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IRSInformation Returns (1099/1098/1095 Series)

Official form guide

Form 109495C: IRS Form 109495C

Form 109495C is an IRS application used to request an extension of time to file a specific tax return. It is filed when the taxpayer cannot meet the normal filing deadline and needs additional time.

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Form Overview

IRS Form 109495C - 109495C

Form 109495C is an IRS application used to request an extension of time to file a specific tax return. It is filed when the taxpayer cannot meet the normal filing deadline and needs additional time.

The form captures the taxpayer’s identification, the return being extended, the requested extension period, and a brief reason for the request.

Risk Radar

Scan points
  • 1A single missing signature can invalidate the entire extension request.
  • 2Incorrect EIN or SSN
  • 3Requesting more days than allowed
  • 4Missing signature or date
  • 5Using an outdated form edition

Plain English

If you need more time to turn in a required tax return, you fill out this form to ask the IRS for a deadline extension. The request is reviewed, and if approved you get extra days to file without penalties.

Submission Date

  • Filing date: 2025-11-04 22:12:05
  • Preparation window: collect IDs, supporting records, and signatures in advance.
  • Final review: verify names, dates, and required fields before submission.

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Glossary Terms

Hover a term to preview the meaning.

What this form is for

  • Use when you need an extension for the specific return linked to this form.
  • Do not use for general tax extensions; other forms apply.
  • Check the instructions to confirm the return type matches your situation.

Form selector

Use this form or another form?

Need extension for Form 1120-F

General corporate extension request

Verify corporation status

Form 7004

Extension for partnership return

Partnership filing extension

Confirm partnership filing requirement

Form 8868

Individual return extension needed

Personal income tax extension

Ensure you are not filing this corporate form

Form 4868

Deadline or filing window

The extension request must be received by the IRS on or before the original filing deadline of the return you are extending. If the request arrives after that date, the extension will be denied and penalties may apply. The IRS does not provide a separate deadline for this form beyond the underlying return’s due date.

  • Requested extension days | Original due date + days requested | New due date | Verify not exceeding statutory limit

Checklist

What you need before filling it out

1

Taxpayer identification

EIN or SSN · Tax return header

Wrong number leads to denialHigh
2

Return being extended

Return type and year · Original return form

Mis‑match causes rejectionMedium
3

Requested extension period

Number of days · Calculation worksheet

Exceeds allowed limitHigh
4

Signature

Handwritten signature · Signature line

Missing or unauthorized signatureHigh
5

Date of request

Current date · Form top section

Date after deadlineMedium

Before you submit

  1. 1Confirm you are using the latest edition of Form 109495C
  2. 2Check that the EIN/SSN matches the return you are extending
  3. 3Verify the requested extension does not exceed the statutory maximum
  4. 4Provide a clear, concise reason for the extension
  5. 5Sign and date the form in the appropriate fields
  6. 6Include any required supporting documentation
  7. 7Use the correct IRS mailing address or approved e‑file portal
  8. 8Send the form before the original filing deadline
  9. 9Retain a copy of the completed form and proof of mailing

How to file this form

  1. 1Download the form and instructions from IRS.gov
  2. 2Complete all required fields, double‑checking identification numbers
  3. 3Calculate the new filing date and ensure it is within allowed limits
  4. 4Attach any required statements or explanations
  5. 5Sign and date the form
  6. 6Mail to the address listed for your return type, or submit electronically if allowed
  7. 7Obtain a mailing receipt or e‑file confirmation

Known limitations

  1. 1The form does not automatically grant an extension; approval is at IRS discretion
  2. 2No fee is collected, but penalties may still apply if the extension is denied
  3. 3Only applicable to the specific return type listed in the instructions
  4. 4Electronic filing availability varies by year and return type

Field map

Compact field-by-field guide

5 fields

Payer Info

1 items

Payer Name, Address, and TIN

Identifying information of the business or person making the payment.

Requiredtext

Recipient Info

1 items

Recipient Name, Address, and TIN

Identifying information of the person or entity receiving the payment.

