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COVID-19 Q1 B&O Tax Interest and Penalties Waiver Request Form

2. If you are submitting your Q1 tax form after the April 30 due date, due to COVID-19, you may use this form to request a waiver on Q1 penalties and interest.

   If you are submitting your Q1 tax form after the April 30 due date, due to COVID-19, you may use this form to request a waiver on Q1 penalties and interest.

4. Account Number*

5. UBI Number*

7. First Name*

8. Last Name*

10. Email address*

12. Phone Number*

14. Have you submitted your Q1 tax form yet? *
    -- Select One --YesNo

16. Request for waiver due to COVID-19*

    Please provide us with the reason your Q1 taxes were filed late due to COVID-19.

Leave This Blank:


17. 1. Receive an email copy of this form.
18. Email address

    This field is not part of the form submission.

19. Submit

* indicates a required field