Texas Franchise Tax Extension Request
 
 

 Tcode 13258 AnnualFranchise
 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