DELAWARE DIVISION OF REVENUE
FORM 1100-T-EXT - DELAWARE CORPORATE INCOME TAX REQUEST FOR EXTENSION                                                                 Reset                         Print Form
  ACCOUNT NUMBER                       VERIFY BUSINESS FEIN                                          CALENDAR OR FISCAL YEAR ENDING DUE ON OR BEFORE     VOUCHER    EXTENSION TO
  0-000000000-000                                                                                             12-31-22                04-17-23                 T-5  10-16-23

  00422505000000000000012312204172300000000000000000000E

                                                                                                Check here if 
FILEa RequestBALANCE(BALANCE OF TAX DUE FOR THE YEAR)                                                                                                                                          DUETHISFROMFORMFor LINEIF EXTENSIONOF7 WORKSHEETIS REQUESTED 
                                                                                                Change form is 
                                                                                                being filed.
                                                                                                                                                                    . 0 0

                                                                                                                             *DF62415019999*
                                                                                                                                      DF62415019999
                                                                                                                             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 Delaware taxable income for the year                                                                         $

  2.  Multiply line 1 by corporate income tax rate                                                                                  x                          0.087

  3.  Multiply line 1 by line 2, enter result on line 3                                                                      $

  4.  Estimated tax paid                                                                                                     $

  5.  Subtract line 4 from line 3                                                                                            $

  6.  Less credit carryover                                                                                                  $

  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 this information.

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