8809 Form

Email*

Payer’s/filer’s information

Payer’s/filer’s name

Address

City

State

Zip Code

Contact Name

Telephone Number

Email address

2. Taxpayer identification number (TIN)

3. Select your method of filing information returns. Use a separate Form 8809 for each method

Electronic
Paper

4. Enter the total number of payers/filers and attach a typed list of names and TINs

5. Check this box only if you already requested the automatic extension and you now need an additional extension

6. Check only the box(es) that apply

7. If you are requesting an extension for Forms W-2 or 1099-NEC, or if you checked the box on line 5, you must meet one of the following criteria. Check the applicable box(es) that describes your need for an extension.

The filer suffered a catastrophic event in a federally declared disaster area that made the filer unable to resume operations or made necessary records unavailable
Fire, casualty, or natural disaster affected the operation of the filer
Death, serious illness, or unavoidable absence of the individual responsible for filing the information returns affected the operation of the filer
The filer was in the first year of establishment
The filer did not receive data on a payee statement such as Schedule K-1, Form 1042-S, or the statement of sick pay required under section 31.6051-3(a)(1) in time to prepare an accurate information return

Sign here

Title:

Date:

8809

Step 1 of 2

Payer’s/filer’s information

Address

Sign here