APPLICATION FOR EXTENSION OF TIME TO FILE
         BUSINESS EARNINGS TAX RETURN (FORM E-234)
                     (Application does not extend time to pay)
GREGORY F.X. DALY, COLLECTOR OF REVENUE, CITY OF ST. LOUIS                                FOR OFFICE USE ONLY
Check type                           Self-Employed                       Partnership                 Corporation
of Business:                         (Business and
                                     Professional Persons)
Name of Taxpayer:                                                                    FEIN or SSN: (See instruction 4)

Trade Name:

Address:

City, State & Zip Code:                                                              Telephone No.:

I request a 6-month extension of time until _________________ 20 ____ , to file the Earnings Tax Form E-234 for
the taxpayer named above for      calendar year ____ or       tax year beginning _____________20_____,  and
ending _____________20_____.         If you do not pay the amount of tax due by the regular due date, you will owe interest. You may also be charged
                                     penalties. See instructions 8 and 9.
If this tax year is for less than 12 months, check reason, (See Instruction 6)
Initial return          Final return       Change in accounting period
Other (explain)

A PAYMENT OF 100% OF YOUR ESTIMATED TAX DUE FOR THE CURRENT TAX YEAR IS REQUIRED WITH THIS
REQUEST. MAKE CHECK PAYABLE TO: GREGORY F.X. DALY, COLLECTOR OF REVENUE. (See Instruction 8 & 9).
AMOUNT PAID WITH THIS EXTENSION REQUEST ..................................................................................   $ ____________

         Taxpayer’s Signature                     Type or Print Name                          Title            Date

ONLY TAXPAYERS WHOSE EXTENSION HAS BEEN REJECTED WILL BE NOTIFIED.
                     FAILURE TO PAY AT LEAST 90% OF THE ACTUAL TAX DUE WILL RESULT IN
             PENALTIES BEING ASSESSED FROM THE ORIGINAL DUE DATE (See Instruction 9).

                                                FOR OFFICE USE ONLY

Your application for extension of time to file is granted until ................................................20 ........  . Interest accrues
on unpaid tax at the rate of 12 percent a year during the period of any extension. (See Instruction 8).

Your extension has been rejected for the following reasons:

        We cannot grant your extension request due to the following Earnings and/or Payroll Expense Tax 
        delinquency(s) indicated on the attached “Statement of Tax Delinquency”.

        We  cannot  grant  your  extension  request  due  to  Personal  Property  Tax  delinquency  for  account 
        number                       .  Please  contact  (314) 622-4108  for  assistance  with  resolving  this 
        delinquency.

        If the requirement causing this rejection is satisfied within 10 days, your request may be resubmitted 
        or you may contact our office at (314) 622-4248.

             Approval Date                         Reject Date                       Extension Section - Earnings Tax Division
Form E-8 (Rev. 11/12)

                                           INSTRUCTIONS

 1. Who  May  File --  This  application  (Form  E-8)  is  to  be  used  by  a  Corporation,  Partnership  or  Self-Employed 
    Business/Professional Person to request an extension of time to file the Annual Earnings Tax Return (Form E-234).

 2. When to File -- File this application requesting a six (6) month extension on or before the original due date of the 
    return, which is the 15th day of the 4th month following the close of the taxable year.

 3. How and Where to File -- File one copy of this form with the Collector of Revenue, Earnings Tax Division, 410 
    City Hall, 1200 Market St., St. Louis, MO 63103-2841. Only taxpayers whose extension has been rejected will be 
    notified.

 4. Indicate Appropriate Identification Number -- All employers of one or more persons and all Corporations and 
    Partnerships, whether or not they have employees, must indicate their Federal Employer Identification Number. All 
    other self-employed persons must indicate their Social Security Number. Each business entity with a separate I.D. 
    number requires a separate application.

 5. Period of Extension -- An extension of time to file an annual return may not be granted for a period of time in 
    excess of six months (computed from the original due date of the return).

 6. Short Returns -- Indicate the reason for any tax period not equal to 12 months or if this is the first period for which 
    a tax return is due for this Federal E.I. Number. Also, please explain any changes in business type or tax reporting 
    period. Attach letter if necessary.

 7. Amount to be paid -- All extension requests must be received with 100% of the current year’s tax tentatively 
    determined to be due. Make checks payable to: Gregory F.X. Daly, Collector of Revenue. If taxpayer anticipates 
    a loss, write “Loss - no tax due.”

 8. Interest   -- The  completed  annual  return,  Form  E-234,  must  be  filed  on  or  before  the  extended  due  date  with  
    remittance of any tax balance due. The tax balance due bears interest at the rate of 1% of the tax balance due per 
    month or fraction thereof, from the original due date of the return until the date the completed return is filed.

 9. Penalty -- Any completed return filed after the extended due date bears penalty at the rate of 5% of the tax balance 
    due per month, or fraction thereof (not to exceed 25%), from the extended due date, until the date the completed 
    return is filed. If the balance of the tax due with your return exceeds 10% of the total tax amount due, the 5% per 
    month penalty will be charged on the tax balance due from the original due date.

10. Overpayment -- If the amount paid with the extension request exceeds the actual tax due on the completed return, 
    the overpayment will be refunded. If you wish the overpayment to be applied to the next tax year’s liability, please 
    indicate so on line 17, Form E-234.

11. Signature -- Signature on Form E-8 shall be that of an officer of the Corporation, a member of the Partnership or 
    the Individual Business/Professional Person, or authorized agent.

                                           GREGORY F.X. DALY
                                           COLLECTOR OF REVENUE
                                           TELEPHONE: (314) 622-4248
                                           FAX: (314) 622-4847
                                           WEBSITE ADDRESS: www.stlouiscollector.com