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Form 1127 Application for Extension of Time for Payment of
(Rev. December 2011) OMB No. 1545-2131
Department of the Treasury Tax Due to Undue Hardship
Internal Revenue Service
Before you begin: Use the chart on page 3 to see if you should file this form.
Name(s) shown on return Identifying number

Number, street, and apt., room, or suite no. If you have a P.O. box, see instructions.

City, town, or post office, state, and ZIP code. If you have a foreign address, see instructions.

Part I Request for Extension
I request an extension from , 20 , to , 20 , to pay tax of $ .
This request is for (check only one box):
The tax shown or required to be shown on Form .
An amount determined as a deficiency on Form .
This request is for calendar year 20 , or fiscal year ending , 20 .

Part II Reason for Extension
Undue hardship. Enter below a detailed explanation of the undue hardship that will result if your application is denied. (If more space
is required, please attach a separate sheet.) To establish undue hardship, you must show that you would sustain a substantial
financial loss if forced to pay a tax or deficiency on the due date. For a complete definition of “undue hardship,” see the instructions
on page 3 under Who Should File.

Part III Supporting Documentation
To support my application, I certify that I have attached (you must check both boxes or your application will not be accepted):
A statement of my assets and liabilities at the end of last month (showing book and market values of assets and whether
securities are listed or unlisted), and
An itemized list of my income and expenses for each of the 3 months prior to the due date of the tax.
Signature and Verification
Under penalties of perjury, I declare that I have examined this application, including any accompanying schedules and statements, and to the best of my
knowledge and belief, it is true, correct, and complete; and, if prepared by someone other than the taxpayer, that I am authorized to prepare this form.
Signature of taxpayer ▶ Date ▶

Signature of spouse ▶ Date ▶
Signature of preparer
other than taxpayer ▶ Date ▶

FOR IRS USE ONLY (Do not detach)
This application is Approved Denied Returned:

Reason(s):

Signature of authorized official Date
For Privacy Act and Paperwork Reduction Act Notice, see instructions. Cat. No. 17238O Form 1127 (Rev. 12-2011)

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Form 1127 (Rev. 12-2011) Page 3
Section references are to the Internal Revenue Code. • Taxes on qualified investment entities.
• Taxes on greenmail.
General Instructions • Taxes on structured settlement factoring transactions.
What's New • Gift taxes.
Form 1127 can also be filed if you receive a notice and demand for
The IRS has created a page on IRS.gov for information about Form payment (or tax bill) for any of the taxes shown below and paying
1127 and its instructions at www.irs.gov/form1127. Information them at the time they are due will cause an undue hardship.
about any recent developments affecting Form 1127 will be posted
on that page. • Normal taxes and surtaxes.
• Taxes on private foundations and certain other tax-exempt
Purpose of Form organizations.
Use Form 1127 to request an extension of time under section • Taxes on qualified investments.
6161 for payment of the following amounts. • Gift taxes.
• The tax shown or required to be shown on a return. Undue hardship. The term “undue hardship” means more than an
• An amount determined as a deficiency (an amount you owe inconvenience. You must show you will have a substantial financial
after an examination of your return). loss (such as selling property at a sacrifice price) if you pay your tax
on the date it is due.
Determination Chart Note. If you need an extension to pay estate tax, file Form 4768.
Use this chart to determine if Form 1127 is the correct form for you
to file. When To File
IF you . . . THEN . . . Form 1127, and its supporting documentation, should be filed as
soon as you are aware of a tax liability or a tax deficiency you
Are seeking an extension of File Form 4868, Application for cannot pay without causing undue hardship.
time to file your income tax Automatic Extension of Time To If you are requesting an extension of time to pay the tax due on
return File U.S. Individual Income Tax an upcoming return, Form 1127 must be received on or before the
Return, or Form 2350, Application due date of that return, not including extensions.
for Extension of Time To File U.S.
Income Tax Return. Do not file If you are requesting an extension of time to pay an amount
Form 1127. determined as a deficiency, Form 1127 must be received on or
before the due date for payment indicated in the tax bill.
Are seeking an extension of File Form 4768, Application for
time to pay estate tax Extension of Time To File a Where To File
Return and/or Pay U.S. Estate File Form 1127 with the Internal Revenue Service (Attn: Advisory
(and Generation-Skipping Group Manager), for the area where you maintain your legal
Transfer) Taxes. Do not file residence or principal place of business. See Pub. 4235, Collection
Form 1127.
Advisory Group Addresses, to find the address for your local
Are requesting a monthly See Form 9465, Installment advisory group.
installment payment plan Agreement Request. Do not file However, if the tax due is a gift tax reportable on Form 709, send
Form 1127. Form 1127 to:
Are requesting to postpone File Form 1127 by the due date of Department of the Treasury
payment of the full amount of your return or by the due date for Internal Revenue Service Center
tax shown on your return or the amount determined as a Cincinnati, OH 45999
any amount determined as a deficiency.
deficiency Extension Period
Owe any tax and are not Call, write, or visit your local IRS An extension of more than 6 months generally will not be granted
requesting, or do not qualify office to discuss your situation. to pay the tax shown on a return. However, except for taxes due
for, either a monthly installment For more information, see Pub. under sections 4981, 4982, and 5881, an extension for more than
payment plan or an extension of 594, The IRS Collection Process. 6 months may be granted if you are out of the country.
time to pay the full amount Do not file Form 1127. An extension to pay an amount determined as a deficiency is
generally limited to 18 months from the date payment is due.
However, in exceptional circumstances, an additional 12 months
Who Should File may be granted.
You can file Form 1127 if you will owe any of the following, and Note. An extension to pay a deficiency will not be granted if the
paying the tax at the time it is due will cause an undue hardship. deficiency is due to negligence, intentional disregard of rules and
• Income taxes. regulations, or fraud with intent to evade tax.
• Self-employment income taxes. Payment Due Date
• Withheld taxes on nonresident aliens and foreign corporations. You must pay the tax before the extension runs out. Do not wait
• Taxes on private foundations and certain other tax-exempt to receive a bill from the IRS.
organizations.

