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4 State of Rhode Island Division of Taxation 4
5 Form BUS-EXT 5
6 Business Tax Automatic Extension Request 23111499990101 6
7 7
8 Name Federal employer identification number 8
9 9
10 XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX 99-9999999 10
11 Address For the period ending: 11
12 XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX 12/31/2023MM/DD/YYYY 12
13 Address 2 13
14 14
15 15
XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXCity, town or post office State ZIP code E-mail address
16 16
17 XXXXXXXXXXXXXXXXXXXXXXXXX XX 99999 XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX 17
18 This form must be completed and filed before the date prescribed for payment of the tax. 18
19 19
20 Part 1: Automatic extension 20
21 21
22 Check the box next to the form for which you are requesting an extension. Check only one box. 22
23 23
Form RI-1065/RI-1120 - Rhode Island Corporate Income Tax ELECTRONIC MANDATE
24 The Rhode Island Division of Taxation24has an
25 electronic mandate that requires Larger 25
26 Form RI-1120POL - Rhode Island Political Organization -6 month extension Business Registrants use electronic means26 to
27 file returns and remit taxes beginning on 27
Form T-72 - Rhode Island Public Service Corporation Gross Earnings - see below January 1, 2023.
28 28
29 For more information, refer to the instruc29
30 Form T-74 - Rhode Island Banking Institution Excise -see below tions for the form which you are making30this
31 payment on Taxations’ website: 31
Form RI-PTE - Pass-Throughsee belowEntity Election - https://tax.ri.gov/forms
32 32
33 To file and pay, visit Taxation’s portal: 33
34 Automatic Extension Periods https://taxportal.ri.gov/ 34
35 Automatic six (6) month extension for calendar and fiscal year filers (except for filers with a 35
If you are not required to file and pay via
36 June 30 fiscal year end) of Form T-72, T-74 or RI-PTE. electronic means, send form and payment36 to:
37 Automatic seven (7) month extension for June 30 year end filers of Form T-72 or T-74 or RI-PTE R.I. Division of Taxation 37
38 One Capitol Hill 38
39 Providence, RI 02908 39
40 Part 2: Amount due with extension 40
41 41
42 1 Estimated tax due for the current year..................................................................................... 1 9999999999 99 42
43 43
44 2 Carry forward and estimated payments paid to date............................................................... 2 9999999999 99 44
45 45
46 3 Balance due with extension request. Subtract line 2 from line 1............................................ 3 9999999999 99 46
47 47
48 4 Amount paid with extension request........................................................................................ 4 9999999999 99 48
49 49
50 50
NOTE: If payment is made online, you do not need to send this form in.
51 For more information about Taxation’s portal, visit: https://tax.ri.gov/online-services/tax-portal 51
52 52
Under penalties of perjury, I declare that I have examined this return and accompanying schedules and statements, and to the best of my knowledge and
53 belief, it is true, accurate and complete Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge 53
54 Authorized officer signature Print name Date Telephone number 54
55 XXXXXXXXXXXXXXXXXXXXX 12/31/2022 (999) 999-9999 55
56 Paid preparer signature Print name Date Telephone number 56
57 57
58 XXXXXXXXXXXXXXXXXXXXX 12/31/2022 (999) 999-9999 58
59 Paid preparer address City, town or post office State ZIP Code PTIN 59
60 XXXXXXXXXXXXXXXXXXXXX XXXXXXXXXXXXXXX XX 99999 P99999999 60
61 61
62 May the Division of Taxation contact your preparer? YES 62
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34567890123456789012345678901234567890123456789012345678901234567890123456789012 Revised
11/2023