INSTRUCTIONS FOR 
               APPLICATION FOR EXTENSION OF TIME 
 TO FILE A LAPEER CITY INCOME TAX RETURN 
 
WHO MAY REQUEST AN EXTENSION 
A taxpayer may request an extension of time to  file an individual income tax return.  An 
extension is a request for additional time to file a  tax return.  Extensions  of time to file are 
allowed for resident or nonresident individuals filing Form L-1040, individual income tax return. 
 
AN EXTENSION IS NOT A REQUEST FOR ADDITIONAL TIME TO PAY TAX DUE. 
 
The filing of federal Form 4868, Application for Automatic Extension of Time to File U.S. 
Individual Income Tax return, with the Internal Revenue Service, does not grant an extension 
of time to file a city income tax return.  An Application for an Extension of Time to File a City 
Income Tax Return must be filed. 
 
PERSONS OUTSIDE THE UNITED STATES 
Where the federal internal revenue code grants an automatic two-month extension to persons 
living outside the United States, an automatic extension to the same date will be granted.  If 
more time is needed than this automatic extension allows, an Application for an Extension of 
Time to File a City Income Tax Return must be filed. 
 
EXTENSION AUTOMATICALLY GRANTED 
Upon filing an Application for Extension of Time to File a Lapeer City Income Tax Return, the 
City’s Income Tax Department will automatically grant an extension for up to six months 
provided that: 
 1.  The extension request is filed by the due date of the return; 
 2.  The tentative tax return section of the application is completed; 
 3.  Payment of the tentative tax balance due is made; and 
 4.  All filing and payment requirements of the City’s Income Tax Ordinance are satisfied. 
An extension is not necessary where no tax will be due when the return is filed.  Extensions 
filed without payment of the tentative tax due will not be accepted. 
 
PREPARING THE APPLICATION FOR EXTENSION 
Prepare the application for extension in duplicate.  File the original with the Lapeer City Income 
Tax Department.  When the application for extension is timely filed and the tax payment 
requirements are met, the extension is automatically granted.  A copy of the application for 
extension is to be attached to the City’s income tax return at the time of filing the return. 

CITY OF LAPEER                                                  TAX YEAR ___________ 
                                  
                       APPLICATION FOR EXTENSION OF TIME  
          TO FILE A LAPEER CITY INCOME TAX RETURN 
                                  
Prepare this form in duplicate.  File the original with the Lapeer City Income Tax Department on or 
before the due date for filing a return.  Attach the duplicate to your city income tax return. 
Name                                                 Social Security Number 
  
Address (Street number and name)                     Mark type of return to be filed 
  
                                                                 Form L-1040
City, State & Zip Code                                           Form L-1120 or L-1120S   
                                                                 Form L-1065
     
Reason for extension request 
 
The City Income Tax Ordinance limits the extension of time for filing annual returns to SIX months 
from the original due date. 
 
A _______ month extension of time is hereby requested in which to file the income tax return of the 
above named taxpayer.  The extended due date of the return is the last day of _______________, 2______

                                 TENTATIVE TAX RETURN 
     THE TENTATIVE TAX BALANCE DUE MUST BE PAID WITH THIS EXTENSION.                                                 
 
 1.  Tentative Tax (Estimate total tax liability)............................................  $ ___________  
  
 2. Less: 
     a.  Estimated income tax payments.....................................................  $ ___________  
     b.  Other credits ..................................................................................  $ ___________  
      
 3.  BALANCE DUE (Line 1 less lines 2a and 2b) ..................................  $ ___________  
     (Include payment of this amount with extension) 
     The extension is automatically granted upon payment of the tentative tax balance due. 
     Failure to pay the tentative tax balance due invalidates the extension request. 
     An extension filed without a payment will not be accepted. 
 
     ________________________________________                         _________________ 
     Signature of taxpayer, officer or agent                                                         Date 
_____________________________________________________________________________________ 
.................................................................... MAIL TO:  City of Lapeer Income Tax Department 
                                 576 Liberty Park 
                                 Lapeer MI  48446