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                 Louisville Metro Revenue Commission 
                                                                                                             2022
                 Louisville Metro Revenue 
                                                                                                                   Form 
                 Commission Extension Request                                                                           OL-3EXTINDIVIDUAL/ SOLE PROPRIETOR         ▼ 
Last name                                                 First name                            MI           Social Security Number CORPORATION/ PARTNERSHIP          ▼ 
Legal name/ Business name                                                                                    Federal ID Number CHECK IF CHANGE IN ADDRESS IS BELOW 
Address (number and street)                                                       Unit/Apt. no.                Account ID 

City, town, or post office                                State                   Zip code                     Tax Year Ending 

Email                                                     Phone no.               Ext.                       Estimated Payment 
                                                                                                                                                       .00 
                                                                                                            A 90% estimated payment                 
                                                                                                             of the final tax liability is 
                                                                                                             required to avoid penalty. 
                                                                                                                 (See instructions) 
Corporations               Tax year end changed to:                                            (enter month) 
and                        Final return - Business ceased 
Partnership                Corporate Merger - Short year return due to merger on 
If this extension 
request is for a tax       Corporate Acquisition - Short year return due to the acquisition on 
period of less than        After this short year return, our tax year end will be              (enter month) 
twelve (12) 
months, please       MERGER/ACQUISITION DETAILS 
indicate the reason  Legal name/ Business name                                                               Federal ID Number 
in this section. 
                     Address (number and street)                                                   Unit/Apt. no. 

                     City, town or post office                                    State            Zip code 

                     Email                                                        Phone no.        Ext. 

                            Other:  (Please explain) 

Sign                 I hereby certify, under penalty of perjury, that the information provided and the attached supporting schedules are true, 
                     correct, and complete to the best of my knowledge. 
Here                 Your signature                                                   Date 

                     Print/type your name                       Your title                         Daytime phone number 

Preparer             Print/Type preparer’s name      Preparer’s signature              Date        PTIN 
Use Only 
                     Firm’s name      ▶                                                            Firm’s EIN   ▶
                     Firm’s address   ▶                                                            Phone no.   ▶ 

                                                                ELECTRONIC FILING 
            Register for electronic filing. It is an easy, secure, and convenient way to file and pay taxes on-line. For more information log on to 
                                                          https://www.metrorevenue.org 

                             MAILING ADDRESS: P.O. BOX 35410, LOUISVILLE, KENTUCKY 40232-5410 
                                                          Telephone: (502) 574-4860   
                            Please do not send general correspondence with this form/payment to this address.






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