State of Rhode Island Division of Taxation 
       Form RI-4768 
       Estate Tax Extension Application                                                   16160499990101

                     APPLICATION FOR 6 MONTH EXTENSION OF TIME TO FILE
                     Decedent's first name                              MI     Last name                                                                   Suffix Decedent's social security number

       Additional    Decedent's address - Legal residence (domicile) at time of death     City, town or post office                                                 State          ZIP code
       Extension 
       Request 
                     Date of death           Estate tax return due date                   Executor: If you are out of the country and filing                        Requested extension date
The $50 filing fee                                                                        for additional time to file, enter the requested 
must accompany                                                                            extension date in the box on the right
this extension. Do   Executor/personal rep/admin's first name      MI     Last name                                                                        Suffix Executor/personal rep/admin's SSN
not remit again 
when form RI-706 is 
filed.               Executor/personal rep/admin's address                                City, town or post office                                                 State          ZIP code

                     Preparer's first name                               MI     Last name                                                                  Suffix Preparer telephone number

                     Preparer's firm name, if applicable

                     Preparer's address                                                   City, town or post office                                                 State          ZIP code

                     Marital status of the decedent at time of death
                      Married                 Widow/widower         Single                Legally separated                                                 Divorced
Payment to Accompany Extension Request
1      Estimated gross estate  ........................................................................................................................... 1

2      Amount of Rhode Island estate taxes estimated to be due......................................................................                       2

3      Amount enclosed with extension application............................................................................................              3

Additional Extension Request
If you are an executor out of the country applying for an extension of time to file in excess of 6 months, check the box above and enter 
the requested extension date on line 3 of the header. Attach a statement explaining in detail why it is impossible or impractical to file 
Form RI-706 by the due date.
If filed by other than the executor (check the appropriate box):
       A member in good standing of the bar of the highest court of (specify jurisdiction)____________________________

       A certified public accountant duly qualified to practice in (specify jurisdiction) ______________________________

       A licensed public accountant in (specify jurisdiction) ______________________________

       A person actively enrolled to practice before the Internal Revenue Service.

       A duly authorized agent holding a power of attorney. (Unless requested, the power of attorney does not need to be submitted.

If filed by executor - Under penalties of perjury, I declare that I am an executor of the estate of the above-named decedent and that to the best of my 
knowledge and belief, the statements made herein and attached are true and correct.  Otherwise - Under penalties of perjury, I declare that to the best of 
my knowledge and belief, the statements made herein and attached are true and correct, that I am authorized by an executor to file this application, and 
that I am filing this extension in the capacity stated above.
Executor's signature                                                                                   Date                                                         Telephone number

Preparer signature if filed by someone other than executor                                             Date                                                                    PTIN

                                             May the Division of Taxation contact your preparer?   YES
                                        Mail to RI Division of Taxation - One Capitol Hill - Providence, RI 02908

A DEATH CERTIFICATE MUST BE ATTACHED TO FORM RI-4768 WHEN REQUESTING AN EXTENSION.
                                                                                                                                                                                   Revised 10/2021