Extension

Extension

D&R TaxGuys, Inc.

250 Eighth Avenue, #2N, New York, NY 10011           Info@DrTaxGuys.com                Voice - 212.645.4889  fax - 212.255.6816               www.DrTaxGuy.com

Please complete the information below and press the submit button at the bottom of the page and we will receive it via email. PLEASE NOTE BELOW statement re email. CLIENT INFORMATION:

Taxpayer Name:                                          Spouse Name:

Social Security Number:

Address:

Social Security Number:

City

Home Phone:

Email:

State

Zip Code:

Cell Phone:

This authorizes D&R Taxguys, Inc. to file on my behalf to extend the due date of my/our return to October 15, 2010 for the tax year 2009. I/we UNDERSTAND that this is an extension to FILE not an extension TO PAY. If, when the return is complete, there are payments due I/we realize that penalties and interest will be due.

Signature

Signature

Date

PLEASE NOTE: If you do not receive a confirmation reply from us, you need to print out this page and fax it to 212.255.6816. Unfortunately all web browsers do not act the same and yours may be one not compatible with this function. Don’t worry if you get a message saying the email won’t be encrypted as this site is secure. Please check your “sent folder” to ensure the extention was actually sent.