8809

Department of the Treasury

Internal Revenue Service  Send to IRS–Martinsburg Computing Center. See Where to file below.

(Enter one

year only.)

Electronic/magnetic media

requests only. Enter the total

number of records in your file.

4 If you are requesting an extension for more than

one filer, enter the total number of filers and

attach a list of names and taxpayer identification

numbers. Requests for more than 50 filers must

be filed electronically or magnetically. See How

to file below for details. 

Under penalties of perjury, I declare that I have examined this form, including any accompanying statements, and, to the best of my knowledge and belief, it is true, correct, and

complete.

2

Application for Extension of Time

To File Information Returns Form

OMB No. 1545-1081

(Rev. December 2003) (For Forms W-2 series, W-2G, 1042-S, 1098 series, 1099 series, 5498 series, and 8027)

1 Filer or transmitter information. Type or print clearly in black ink. Taxpayer identification number

(Enter your nine-digit number. Do

not enter hyphens.)

Extension

Requested

for Tax Year 

Check your method of filing information returns 6

(check only one box). Use a separate Form 8809

for each method.

5

8 Check the box(es) that apply. Do not enter the number of returns.

Form here Form

W-2 series 5498

1098 series, 1099 series, W-2G

9 If you checked the box on line 7, state in detail why you need an additional extension of time. You must give a

reason or your request will be denied. If you need more space, attach additional sheets.

Signature  Title  Date 

Cat. No. 10322N Form 8809 (Rev. 12-2003)

Check this box only if you already received the automatic extension and you now need an additional extension. See

instructions. 

7

1042-S

Caution: Do not use this form to request an extension of time to (1) provide statements to recipients, (2) file Form 1042

(instead use Form 2758), or (3) file Form 1040 (instead use Form 4868).

5498-MSA

5498-ESA

General Instructions

Purpose of form. Use this form to request an extension of time

to file any forms shown in line 8.

Who may file. Filers of returns submitted on paper, on magnetic

media, or electronically may request an extension of time to file

on this form.

How to file. When you request extensions of time to file for

more than 50 filers for the forms shown in line 8, except Form

8027, you must submit the extension requests magnetically or

electronically. For 10–50 filers, you are encouraged to submit

the extension request magnetically or electronically. 

For Privacy Act and Paperwork Reduction Act Notice, see page 2.

Form

3 Transmitter Control Code (TCC)

electronic magnetic media paper

Also, see Pub. 1220, Specifications for Filing Forms 1098,

1099, 5498, and W-2G Electronically or Magnetically and Pub.

1187, Specifications for Filing Form 1042-S, Foreign Person’s

U.S. Source Income Subject to Withholding, Magnetically or

Electronically.

If filing on paper with 50 or less filers, you must attach a list

of the filers’ names and taxpayer identification numbers. If you

are filing the extension request magnetically or electronically, you

do not have to provide a list.

8027

1099-INT/OID for REMIC

Filer/Transmitter Name

Address

E-mail address

City

Contact Name

here here

Do not attach a list.



State ZIP Code

Telephone number ( )

20

What’s New for 2003

Temporary Regulations section 1.6081-8T allows filers and

transmitters to request one automatic 30-day extension of time

to file. No signature or explanation is required for the automatic

30-day extension. One additional extension of not more than 30

days will require a second Form 8809 with a signature and a

detailed explanation.

Where to file. Send Form 8809 to IRS-Martinsburg Computing

Center, Information Reporting Program, Attn: Extension of Time

Coordinator, 240 Murall Dr., Kearneysville, WV 25430. To avoid

delays, be sure the attention line is included on all envelopes

and packages containing Form 8809.
Form 8809 (Rev. 12-2003) Page 2

Line 2. Enter your nine-digit employer identification number (EIN)

or qualified intermediary employer identification number (QI-EIN).

If you are not required to have an EIN or QI-EIN, enter your

social security number. Do not enter hyphens. Failure to provide

this number, and the list of numbers if you are acting as a

transmitter as explained under Line 1, will result in automatic

denial of the extension request.

1098 Series

Extension period. The automatic extension is 30 days from the

original due date. You may request one additional extension of

not more than 30 days by submitting a second Form 8809

before the end of the first extension period (see Line 7 below).

Requests for an additional extension of time to file information

returns are not automatically granted. Approval or denial is

based on administrative criteria and guidelines. The IRS will send

you a letter of explanation approving or denying your request.

Line 3. For electronic or magnetic media only. If you filed Form

4419, Application for Filing Information Returns Magnetically/

Electronically, to file Forms 1042-S, 1098, 1099, 5498, W-2G, or

8027, and it was approved, the IRS-Martinsburg Computing

Center assigned you a five-character Transmitter Control Code

(TCC). Enter that TCC here. Leave this line blank if you (1) are

requesting an extension to file any Forms W-2, (2) are requesting

an extension to file forms on paper, or (3) have not yet received

your TCC.

