EXTENSION REQUEST INSTRUCTIONS 
                                                                                                   
     EXTENSION        REQUEST:
     To be used by a corporation, an LLC or partnership for requesting an automatic extension of time for filing Rhode Island 
     Form RI-1120C, RI-1120S or RI-1065. 
     Automatic six (6) month extension for filers of Form RI-1120C (except for filers with a June 30 fiscal year end), Form RI-
     1120S or Form RI-1065 (LLC, LLP, LP, Partnership, SMLLC). 
     Automatic seven (7) month extension for June 30 year end filers of Form RI-1120C. 
      
     TO BE EFFECTIVE: 
          1. Payment of the full amount of the tax reasonably estimated to be due must be submitted with this request. 
         2. This form must be completed and filed before the date prescribed for payment of the tax. 
         3. This form must be signed by a person authorized to represent the corporation in this matter. 
      
     NOTE: 
     The extension of time is limited to: 1) The date requested, or 2) The date on which a certificate of good standing is 
     required to be issued, whichever is earlier. 
      
     ONLINE PAYMENT 
     Your extension payment can be made online.  For more information, visit:  
     https://www.ri.gov/taxation/business/index.php 
      
     If you make your payment online, you do not need to send in this extension request form.

                                                                                           STATE OF RHODE ISLAND 
RI-7004                                                        AUTOMATIC EXTENSION REQUEST FOR RI-1120C, RI-1120S and RI-1065 FILERS 
                                                               DIVISION OF TAXATION - ONE CAPITOL HILL - PROVIDENCE, RI 02908

                                                                                                                       16113299990101

           YOUR COPY                                                                              For the Taxable Year Ending:                     /        /
      DO NOT FILE THIS COPY WITH THE                                                              ESTIMATED TAX 
RHODE ISLAND DIVISION OF TAXATION                                                                 CURRENT YEAR                                               00  
NAME                                                                                                                   $
                                                                                           RI-7004 AMOUNT PAID AND 
                                                                                                  CREDITED TO DATE     $                                     00
FEDERAL EMPLOYER IDENTIFICATION NUMBER
                                                                                                  AMOUNT DUE  
                                                                                                  WITH EXTENSION       $                                     00  
I declare, under the penalties of perjury, that this document has been examined by me and, 
to the best of my knowledge and belief, is true, and complete.                                                                                                
                                                                                                  AMOUNT 
                                                                                                  ENCLOSED
                      Signature of officer or agent.                                                                   $                                     00

                                                                                           STATE OF RHODE ISLAND 
RI-7004                                                        AUTOMATIC EXTENSION REQUEST FOR RI-1120C, RI-1120S and RI-1065 FILERS 
                                                               DIVISION OF TAXATION - ONE CAPITOL HILL - PROVIDENCE, RI 02908

                                                                                                                       16113299990101

NAME
                                                                                                  For the Taxable Year Ending:                     /        /
ADDRESS                                                                                           ESTIMATED TAX 
                                                                                                  CURRENT YEAR         $                                     00  
                                                                                           RI-7004
CITY, STATE, ZIP CODE                                                                             AMOUNT PAID AND 
                                                                                                  CREDITED TO DATE     $                                     00
FEDERAL EMPLOYER IDENTIFICATION NUMBER                                                            AMOUNT DUE 
                                                                                                  WITH EXTENSION       $                                     00  
I declare, under the penalties of perjury, that this document has been examined by me and,                                                                    
to the best of my knowledge and belief, is true, and complete.
                                                                                                  AMOUNT 
                                                                                                  ENCLOSED             $                                     00
                      Signature of officer or agent.