Form 05-164-A — Texas Franchise Tax Extension Request (Annual)

Taxpayer number Due dateReport year
State Country address has changed
Blacken circle if this is a combined report
City
Taxpayer name
Mailing address
ZIP code plus 4 Blacken circle if the
Tcode 13258 Annual

1. Extension payment 1.(Dollars and cents)

Print or type name Area code and phone number
( ) -
VE/DE
PM Date
(Rev.9-16/9)
Texas Franchise Tax Extension Request
If an online extension payment is made, the taxable entity should NOT submit a paper Extension Request (Form 05-164).
If this extension is for a combined group, you must also complete and submit Form 05-165.
Note to mandatory Electronic Fund Transfer(EFT) payers:
I declare that the information in this document and any attachments is true and correct to the best of my knowledge and belief.
Date
Mail original to:
Texas Comptroller of Public Accounts
P.O. Box 149348
Austin, TX 78714-9348
Instructions for each report year are online at www.comptroller.texas.gov/taxes/franchise/forms. If you have any questions, call 800-252-1381.
Taxpayers who paid $10,000 or more during the preceding fiscal year (Sept. 1 thru Aug. 31) are required to electronically pay their franchise tax. For more information visit www.comptroller.texas.gov/taxes/franchise/filing-requirements.php.