresident Consolidated
Tax Return. Athletes & Entertainers

Street Number and Name

PA-41 Fiduciary Income Tax Return
PA-20S/PA-65

City or Post Office

State

Indicate the taxable year. Fill in the oval.

ZIP Code

MM/YY

Calendar Year
Fiscal Year, beginning

MM/DD/YYYY
An extension of time until

month

date

taxpayer for the taxable year beginning

year
month

AMOUNT OF YOUR PAYMENT

is requested to file the PA return of the above-named
date

year

(See instructions regarding type and length of extension.)

and ending

month

date

year

Was an extension of time to file previously granted for this taxable year?

.

$
Yes

No

IF YOU ARE SUBMITTING A PAYMENT WITH THIS APPLICATION, COMPLETE THE “AMOUNT OF YOUR PAYMENT” BLOCK ABOVE
AND THE EXTENSION PAYMENT VOUCHER.
State in detail the reason the taxpayer needs an extension. (Use additional sheet if necessary)

SIGNATURE AND VERIFICATION

If prepared by taxpayer: Under penalties of perjury, I declare that to the best of my knowledge and belief, the statements made herein are true and correct.

PLEASE SIGN YOUR RETURN
Taxpayer’s Signature _______________________________________________
Date ____________

MM/DD/YYYY

SPOUSE'S SIGNATURE, PLEASE SIGN
Spouse’s Signature ________________________________________________
Date ____________

If prepared by someone other than taxpayer: Under penalties of perjury, I declare that to the best of my knowledge and belief, the statements made herein
are true and correct, that I am authorized by the taxpayer to prepare this application and that I am:
A member in good standing of the bar of the highest court of (specify jurisdiction)
A public accountant duly qualified to practice in (specify jurisdiction)
A person enrolled to practice before the Internal Revenue Service.
A duly authorized agent holding a power of attorney. (The power of attorney need not be submitted unless requested.)
A person standing in close personal or business relationship to the taxpayer who is unable to sign this application because of illness, absence or other
good cause. My relationship to the taxpayer and the reason(s) why the taxpayer is unable to sign this application are:
Relationship __________________________________________________________ Reason(s)
SIGNATURE OF PREPARER OTHER THAN TAXPAYER

SIGNATURE OF PREPARER OTHER THAN TAXPAYER

Mail extension, the extension payment voucher and payment, if applicable, to:

1603610054
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PA DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
PO BOX 280504
HARRISBURG PA 17128-0504

DATE

MM/DD/YYYY

1603610054
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TIMELY PAYMENT OF TAX REQUIRED

An extension of time to file a PA income tax or information return does not extend the time for full payment of the tax, nor does it
preclude the assessment of penalty and interest for underpayment of tax due. Pay in full the amount reasonably estimated as your
Pennsylvania tax due on or before the original due date using the attached Extension Payment Voucher.
Remittances should be made payable to the PA Dept. of Revenue and submitted with this application on or before the original due
date of the tax return.

INSTRUCTIONS FOR APPLICATION FOR EXTENSION OF TIME TO FILE

1. HOW TO FILE

tance in spite of timely efforts to obtain it, will also be considered.

Use this form for an extension of time to file a PA-40, PA-41 or
PA-20S/PA-65 if you do not apply for a federal extension or if
your request for a federal extension was denied. If you owe tax
on your PA-40, PA-41 or PA-20S/PA-65 return, you must submit
this extension form along with your payment and completed Extension Payment Voucher. You must also submit this form for an
extension of time to file a PA-40NRC or PA-40NRC-AE, as a request for federal extension cannot be filed for these returns. You
will only receive notification from the department in the event
your extension is denied.
If you have an extension for filing your federal income tax return,
you still may request an extension of time for filing your PA tax
return.
When submitting this application, clearly describe in detail the
circumstances beyond your control that will cause an unavoidable
delay in filing the return. Applications that give incomplete reasons
or inadequate explanations, such as “illness” or “practitioner too
busy,” will not be approved.
Fiduciary Accounts: Enter the name of the estate or trust,
starting with the “Last, Estate or Trust, or Entity Name“ area and
continuing through “First Name”. Enter the name of the trustee
in the designated area continuing through the area designated
for the spouse’s first name. Do not use the first address line
designated for PO BOX, apartment number, etc. for fiduciary accounts.
If you pay by credit card or ACH debit on or before April 15,
you can get an automatic six-month extension without
mailing REV-276. Visit the Revenue e-Services Center at
www.revenue.pa.gov for more information.

