DELAWARE DIVISION OF REVENUE                                                                                                                 Reset                      Print Form
FORM 1100-P-EXT – DELAWARE “S” CORPORATION REQUEST FOR  EXTENSION
               ACCOUNT NUMBER                   VERIFY BUSINESS FEIN                                          CALENDAR OR FISCAL YEAR ENDING DUE ON OR BEFORE     VOUCHER    EXTENSION TO
               0-000000000-000                                                                                 12-31-23                      03-15-24                   P-5  09-16-24

               00932505000000000000012312303152400000000000000000000M

                                                                                                         Check here if 
     FILE THIS FORMa RequestBALANCE(BALANCE OF TAX DUE FOR THE YEAR)                                                                                                                                    EXTENSIONIF DUE FROMIS REQUESTEDLINE OF7 WORKSHEETFor 
                                                                                                         Change form is 
                                                                                                         being filed.
                                                                                                                                                                             . 0 0

                                                                                                                                      *DF62115019999*
                                                                                                                                             DF62115019999
                                                                                                                                      Mail this form with remittance to:
CHANGES MUST BE MADE ON THE REQUEST FOR CHANGE FORM.                                                                                  Delaware Division of Revenue
CHECK THIS BOX IF YOU ARE FILING A CHANGE FORM.                                                                                       P.O. Box 830, Wilmington, DE 19899-0830

X                                                                                                                    TELEPHONE NUMBER                                   DATE MM DD YY
AUTHORIZED SIGNATURE          Iisdeclarea true, correct,under penaltiesand completeof perjuryreturn.that this           EMAIL ADDRESS                                          (Rev(Rev 09/2018)09/2018)

                                                                              CUT COUPON ON LINE ABOVE

               TAXPAYER’S WORKSHEET AND RECORD OF PAYMENTS

1.  Estimated amount of distributive income for the taxable year                                                                                   $

2a. Total percentage of stock owned by non-resident shareholders                                                                                   x

2b. Multiply line 1 by line 2a and enter result on line 2b                                                                                         $

3a. Enter corporation’s apportionment percentage                                                                                                   x

3b. Multiply line 2b by line 3a and enter result on line 3b                                                                                        $

4.  Multiply line 3b by 6.60% and enter the result on line 4.                                                                                      $
               (This is the total amount of personal income tax required to be 
               paid on behalf of the non-resident shareholders.)

5.  Actual tax liability for the year                                                                                                              $

6.  Estimated tax paid                                                                                                                             $

7.  Amount due with extension                                                                                                                      $

Please fill in the federal identification number, business name, and address in the spaces 
provided.  Sign and date the return and supply a telephone number where we may contact 
someone regarding the information on the tax return.

PLEASE NOTE:                  Voucher 1 (P-1) is due the 15th day of the 4th month following the end of the year.
                              Voucher 2 (P-2) is due the 15th day of the 6th month following the end of the year.
                              Voucher 3 (P-3) is due the 15th day of the 9th month following the end of the year.
                              Voucher 4 (P-4) is due the 15th day of the 12th month following the end of the year.