Labels:text | paper | book | letter | font | paper product | handwriting | menu OCR: 1040EZ Departincrit of the Name & addres- 4868 Application for Au Form To File U.S. Indivi Department of the Treasury Internal Revenue Service Your first name and indial Please " a point retur, spouse's first name and hissar Department of the Treasury -Internal Revenue Sean U.S. Individual Income Tax Reti Type or Present home address (number, street, and apr. no, or rueil route) er yo 1040 For the year Jan -Dec: 31. 199t, or other tax year beg Print Your first name and Nitidi City, town or post office, state, and ZIP code abel If a jott return, spouse's Sirat name and ribal Note: File this form with the Internal Revenue Service Center where you are amount(s) you owe. This is not an extension of time to pay your tax. Home address (number and streat). if you har I request an automatic 4-month extension of time to August 17, 1992. to file Form Town or post office, state, and 21P cod (or if a fiscal year Form 1040 to , 19 for the Isx yte nigt $1 to go to this fu does your spous Total tax liability for 1991. This is the amount you expect to enter on line 27 of Fom line 53 of Form 1040. If you do not expect to owe tax, enter 0 -. Caution: You MUST enter an amount on line 1 or your extension will be dened , this amount, but be as exact as you can with the information you have if we estimate was not reasonable, the extension will be null and void. D CO - Federal income tax withheld 1 estimated lax payments (include 1990 overpayment allowed as syments and credits you expect to show on Form 10404 2, 3, and 4 QUE (subtract line 5 from line 1). ith this form. (If line 5 is m hift or generation C 43.00 of include 50.00 14.97 - 282-69 - 229.55 1,899.85 * 186-10 * 66+80 392.11 x 63.0
