Request For Six Month Filing Extension

Moshe Klein & Associates, Ltd is pleased to offer this FREE service. You do not need to be a client of the firm to take advantage of this FREE service. There is no cost or obligation of any kind to have MKA secure a six-month filing extension for your business or personal returns. In accordance with the IRS and many state requirements, a copy of the front and back of your drivers license or state issued ID is required.

It’s important to keep in mind that an extension of time to file tax returns is not an extension of time to pay any taxes that might be owed. Please consult with your tax adviser and/or your legal adviser regarding your personal or business circumstances.

By requesting assistance from Moshe Klein & Associates, Ltd as outlined in this document, you are not engaging the services of MKA, Ltd. for any other purpose or services. And MKA, Ltd. is not agreeing to provide any other services of any kind unless a separate service agreement is signed under separate cover. If you would like MKA, Ltd. to assist with your personal and/or business tax returns for this tax year or for prior years, just let us know. We will be glad to schedule a FREE and CONFIDENTIAL consultation right away.

Please Select Tax Year

Required Tax Returns (Select Which Returns Require a Filing Extension) *

Personal Tax Returns (Form 1040)
Multi-member LLC (Form 1065)
S Corporation (Form 1120S)
C Corporation (Form 1120)

Primary Taxpayer (Listed First on Most Recently Filed Personal Tax Returns) *

First

Middle

Last

Social Security Number for Primary Taxpayer *

Date of Birth for Primary Taxpayer *

Mailing Address for Primary Taxpayer *

Address Line 1

Address Line 2

City

State

Zip Code

Cell Phone Number for Primary Taxpayer *

Email Address for Primary Taxpayer *

Secondary (Spouse) Taxpayer (If Applicable for Personal Tax Returns)

First

Middle

Last

Social Security Number for Secondary Taxpayer

Date of Birth for Secondary Taxpayer

Mailing Address for Spouse/Secondary Taxpayer

Address Line 1

Address Line 2

City

State

Zip Code

Cell Phone Number for Secondary Taxpayer

Email Address for Secondary Taxpayer

Legal Name of Business (write NA if you don't own a business)

Business Tax ID Number (write NA if you don't own a business)

Business Mailing Address (write NA if you don't own a business)

Address Line 1

Address Line 2

City

State

Zip Code

Name of Primary Contact for The Business

As stated above, an extension of time to file tax returns is not an extension of time to pay any taxes that might be owed. The IRS and State revenue agencies can impose steep fines, penalties and interest on unpaid tax balances or balances paid after the original due date.

Therefore, MKA strongly recommends that you pay any amount owed (estimated) by the due date. The exact amount of taxes owed to the Federal and/or State agencies can only be known after tax returns are prepared

If you would like to, MKA can assist with your estimated tax payment. Please complete the information section below regarding your tax payment.

Amount you would like to pay to the IRS (federal returns): *

In what state do you owe taxes? *

Amount you would like to pay to the above state revenue authority? *

Is there another state in which you might owe taxes?

Amount you would like to pay to the second state revenue authority?

Bank Account Number: *

Bank Routing Number:

Special Notes/Comments:

By my signature below, I certify that I understand that the 2021 tax forms and / or balance of taxes that might be owed for 1120S, and 1065 entities are due on March 15, 2022, and for Forms 1120 and 1040 are due on April 18, 2022. By filing an extension, the forms 1120S, or 1065 can be filed timely as late as September 15, 2022 and Forms 1040 and 1120 can be filed as late as October 15, 2022. However, any taxes owed are still due on the original filing date, either March 15, 2022, or April 18, 2022, as mentioned above. Interest and penalties can be charged by the tax agency on tax balances owed but paid after the original due date, either March 15, 2022, or April 18, 2022, as mentioned above. If estimated taxes are owed, those taxes are due on their quarterly due dates, July15, 2021, September 15, 2021, and January 15, 2022. I understand I only owe the correct amount of taxes due and that any amount paid with the extension is an estimate. The exact amount owed is known only with a correctly prepared Form 1040, 1120, 1120S, or 1065.

By my signature below, I further acknowledge that I have read, understand, and agree to the policies, terms, conditions, and procedures as outlined on this document.

By signing this Acknowledgement, I agree that my electronic signature is the legally binding equivalent to my handwritten signature. Whenever I execute an electronic signature, it has the same validity and meaning as my handwritten signature. I will not, at any time in the future, repudiate the meaning of my electronic signature or claim that my electronic signature is not legally binding.

Signature of Taxpayer *

Clear Signature

Printed Name of Taxpayer *

Today's Date *

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