Address MM DD YYYY
City Town or Post Office State ZIP Code
Corporation Name Federal Employer Identifi cation Number
CORPORATIONS *1200300*
DO NOT STAPLE OR TAPE CHECK TO YOUR FORM DO NOT CUT FORM DO NOT SEND PHOTOCOPIES OF FORMS
Enter the beginning and ending dates for the tax year (NOT the quarter dates)
FORM 1120EXT ME
MAINE EXTENSION TAX
Maine Revenue Services P O Box 9101 Augusta ME 04332 9101
Make check payable to TREASURER STATE OF MAINE Mail both to:
MM DD YYYY MM DD YYYY Amount of Payment
Original Due Date of
PAYMENT VOUCHER FOR
Your Federal Tax Return
