20                                                                                                                  20
                             City of Hamtramck

                             APPLICATION FOR EXTENSION OF TIME
                                 TO FILE INCOME TAX RETURN

Prepare this form in duplicate. File the original with the City’s Income Tax Department on or before the due date for
ling a return. Attach the duplicate to your city income tax return.

NAME                                                                                                  TAXABLE PERIOD
                                                                   Calendar Year ______________________________________________
                                                                   Fiscal Year Ending __________________________________________

ADDRESS (STREET NUMBER AND NAME)                                                                      TYPE OF RETURN

                                                                    Corporation                        Individual
                                                                      Partnership                      Resident
                                                                     Estate or Trust                   Non-Resident
CITY, STATE & ZIP CODE
                                                                     Employer Identication Number or
                                                                       Social Security Number
                                                                    _________________________

Reason for extension request:

The City Income Tax Ordinance limits the extension of time for filing annual returns to SIX months from the original due date.
A __________ month extension of time is hereby requested in which to file the income tax return of the above named Taxpayer. The extended 
due date of this return is the last day of ____________________, 20

                                             TENTATIVE TAX RETURN
          THE TENTATIVE TAX BALANCE DUE MUST BE PAID WITH THIS EXTENSION.
1.   Tentative Tax (Estimate total tax liability) . . . . . . . . . . . . . . . . . . . . . . .       $ ______________________
2.   Less:
     a.   Estimated income tax payment . . . . . . . . . . . . . . . . . . . . . . .                  $ ______________________
     b.   Other credits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   $ ______________________
3.   BALANCE DUE (Line 1 less lines 2a and 2b) . . . . . . . . . . . . . . . . . . . .                $ ______________________
     (Include payment of this amount with extension)
     The extension is automatically granted upon payment of the tentative tax balance due. Failure to pay tentativetax( if 
     due) could result in penalty for failure to pay.

     ____________________________________________________                                             __________________________
     Signature of taxpayer, ofcer or agent                                                           Date

                                            MAIL TO:  City of Hamtramck
                                                                   Income Tax Department
                                                                   P.O. Box 209
                                                                   Eaton Rapids, Mi 48827-0209
                                             

                         INSTRUCTIONS FOR

           APPLICATION FOR EXTENSION OF TIME

                  TO FILE CITY OF HAMTRAMCK

                         INCOME TAX RETURN

WHO MAY REQUEST AN EXTENSION
A taxpayer may request an extension of time to file an individual income tax return. An extension is
a request for additional time to file a tax return. Extensions of time to file are allowed for resident or
nonresident individuals filing form HP-1040, individual income tax return.

An extension is not a request for additional time to pay tax due.

The filing of federal Form 4868, Application for Automatic Extension of Time to File U.S. Individual
Income Tax return, with the Internal Revenue Service, does not grant an extension of time to file a
city income tax return. An Application for an Extension of time to file a City of Hamtramck Income  
Tax Return must be filed.

PERSONS OUTSIDE THE UNITED STATES
Where the federal internal revenue code grants an automatic two-month extension to persons liv-
ing outside the United States, an automatic extension to the same date will be granted. If more
time is needed than this automatic extension allows, an Application for an Extension of Time to File
City of Hamtramck Income Tax Return must be filed.

EXTENSION AUTOMATICALLY GRANTED
Upon filing an Application for Extension of time to File a City of Hamtramck Income Tax Return,
the City of Hamtramck’s Income Tax Department will automatically grant an extension for up to
six months provided that:

        1. The extension request is filed by the due date of the return;
        2. The tentative tax return section of the application is competed;
        3. Payment of the tentative tax balance due (if owed) is made; and
        4. All filing and payment requirements of the City of Hamtramck
           Income Tax Ordinance are satisfied.

An extension is not necessary where no tax will be due when the return is filed. Extensions filed
without payment of the tentative tax due will not be accepted.

PREPARING THE APPLICATION FOR EXTENSION
Prepare the Application for Extension in duplicate. File the original with the City of Hamtramck’s
Income Tax Department. When the Application for Extension is timely filed and the tax payment re-
quirements are met, the extension is automatically granted. A copy of the Application for Extension
is to be attached to the City of Hamtramck’s Income Tax Return at the time of filing the return.