Combat Zone and Hazardous Duty Service
If serving in an area so designated by the President of the U.S.,
Pennsylvania allows the same automatic extensions of time to
file and pay your PA tax return that the IRS provides for the
federal income tax return. When you file your PA income tax return, please print “COMBAT ZONE” at the top of your PA-40 or
computer-generated PA tax return. Copies of your orders and
discharge papers must accompany your return. If filing an electronic return through Federal/State e-file, you must still fax or
mail copies of your orders and discharge papers. Print “COMBAT
ZONE” at the top of each page.

5. PERIOD OF EXTENSION

If an extension is granted for the taxpayer’s federal return, the
extension period granted by Pennsylvania for the PA-40 will be
equivalent to the extension granted by the IRS. This period is
generally six months. Only taxpayers living outside the U.S. may
obtain an extension period greater than six months.
For extensions of PA-40NRC and PA-40NRC-AE returns, the extension of time to file will be six months. In no case will an extension be granted for more than six months for taxpayers within
the U.S.
For extensions for estates and trusts filing PA-41s, the extension
of time to file will be five-and-a-half months. In no case will an
extension be granted for more than five-and-a-half months for
taxpayers within the U.S.

2. WHEN TO FILE

For extensions for partnerships and limited liability companies filing PA-20S/PA-65s, the extension of time to file will be five
months. In no case will an extension be granted for more than
five months for taxpayers within the U.S.

3. WHAT AND WHERE TO FILE

Blanket requests for extensions of time for filing Pennsylvania
tax returns will not be considered. A separate application must
be submitted for each return.

Submit this application before the return due date, usually
April 15 for calendar year filers, and the 15th day of the fourth
month following the close of the fiscal year for fiscal year filers.
Submit the completed application along with the extension payment voucher and payment, if applicable, to the following address:

PA DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
PO BOX 280504
HARRISBURG PA 17128-0504

4. REASONS FOR EXTENSION

The PA Department of Revenue will grant a taxpayer an automatic extension of time for filing a PA tax return if an extension
has been granted by the Internal Revenue Service (IRS) for filing
the federal tax return. A copy of the federal extension must accompany your return.
A reasonable extension of time will be granted if the taxpayer
is unable to file the return by the regular due date because of
circumstances beyond his or her control. An application will be
considered based on the efforts made by the taxpayer to fulfill
his or her own filing responsibility, rather than the convenience
of someone who provides assistance. Circumstances in which
the taxpayer’s practitioner is unable to complete the return for
filing by the due date, due to reasons beyond his or her control,
will also be taken into consideration. Other circumstances, such
as when a taxpayer is unable to get essential professional assis-

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6. BLANKET REQUESTS

7. FORMS ORDERING

Forms are available on the department’s website at
www.revenue.pa.gov and by calling 1-888-PATAXES
(7282937) or 1-800-362-2050 (for those without touchtone phone
service). Taxpayers with special hearing and/or speaking needs
may call, toll-free, 1-800-447-3020. Forms can also be obtained by emailing [email protected] or writing to the PA Department of Revenue, Tax Forms Service Unit,
1854
Brookwood St., Harrisburg, PA 17104-2244.

8. Extension Payment Voucher Instructions

If not using the Fill-In Form feature for completing the application, use the following instructions to complete the voucher:
• Write the taxpayer’s SSN, the estate or trust’s Federal
Employer Identification Number (FEIN) or the partnership
or limited liability company’s FEIN in the space provided.
• Include an: I for individual; F for estate or trust; G for PA40NRC; or C for PA-40NRC-AE, partnership or limited liability company in the Type column.
• Include the same check digits as used on the application.
• Fill in the amount of the payment being included. If no
payment is required to be made with the application, the
Extension Payment Voucher should not be submitted.

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2016 REV-276 EXTENSION PAYMENT VOUCHER

SSN/FEIN NUMBER

TYPE

CHECK DIGIT

1603610054

PAYMENT AMOUNT

$

DEPARTMENT USE ONLY

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