Form 8809

(Rev. August 1990)

Department of the Treasury
Internal Revenue Service

Request for Extension of Time
To File Information Returns

(For Forms W-2, W-2P, 1098, 1099, 5498, and W-2G)
Send to Martinsburg, WV. See Where To File.

OMB No. 1545-1081
Expires 11-30-91

i 1 Filer or transmitter name and mailing address (number and street (including room or suite number) 2 Federal identification number
Extension or post office box, city, state, and ZIP code) (Enter a 9-digit number. Do not
Request for enter a hyphen.)

Tax Year
19__ Lit itt id
Enter only 3 Transmitter control code (IRS magnetic media filers only) | 4 Person IRS can contact about this request 5 Telephone number
¢ )
6 Check the boxes that apply. You need not enter the number of returns.
‘Type of Return | Paper Returns |MagneticMedia*| Type of Return | Paper Returns |MagneticMedia*| Type of Return | Paper Returns | Magnetic Media*
WV) VY) (vy) WV) (Y) iY)
W:2 1099-DIV 1099-PATR
W-2P
(1990 only) 1099-G 1099-R
1098 1099-INT 1099-S
1099-A 1099-MISC 5498
1099-B 1099-OID W-2G
includes electronic filing.
7 State in detail why you need an extension. If you need more space, attach additional sheets.
8 Will you provide, or have you provided, a copy of the information return or the required statement to the
YesC] Nol]

recipient on time? (See instructions.)

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

Signature >

Title >

Date >

For Paperwork Reduction Act Notice, see back of form.

Form 8809 (Rev. 8-90)


Form 8809 (Rev. 8-90)

Page 2

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
taxpayers 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 44 mins.
Learning about the

law or the form 14 mins.
Preparing the form 50 mins.
Copying, assembling,

and sending the form

to IRS 26 mins.

If you have comments concerning the
accuracy of these time estimates or
suggestions for making this form more
simple, we would be happy to hear from
you. You can write to both the Internal
Revenue Service, Washington, DC 20224,
Attention: IRS Reports Clearance Officer,
T:FP: and the Office of Management and
Budget, Paperwork Reduction Project
(1545-1081), Washington, DC 20503. DO
NOT send this form to either of these
offices. Instead, see Where To File, below.

General Instructions

Purpose of Form.—Use this form to
request an extension of time to file Forms
W-2, W-2P (for 1990 only), 1098, 1099,
5498, or W-2G. Note: Do NOT use this
form to request an extension of time to
furnish the statement to the recipient or for
an extension of time to file Form 1040. For
rules on extending the time to file Form
1040, see the Form 1040 instructions.

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, addresses, and
employer identification numbers of those
for whom they will be filing.

When To File. —Your request for an
extension of time to file must be filed by the
due date of the returns. For example, a
request for an extension of time to file Form
1099-INT, Statement for Recipients of
Interest Income, must be filed (postmarked)
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 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, Individual Retirement
Arrangement Information, you must file
Form 8809 by February 28. You may
complete more than one Form 8809 to
avoid this problem. You can request an
extension for only 1 tax year on this form.

Filing Due Dates

Form Number Due Date
W-2 February 28
W-2P (for 1990 only) February 28
1098 February 28
1099 February 28
5498 May 31
W-2G February 28

Where To File.—Send Form 8809 to
Internal Revenue Service, Martinsburg
Computing Center, P.O. Box 1359,
Martinsburg, WV 25401-1359, or Internal
Revenue Service, Martinsburg Computing
Center, Route 9 and Needy Road,
Martinsburg, WV 25401.

Extension Period.—If your extension
request is approved, you will be granted an
extension for 30 days from the original due
date.

Additional extension.—lf you need
additional time to file, you may request an
additional 30 days by submitting a letter
and attaching a copy of the first approval
letter you received from IRS 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. IRS
will send you a letter of explanation
approving or denying your request. If the
request 1s approved, a copy of the letter of
approval must be sent with the returns that
you file after February 28 (May 31 for
Forms 5498).

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).

@ $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 fail to file correct information returns
because of intentional disregard of the filing
and correct information requirements, the
penalty is at least $100 per information
return with no maximum penalty.

Specific Instructions

Item 1.—Enter the name and complete
mailing address, including room or suite
number, of the filer requesting the
extension of time. If you act as transmitter
for a group of filers, enter the transmitter
name and address here, and attach a list of

filer names, addresses, and employer
identification numbers (EINs). Notify
Martinsburg Computing Center in writing of
any change in mailing address. Include a
copy of your original Form 8809

Note: Approval or denial notification will be
sent only to the person who requested the
extension (filer or transmitter).

Item 2.—Enter your nine-digit Federal
employer identification number or social
security number if you are not required to
have an employer identification number Do
not enter hyphens. A transmitter should
enter the transmitter’s Federal EIN in this
box. Failure to provide this number, or list of
numbers if you are acting as a transmitter
as explained under /tem 1, will result in an
automatic denial of the extension request.
Item 3.—For magnetic media filers only,
enter your Transmitter Control Code (TCC).
This will apply only if you have filed Form
4419, Application for Filing Information
Returns Magnetically/Electronically, to file
Forms 1098, 1099, 5498, and/or W-2G,
with IRS on magnetic media. The IRS
Martinsburg Computing Center assigns a
five-character TCC on approval of the Form
4419. See Form 4419 for more
information. Leave this item blank if your
extension request is for filing paper forms,
for filing Forms W-2 or W-2P, or if you have
not yet been assigned a TCC.

Item 4.—Enter the name of someone who
is familiar with this request that IRS can
contact if additional information is required.
Item 5.—Enter the telephone number,
including area code, of the person shown in
item 4.

Item 6.—Indicate the type(s) of
information returns for which you are
requesting an extension of time to file and
how they will be filed by checking the
appropriate box(es). For example, if you are
requesting an extension of time to file
Forms 1099-INT on magnetic media, check
the box titled “Magnetic Media” beside the
block for 1099-INT Note: You are required
to file your information returns on magnetic
media if you are required to file 250 or more
returns. See the Instructions for Forms
1099, 1098, 5498, and W-2G, and the
Instructions for Forms W-2 and W-2P, for
more information about who is required to
file on magnetic media.

Item 7.—Explain why you need an
extension of time to file your information
returns.

Item 8.—Check the appropriate box to
indicate whether you will provide, or have
provided, a copy of the information return
or the required statement to the recipients
‘on time. Note: /f this extension request is
approved, it will only extend the due date
for filing the returns. It will not extend the
due date for furnishing the required copies
or statements to recipients.
Signature.—The extension request must
be signed by you or a person who is duly
authorized to sign a return, statement, or
other document.

Note: Failure to properly complete and sign
this form may cause delay in processing or
result in denial of your request. Be sure you
are requesting an extension of time to file
only those returns listed on page 1