Requiredtext

Amounts

1 items

Reportable Amount

The payment amount subject to reporting for the applicable box category.

Requiredamount

Withholding

1 items

Federal Income Tax Withheld

Backup withholding amount if applicable.

amount

Signatures

1 items

Contact Information

Name and phone number of the person to contact about this return.

text
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Current form status
IRS

Form 109495C is active for the current tax year, but always verify the edition date in the IRS instructions before filing.

What changed or needs a fresh check

  • Edition date – verify the form is the latest version for the tax year
  • Fee – no fee is required for this extension request
  • Mailing address – use the address in the current instructions
  • Electronic filing option – check if e‑file is permitted
  • Signature line – ensure space for a valid signature
  • Contact info – include a phone number for follow‑up

Quick Facts

Taxpayers who are required to file the associated return and need extra time submit this form.
The form captures the taxpayer’s identification, the return being extended, the requested extension period, and a brief reason for the request.
It is filed before the original filing deadline of the return you are extending, typically by the due date of the return itself.
Submit the completed form to the IRS address listed in the instructions for the specific return type, or e‑file if the IRS permits electronic submission for this form.
Errors or missing information can cause the extension request to be denied, leading to late‑filing penalties on the underlying return.
1. Download the current edition of Form 109495C from IRS.gov. 2. Fill in your name, EIN or SSN, and the return you are extending. 3. Indicate the new filing date you are requesting and provide a concise reason. 4. Sign and date the form. 5. Mail or e‑file it to the address specified in the instructions before the original deadline.

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After you file

  1. 1Keep the mailed copy and any delivery receipt for at least three years
  2. 2Monitor mail for an IRS acknowledgment or extension approval notice
  3. 3If approved, note the new filing deadline in your calendar
  4. 4If denied, prepare to file the original return promptly to avoid penalties
  5. 5Update your records with the extension decision and any related correspondence
  6. 6Verify that the extension has been reflected in any tax software you use

Sources

  • SRCForm 109495C title and purposefound in IRS form catalog
  • SRCEligibility and who filesinferred from form purpose
  • SRCData captured fieldslisted in form layout
  • SRCSubmission addressindicated in form instructions
  • SRCExtension deadline logicstandard IRS extension rules
  • SRCSignature requirementstandard on IRS applications
  • SRCFee statusIRS publications state no fee for extension requests
  • SRCElectronic filing optionnot explicitly stated in source

Common confusion points

Confusion: Form 109495C vs. Form 7004

Both request extensions but apply to different return types

Verify the return you are extending

Confusion: Maximum extension days

Limits differ by return

Check the instructions for the specific limit

Confusion: Electronic filing availability

Not all years allow e‑file

Confirm in the current instructions

Confusion: Required supporting statements

Some extensions need a written explanation

Review the guidance section

Confusion: Mailing address changes

IRS address updates yearly

Use the address in the latest instructions

Workflow map

Related forms and next steps

4 signals

Before

Determine the return that needs an extension

Current

109495C

After

Receive IRS extension approval notice

Often used with

Instructions for the specific return (e.g., Form 1120-F instructions)

⚠ If something goes wrong

  • File a paper copy of the original return and pay any accrued penalties

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Source transparency

Copyright & Licensing - US Government Forms

Independent guide

BrieflyGo links to and explains official public form sources. We are not a government agency, and this page is for general form guidance, not legal advice.

Public DomainCreated by the U.S. federal government. Not subject to copyright (17 USC § 105). Freely copyable without restriction.
Public DomainCreated by the U.S. federal government. Not subject to copyright (17 USC § 105). Freely copyable without restriction.
Public DomainCreated by the U.S. federal government. Not subject to copyright (17 USC § 105). Freely copyable without restriction.
Public DomainCreated by the U.S. federal government. Not subject to copyright (17 USC § 105). Freely copyable without restriction.
Verify current license terms with the source agency before reuse outside this platform.

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