Penalty. If you file required information returns late and you have

not applied for and received an approved extension of time to

file, you may be subject to a late filing penalty. The amount of

the penalty is based on when you file the correct information

return. For more information on penalties, see the General

Instructions for Forms 1099, 1098, 5498, and W-2G.

Signature. No signature is required for the automatic 30-day

extension. For an additional extension, Form 8809 must be

signed by you or a person who is duly authorized to sign a

return, statement, or other document.

Specific Instructions

Line 1. Enter the name and complete mailing address, including

room or suite number of the filer or transmitter requesting the

extension of time. Use the name and address where you want

Tax year. You may request an extension for only 1 tax year on

this form. If no tax year is shown, the IRS will assume you are

requesting an extension for the returns currently due to be filed.

MAGNETICALLY or on

PAPER, then the due

date is . . .

Last day of February

May 31

February 28

February 28

February 28

If any due date falls on a Saturday, Sunday, or legal holiday,

file by the next business day.

Note: The automatic and any approved additional request will

only extend the due date for filing the returns. It will not extend

the due date for furnishing statements to recipients.

Line 7. Check this box if you have already received the

automatic 30-day extension, but you need an additional

extension for the same year and for the same forms. Do not

check this box unless you received an original extension.

W-2G

March 15

The due dates for filing Form 8809 are shown below.

W-2 Series

1042-S

1099 Series

5498 Series

IF you file Form . . .

Note: Approval or denial notification will be sent only to the

person who requested the extension (filer or transmitter).

8027 Last day of February

Privacy Act and Paperwork Reduction Act Notice. We ask for

the information on this form to carry out the Internal Revenue

laws of the United States. Form 8809 is provided by the IRS to

request an extension of time to file information returns.

Regulations section 1.6081-1 requires you to provide the

requested information if you desire an extension of time for filing

an information return. If you do not provide the requested

information, an extension of time for filing an information return

may not be granted. Section 6109 requires you to provide your

taxpayer identification number (TIN). Routine uses of this

information include giving it to the Department of Justice for civil

and criminal litigation, and cities, states, and the District of

Columbia for use in administering their tax laws. We may also

disclose this information to Federal, state, or local agencies to

enforce Federal nontax criminal laws and to combat terrorism. If

you fail to provide this information in a timely manner, you may

be liable for penalties and interest.

The time needed to complete and file this form will vary

depending on individual circumstances. The estimated average

time is: Recordkeeping, 2 hrs., 10 min.; Learning about the

law or the form, 27 min.; Preparing and sending the form to

the IRS, 28 min.

If you have comments concerning the accuracy of these time

estimates or suggestions for making this form simpler, we would

be happy to hear from you. You can write to the Tax Products

Coordinating Committee, Western Area Distribution Center,

Rancho Cordova, CA 95743-0001. Do not send the form to this

address. Instead, see Where to file on page 1.

You are not required to provide the information requested on

a form that is subject to the Paperwork Reduction Act unless the

form displays a valid OMB control number. Books or records

relating to a form or its instructions must be retained as long as

their contents may become material in the administration of any

Internal Revenue law. Generally, tax returns and return

information are confidential, as required by Code section 6103.

Caution: You do not have to wait for a response before filing

your returns. File your returns as soon as they are ready. For all

forms shown in line 8, except Form 8027, if you have received a

response, do not send a copy of the letter or Form 8809 with

your returns. If you have not received a response by the end of

the extension period, file your returns. When filing Form 8027 on

paper only, attach a copy of your approval letter. If an approval

letter has not been received, attach a copy of your timely filed

Form 8809.

ELECTRONICALLY,

then the due date

is . . .

March 31

March 15

March 31

March 31

March 31

May 31

March 31

When to file. File Form 8809 as soon as you know an extension

of time to file is necessary. However, Form 8809 must be filed

by the due date of the returns. See the chart below that shows

the due dates for filing this form on paper, magnetically, or

electronically. IRS will respond in writing beginning in January.

Filers and transmitters of Form W-2, Wage and Tax Statement,

whose business has terminated, should follow the procedures in

the 2004 Instructions for Forms W-2 and W-3 to request an

extension.

If you are requesting an extension of time to file several types

of forms, you may use one Form 8809, but you must file Form

8809 by the earliest due date. For example, if you are requesting

an extension of time to file both 1099 series and 5498 series

forms, you must file Form 8809 by February 28 (March 31 if you

file electronically). You may complete more than one Form 8809

to avoid this problem. An extension cannot be granted if a

request is filed after the due date of the original returns.

the response sent. For example, if you are a preparer and want

to receive the response, enter your client’s complete name, care

of (c/o) your firm, and your complete mailing address. Enter the

name of someone who is familiar with this request whom the

IRS can contact if additional information is required. Please

provide your telephone number and e-mail address. If you act as

transmitter for a group of filers, enter your name and address

here, and see How to file on page 1.

If you check this box, be sure to complete line 9. Then, sign

and date the request.

Note: Specifications for filing Forms W-2, Wage and Tax

Statements, magnetically or electronically, are only available from

the Social Security Administration (SSA). Call 1-800-SSA-6270

for more information.