Form 4768

(Rev. August 2003) OMB No. 1545-0181

Department of the Treasury

Internal Revenue Service For filers of Form 706, 706-A, 706-D, 706-NA, or 706-QDT (circle only one)

Note: Use Form 2758 to request an extension for Forms 706-GS( D) and 706-GS( T).

Identification

Decedent’s first name and middle initial Decedent’s last name Date of death

Name of executor Decedent’s social security number

Address of executor (Number, street, and room or suite no.) Estate tax return due date

City, state, and ZIP code

Extension of Time To File Form 706 (Section 6081)

Automatic Extension

Extension of Time To Pay (Section 6161)

Enter extension date requested You must attach your written statement to explain in detail why it is impossible or impractical to pay

the full amount of the estate (or GST) tax by the return due date. If the taxes cannot be determined

because the size of the gross estate is unascertainable, check here  and enter “-0-” or other

appropriate amount on Part V, line 3. You must attach an explanation.

Payment To Accompany Extension Request

1 Amount of estate and GST taxes estimated to be due 1

2 Amount of cash shortage (complete Part IV) 2

3 Balance due (subtract line 2 from line 1) (see instructions) 3

Signature and Verification

If filed by executor—Under penalties of perjury, I declare that I am an executor of the estate of the above-named decedent and that

to the best of my knowledge and belief, the statements made herein and attached are true and correct.

Executor’s signature Title Date

If filed by someone other than the executor—Under penalties of perjury, I declare that to the best of my knowledge and belief, the

statements made herein and attached are true and correct, that I am authorized by an executor to file this application, and that I am

(check box(es) that applies):

A member in good standing of the bar of the highest court of (specify jurisdiction)  

A certified public accountant duly qualified to practice in (specify jurisdiction) 

A person enrolled to practice before the Internal Revenue Service.

A duly authorized agent holding a power of attorney. (The power of attorney need not be submitted unless requested.)

Filer’s signature (other than the executor) Date

Application for Extension of Time To File a Return

and/or Pay U.S. Estate

(and Generation-Skipping Transfer) Taxes

Part V

Part I

Part II

Name of application filer (if other than the executor)

Part III Extension of Time To File Form 706-A, 706-D, 706-NA, 706-QDT (Section 6081)

You must attach your written statement to explain in detail why it is impossible or impractical to file Enter extension date requested

a reasonably complete return by the due date of the return.

Part IV

Domicile of decedent (county, state, and ZIP code)

Also you must attach a statement explaining in detail why it is impossible or impractical to file Form

706 by the due date. See the instructions.

If you have not filed a request for an automatic 6-month extension and the time for filing such a request has passed, check here 

Also, you must attach a written statement explaining in detail why you were unable to request an

automatic extension, why it was impossible or impractical to file Form 706 by the due date, and why

you should be granted an extension at this time. See the instructions.

Enter extension date requested

Enter extension date requested

● If this request is for the tax that will be due when the Form 706 is filed, check here 

● If this request is for the tax that will be due as a result of an amended or supplemental Form 706, check here 

● If this request is for additional tax due as a result of an examination of your Form 706, check here 

For Privacy Act and Paperwork Reduction Act Notice, see separate instructions. Cat. No. 41984P Form 4768 (Rev. 8-2003)

Daytime telephone number

( )

If you are applying for an automatic 6-month extension of time to file Form 706, check here (see instructions) 

Additional Extension

If you are an executor out of the country applying for an extension of time to file in excess of 6 months, check here 

Extension for Cause
Notice to Applicant—To be completed by the Internal Revenue Service

2 The application for extension of time to pay (Part IV) is:

1 The application for extension of time to file (Part II or III) is:

Approved

Not approved because

Other 

Form 4768 (Rev. 8-2003)

Part VI

Form 4768 (Rev. 8-2003)

Internal Revenue Service official Date

Approved

Not approved because (see page 3 of the separate instructions for your appeal rights) 

Other 

Internal Revenue Service official Date

Page 2

Decedent’s first name and middle initial Decedent’s last name Decedent’s social security number

Address

Address

Name (Please print)

Title (Please print)

Signature:

Name (Please print)

Title (Please print)

Signature: