STATE OF ARKANSAS  
 AR4EXT 
                     Application for Automatic Extension of Time 
                     to File an Annual Reconciliation, W-2’s or 
                              1099’s for Withholding Taxes 
 
 TAXYEAR: _____                
                               
 FEIN:                          Account ID:                      

 Business Name:                                                                                                         
 
 Address:                                                                                                               
 
 City ,State,Zip:                                                                                                       
 
 Use the Automatic Extension only for remitting the AR-3MAR Annual Reconciliation of Arkansas 
 Withholding taxes, state copies of form W-2, and state copies of form 1099. 
                                                th 
 The due date for the Annual Reconciliation is February 28 of the year following the tax year filed. 
  
 The  due  date  for  form  W-2  and  form  1099  is  January  31 st   of  the  year 
 following the tax year filed. You may request a 30, 60, or 90-day extension of time to file these 
 forms. 
 
 The Automatic Extension with the Withholding Tax Section must be filed before the due date of the 
 forms. Arkansas recognizes a federal extension to the federal extended due date.  You are required to 
 submit a copy of the Arkansas Automatic extension or the federal extension when you file the Annual 
 Reconciliation, W-2 or 1099. 
 THESE WILL BE KEPT ON FILE AND YOU WILL NOT RECEIVE AN APPROVED COPY BACK.                                              
 
 THIS IS NOT AN EXTENSION OF TIME TO FILE WITHHOLDING          P YMENTS.A                                              
 
  Check the box indicating the number of days needed for this extension: 
 
                     30 days            60 days                    90 days 
 
 Signature                                                                                                       Date 
 
                              Mail completed extension request to: 
                              Withholding Tax Branch - Extension 
                                      P. O. Box 8055 
                               Little Rock, AR 72203-8055