Form 4768

OMB No. 1545-0181

(Rev. July 2008)

Department of the Treasury

Internal Revenue Service

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, 706-A, 706-D, 706-NA, or 706-QDT (Section 6081)

Extension of Time To Pay (Section 6161)

Enter extension date requested

(Not more than 12 months) 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 IV, 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 III) 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 apply(ies)):

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 I

Part II

Name of application filer (if other than the executor)

Part III

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.

Enter extension date requested

● If this request is for the tax that will be or was due with the filing of Form 706, 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 Paperwork Reduction Act Notice, see separate instructions. Cat. No. 41984P Form 4768 (Rev. 7-2008)

Daytime telephone number

( )

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 ©

If you are applying for an automatic 6-month extension of time to file:

Automatic Extension

● If this request is for a section 6166 installment payment, check here ©

● Form 706, check here ©

Form 706-A

● Form 706-A, 706-D, 706-NA, or 706-QDT, indicate the form by checking the appropriate box below.

Form 706-D Form 706-NA Form 706-QDT
Notice to Applicant—To be completed by the Internal Revenue Service

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

Approved

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

Other 

Form 4768 (Rev. 7-2008)

Part V

Form 4768 (Rev. 7-2008)

Internal Revenue Service official Date

Page 2

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

Address

Signature:

Name (print)

Title (print)