8809

Department of the Treasury

Internal Revenue Service © Send to Martinsburg, WV. See Where To File on page 2.

(Enter only 1

tax year.)

3 Person IRS can contact about this request Telephone number

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

Request for Extension of Time To

File Information Returns Form

OMB No. 1545-1081

(Rev. June 1997) (For Forms W-2, W-2G, 1042-S, 1098, 1099, 5498, and 8027)

1 Filer or transmitter name and mailing address (number and street (including room or suite

number) or post office box, city, state, and ZIP code) (Please type or print clearly.)

Federal identification number

(Enter your nine-digit number. Do

not enter a hyphen.)

Extension

Request for

Tax Year 

©

Transmitter control code (IRS magnetic media/electronic filers only) 4 5

8 Check the boxes that apply. You need not enter the number of returns.

Form Check here Form Check here Form Check here

( ) ( )

1099-PATR

1099-C

W-2

1099-G 1099-R

1098

1099-INT 1099-S

1099-A

1099-LTC 5498

1099-OID

1099-B

W-2G

9 State in detail why you need an extension. If you need more space, attach additional sheets.

Signature © Title © Date ©

Cat. No. 10322N Form 8809 (Rev. 6-97)

( )

6 Enter total number of filers for which this request is made (Complete only if you are a transmitter requesting an extension

for more than one filer. You must attach a list of the names and employer identification numbers of such filers. If you are

making the request for 10 or more filers, see the Note under Who May File below) ©

7 Check this box only if you received an original extension and you now need an additional extension. (See instructions.) ©

1099-DIV

( )

1042-S

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

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

1099-MSA

1099-MISC 5498-MSA

8027

General Instructions

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

file Form W-2, W-2G, 1042-S, 1098, 1099, 5498, or 8027.

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. A transmitter for multiple filers may file this form but must

attach a list of the names and employer identification numbers of

those for whom they will be filing.

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. For example, a request for an extension

of time to file Form 1099-INT, Interest Income, must be filed by

February 28. 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

Note: If you are requesting extensions of time to file for more than

50 filers, you must submit the extension requests magnetically or

electronically. If you are requesting extensions of time for 10–50

filers, you are encouraged to submit the extension requests

magnetically or electronically. For more information, see Pub. 1220,

Specifications for Filing Forms 1098, 1099, 5498 and W-2G

Magnetically or Electronically, and Pub. 1239, Specifications for

Filing Form 8027, Employer’s Annual Information Return of Tip

Income and Allocated Tips Magnetically/Electronically.

For Paperwork Reduction Act Notice, see back of form.
Form 8809 (Rev. 6-97) Page 2

Line 2.—Enter your nine-digit Federal EIN or social security number

if you are not required to have an EIN. Do not enter hyphens. A

transmitter must enter the transmitter’s EIN. Failure to provide this

number, and 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

Where To File.—If you use the U.S. Postal Service (USPS) to send

Form 8809, send it to IRS-Martinsburg Computing Center,

Information Reporting Program, P.O. Box 1359, MS-360,

Martinsburg, WV 25402-1359. If you use a carrier other than the

USPS, send Form 8809 to IRS-Martinsburg Computing Center,

Information Reporting Program, Route 9 and Needy Road, MS-360,

Martinsburg, WV 25401.

Extension Period.—If the IRS approves your extension request, you

will be granted an extension of 30 days from the original due date.

Line 3.—For magnetic media or electronic filers 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 Forms W-2, (2) are requesting an

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

TCC.

Additional extension.—Although rarely granted, you may request

an additional 30 days by submitting another Form 8809 before the

end of the initial extension period.

Approval or Denial of Request.— Requests for extensions 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 4.—Enter the name of someone who is familiar with this

request whom the IRS can contact if additional information is

required.

Line 5.—Enter the telephone number, including area code, of the

person shown on line 4.

Line 8.—Indicate the information returns for which you are

requesting an extension of time to file by checking the appropriate

box(es). For example, if you are requesting an extension of time to

file Forms 1099-INT, check the box beside Form 1099-INT.

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. The

penalty is:

● $15 per information return if you correctly file within 30 days (by

March 30 if the due date is February 28); maximum penalty $75,000

per year ($25,000 for certain small businesses).

● $30 per information return if you correctly file more than 30 days

after the due date but by August 1; maximum penalty $150,000 per

year ($50,000 for certain small businesses).

Line 9.—Explain why you need an extension of time to file.

● $50 per information return if you file after August 1 or you do not

file required information returns; maximum penalty $250,000 per year

($100,000 for certain small businesses).

If you intentionally do not file correct information returns, the

minimum penalty is $100 per information return with no maximum

penalty.

Signature.—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 requesting the extension of time.

Use the name and address where you want the response sent. For

example, if you are a preparer and want to receive the response,

Note: Failure to properly complete and sign this form may cause

delay in processing or result in the denial of your request. Be sure

you are requesting an extension of time to file only for returns listed

on line 8 on this form.

Tax Year.—Enter the tax year for which the extension is requested.

If no tax year is shown, the IRS will assume you are requesting an

extension for the returns currently due to be filed.

Due Date

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: If you are required to file 250 or more returns, you must file

them magnetically or electronically. See the Instructions for Forms

1099, 1098, 5498, and W-2G, the Instructions for Form W-2, the

Instructions for Form 1042-S, and the Instructions for Form 8027,

for more information.

Note: If your extension request is approved, it will only extend the

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

providing statements to recipients.

Line 6.—For transmitters requesting an extension for two or more

filers, enter the number of filers. Be sure to attach the required list.

All others should leave this box blank.

Line 7.—Check this box to tell the IRS you have already received at

least one 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.

A small business is a firm with average annual gross receipts of

$5 million or less for the 3 most recent tax years.

W-2G

March 15

Filing Due Dates

W-2

1042-S

1099

5498 (and 5498-MSA)

Form Number

Caution: Do not file Form 8809 with Forms W-2, W-2G, 1042-S,

1098, 1099, 5498, or 8027.

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

who requested the extension (filer or transmitter).

8027 Last day of February

Paperwork Reduction Act Notice.—We ask for the information on

this form to carry out the Internal Revenue laws of the United States.

You are required to give us the information. We need it to ensure

that you are complying with these laws and to allow us to figure and

collect the right amount of tax.

The time needed to complete and file this form will vary

depending on individual circumstances. The estimated average time

is:

Recordkeeping 2 hrs. 4 min.

Learning about the law or the form 10 min.

Preparing and sending the form to the IRS 26 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 Forms Committee,

Western Area Distribution Center, Rancho Cordova, CA 95743-0001.

DO NOT send the form to this address. Instead, see Where To File

above.

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.

enter your client’s complete name, care of (c/o) your firm, and your

complete mailing address. If you act as transmitter for a group of

filers, enter your name and address here, and attach a list of filer

names and employer identification numbers (EINs).

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

returns. File your returns as soon as they are ready. 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. Do not include a copy of

Form 8809.

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

extension of time to file both Forms 1099-INT and Forms 5498, IRA,

SEP, or SIMPLE Retirement Plan Information, you must file Form

8809 by February 28. You may complete more than one Form 8809

to avoid this problem. You may request an extension for only 1 tax

year on this form. An extension cannot be granted if a request is

filed after the due date of the original returns.