8809

Department of the Treasury

Internal Revenue Service © This form may be filled out online. See How to file below.

For extension requests sent

electronically only, enter the total

number of records in your

extension 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 10 filers must

be filed online or electronically. 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. June 2009) (For Forms W-2 series, W-2G, 1042-S, 1098 series, 1099 series, 3921, 3922, 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.)

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, 3921, 3922, 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. Include your name,

taxpayer identification number and TCC on each additional page.

Signature © Title © Date ©

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

1042-S

Caution: Do not use this form to request an extension of time to (1) provide statements to recipients (see Extensions under 

Section M of the General Instructions for Certain Information Returns or see Part D, Section 4, of Publication 1220), (2) file

Form 1042 (use Form 7004), or (3) file Form 1040 (use Form 4868).

5498-SA

5498-ESA

General Instructions

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

to file any forms shown in line 8 for the current tax year.

Who may file. Filers of returns submitted on paper or

electronically may request an extension of time to file on this form.

How to file. This form may be filled out online through the FIRE

system at http://fire.irs.gov for an automatic 30-day extension.

Approvals are automatically displayed online if the request is

made by the due date of the return. If you are requesting an

extension for more than 10 filers, you must submit the request

online as a fill-in form or an electronic file (except for Form

8027). If you are requesting an extension for 10 or fewer filers,

you may use this paper form and mail it to the address listed

below. You are encouraged to submit requests for 10 or fewer

filers electronically via the online fill-in form.

Form

3 Transmitter Control Code (TCC)

electronic paper

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

1099, 3921, 3922, 5498, and W-2G Electronically and Pub. 1187,

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

Source Income Subject to Withholding, Electronically. For

additional information, see Topic 803, Waivers and Extensions,

at www.irs.gov/taxtopics.

If filing on paper with 10 or fewer filers, you must attach a list

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

are filing the extension request online or electronically, you do

not have to provide a list.

8027

Filer/Transmitter name

Address

Email address

City

Contact name

here here

Do not attach a list.

©

State ZIP Code

Telephone number ( )

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

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

Statement, electronically are only available from the Social

Security Administration (SSA). Call 1-800-SSA-6270 for more

information or visit the SSA website at www.socialsecurity.gov.

If you are requesting an extension for more than 10

filers, you must submit the request electronically or

online as a fill-in form (except for Form 8027).

CAUTION

Where to file. Send Form 8809 to Enterprise Computing

Center–Martinsburg, 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. 6-2009) 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, later).

Requests for an additional extension of time to file information

returns are not automatically granted. Generally requests for

additional time are granted only in cases of extreme hardship or

catastrophic event. The IRS will send you a letter of explanation

approving or denying your request for an additional extension.

Line 3. For electronic filing. If you filed Form 4419, Application

for Filing Information Returns Electronically, to file Forms 1042-S,

1098, 1099, 3921, 3922, 5498, W-2G, or 8027, and it was

approved, the Enterprise Computing Center–Martinsburg

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 part O in the

General Instructions for Certain Information Returns, and

Penalties in the Instructions for Form 1042-S, the Instructions for

Form 8027, and the Instructions for Forms W-2 and W-3.

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

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.

ON PAPER, then the

due date is . . .

Last day of February

February 28

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

3921

IF you file Form . . .

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

person who requested the extension (filer or transmitter).

3922 February 28

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 other countries under a tax treaty, or

to federal and state agencies to enforce federal nontax criminal

laws, or to federal law enforcement and intelligence agencies to

combat terrorism.

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, 36 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, SE:W:CAR:MP:T:T:SP, 1111

Constitution Ave. NW, IR-6526, Washington, DC 20224. 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

March 31

March 31

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

the due dates for filing this form on paper or electronically. IRS

will respond in writing beginning in January. Filers and

transmitters of Form W-2 whose business has terminated should

follow the procedures in the 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.

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

and date the request.

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 email 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.

Caution: The name and taxpayer identification number (TIN)

must be consistent with the name and TIN used on your other

returns. Do not use abbreviations.

5498 Series May 31

8027 Last day of February

May 31

March 31