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Form 1127 (Rev. 12-2011) Page 4

Interest. You will owe interest on any tax not paid by the due date Signature and Verification
of the return, or the due date of any amount determined to be a
deficiency, regardless of whether an extension of time to pay the This form must be signed and dated.
tax has been obtained. The interest runs until you pay the tax. Individuals. If this application is for the tax shown on a joint return
Penalties. Penalties may be imposed if you fail to pay the tax or a joint tax liability for an amount determined as a deficiency,
within the extension period granted. both you and your spouse must sign and date this form. If your
spouse cannot sign, see Pub. 501, Exemptions, Standard
Specific Instructions Deduction, and Filing Information.

Name, Address, and Identification Number Privacy Act and Paperwork Reduction Act Notice. We ask for
Individuals. Enter your name, address, and social security number the information on this form to carry out the Internal Revenue laws
(SSN) or individual taxpayer identification number (ITIN). If this of the United States. We need this information to ensure
application is for the tax shown on a joint return or a joint tax compliance with these laws and to properly grant extensions of
liability for an amount determined as a deficiency, include both time to pay tax. Applying for an extension of time for the payment
spouses’ names in the order in which they appear or will appear on of tax is voluntary. However, providing the requested information is
your return, and enter the SSN or ITIN of the spouse whose name mandatory if you apply for the extension. Our legal right to ask for
appears first. the information requested on this form is based in sections 6001,
Corporations. Enter your company’s name, address, and employer 6011, 6109, and 6161 and their regulations. If you fail to provide all
identification number. or part of the information requested, your application may be
denied. If you provide false or fraudulent information, you may be
P.O. box. Enter your box number only if your post office does not subject to penalties.
deliver to your street address.
You are not required to provide the information requested on a
Foreign address. Enter the information in the following order: city, form that is subject to the Paperwork Reduction Act unless the
province or state, and country. Follow the country’s practice for form displays a valid OMB control number. Books or records
entering the postal code. Do not abbreviate the country name. relating to a form or its instructions must be retained as long as
their contents may become material in the administration of any
Part I Internal Revenue law. Generally, tax returns and return information
Request for extension. Enter the due date of your return (not are confidential, as required by section 6103. However, section
including extensions) or the due date for paying the amount 6103 allows or requires the Internal Revenue Service to disclose
determined as a deficiency. Enter the date you propose to pay the the information to others as described in the Code. For example,
tax and the amount of tax you owe. The date you propose to pay we may disclose this information to the Department of Justice for
the tax can be up to: enforcement of civil or criminal tax laws; to cities, states, the
District of Columbia, and U.S. commonwealths or possessions to
• 6 months from the due date of your return (not including administer their tax laws; to other countries under a tax treaty; to
extensions), if your request is for payment of the tax shown on your federal and state agencies to enforce non-tax criminal laws; or to
return (the date you propose can be more than 6 months if you are federal law enforcement and intelligence agencies to combat
out of the country), or terrorism.
• 18 months from the date payment is due, if your request is for The time needed to complete and file this form will vary
payment of an amount determined as a deficiency (an additional 12 depending on individual circumstances. The estimated burden for
months can be requested for a deficiency in exceptional individual taxpayers filing this form is approved under OMB control
circumstances). number 1545-0074 and is included in the estimates shown in the
Check the applicable box and enter the form number to which the instructions for their individual income tax return. The estimated
tax you owe relates. Enter the tax year, if the tax you owe is figured burden for all other taxpayers who file this form is shown below.
on a calendar year; if the tax you owe is figured on a fiscal year, Recordkeeping . . . . . . . . . . . . 3 hr., 6 min.
enter the ending month, day, and year.
Learning about the
Part II law or the form . . . . . . . . . . . . . . 55 min.
Reason for extension. In order for your application to be Preparing and sending
considered, you must provide a detailed explanation of the undue the form to the IRS . . . . . . . . . . . 3 hr., 25 min.
hardship that will result if you pay the tax on or before the due date. If you have comments concerning the accuracy of these time
An extension will not be granted if you provide only a general estimates or suggestions for making this form simpler, we would
statement of hardship. be happy to hear from you. See the instructions for the tax return
for which this form is filed.
Part III
Supporting documentation. You must attach:
• A statement(s) of your assets and liabilities, and
• An itemized list of your income and expenses for each of the 3
months prior to the due date of the tax.
Note. Once your request has been reviewed, additional conditions
may have to be met.

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