Texas Franchise Tax Extension Request

Tcode 13258 AnnualFranchise
Taxpayer number |
|
Report year |
Due date |
|
Taxpayer name |
|
|
|
|
Secretary of State file number |
|
|
|
|
|
or Comptroller file number |
Mailing address |
|
|
|
|
|
|
|
|
|
|
|
|
|
City |
State |
Country |
ZIP Code |
Plus 4 |
Blacken circle if the |
|
|
|
|
|
address has changed |
|
|
|
|
|
|
|
|
Blacken circle if this is a combined report |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
If this extension is for a combined group, you must also complete and submit Form 05-165.
Note to mandatory Electronic Fund Transfer(EFT) payers:
When requesting a second extension do not submit an Affiliate List Form 05-165.
1. Extension payment (Dollars and cents) |
1. |
|
|
|
|
Print or type name |
Area code and phone number |
|
|
|
( |
) |
- |
|
|
|
|
|
|
I declare that the information in this document and any attachments is true and correct to the best of my knowledge and belief. |
|
Mail original to: |
|
Texas Comptroller of Public Accounts |
|
|
|
|
|
Date |
|
P.O. Box 149348 |
|
|
|
|
Austin, TX 78714-9348 |
|
|
|
|
|
|
If you have any questions regarding franchise tax, you may contact the Texas Comptroller's field office in your area or call 1-800-252-1381.
Instructions for each report year are online at www.window.state.tx.us/taxinfo/taxforms/05-forms.html.
Taxpayers who paid $10,000 or more during the preceding fiscal year (Sept. 1 thru Aug. 31) are required to electronically pay their franchise tax.
For more information visit www.window.state.tx.us/webfile/req_franchise.html.
Texas Comptroller Official Use Only
VE/DE
PM Date