Form 4868 Examples: Filled Out Line by Line
Quick answer
Five filled-in Form 4868 examples for common situations: a single filer who owes, a married couple due a refund, an American abroad, a nonresident alien and a freelancer paying part of the balance. Every example is made up, with round numbers, to show what goes on each line.
Names and numbers below are invented. The Social Security numbers are shown as XXX-XX-XXXX. Your own numbers come from your W-2s, 1099s and records.
1. Single filer who owes
Jordan works one job and sold some stock. They expect $8,200 of total tax and had $7,000 withheld.
| Line | What goes there | Entry |
|---|---|---|
| 1 | Name and address | Jordan Lee, 100 Main St, Columbus, OH 43215 |
| 2 | SSN | XXX-XX-XXXX |
| 3 | Spouse's SSN | Blank |
| 4 | Total tax | 8,200 |
| 5 | Total payments | 7,000 |
| 6 | Balance due | 1,200 |
| 7 | Paying now | 1,200 |
| 8 | Out of the country | Not checked |
| 9 | 1040-NR, no wages | Not checked |
Jordan mails the form with a $1,200 check to the payment address for their state. Or Jordan pays $1,200 online, marks it as an extension, and skips the form.
2. Married couple due a refund
Sam and Alex file jointly. Their tax will be about $14,000 and they had $15,500 withheld between them.
| Line | What goes there | Entry |
|---|---|---|
| 1 | Names and address | Sam Rivera & Alex Rivera, 22 Oak Ave, Denver, CO 80203 |
| 2 | First SSN on the return | XXX-XX-XXXX |
| 3 | Spouse's SSN | XXX-XX-XXXX |
| 4 | Total tax | 14,000 |
| 5 | Total payments | 15,500 |
| 6 | Balance due | -0- |
| 7 | Paying now | Blank |
| 8 | Out of the country | Not checked |
One form covers both. With nothing to pay, they mail it to the no-payment address for their state, or e-file it.
3. American living abroad
Riley, a U.S. citizen, lives and works in Portugal. They're out of the country on April 15, 2027, so they already have until June 15, 2027, and they want until October.
| Line | What goes there | Entry |
|---|---|---|
| 1 | Name and address | Riley Chen, Rua Augusta 10, Lisbon, Portugal 1100-053 |
| 2 | SSN | XXX-XX-XXXX |
| 4 | Total tax | 3,100 |
| 5 | Total payments | 2,500 |
| 6 | Balance due | 600 |
| 7 | Paying now | Blank (paying online) |
| 8 | Out of the country | Checked |
Riley files by June 15, 2027 with line 8 checked, using the special-situation mailing address for people abroad. Interest on the $600 runs from April 15, 2027, so Riley pays it as early as they can.
4. Nonresident alien with no U.S. wages
Kim is a nonresident alien with U.S. investment income and no wages subject to U.S. withholding. Kim has an ITIN.
| Line | What goes there | Entry |
|---|---|---|
| 1 | Name and address | Kim Park, foreign address |
| 2 | ITIN | 9XX-XX-XXXX |
| 4 | Total tax | 1,800 |
| 5 | Total payments | 1,800 (withheld at source) |
| 6 | Balance due | -0- |
| 8 | Out of the country | Not checked |
| 9 | 1040-NR, no wages | Checked |
Kim's Form 1040-NR is due June 15, 2027, so Form 4868 is due then too, with line 9 checked. Form 1040-NR filers use their own row of the mailing table.
5. Freelancer paying part of the balance
Morgan is self-employed. They expect $10,500 of total tax, including self-employment tax, and made $6,000 of estimated payments. They can pay $2,500 now.
| Line | What goes there | Entry |
|---|---|---|
| 1 | Name and address | Morgan Diaz, 5 Pine Rd, Portland, OR 97201 |
| 2 | SSN | XXX-XX-XXXX |
| 4 | Total tax | 10,500 |
| 5 | Total payments | 6,000 |
| 6 | Balance due | 4,500 |
| 7 | Paying now | 2,500 |
Paying less than line 6 still gets the extension. Interest and the late-payment penalty run on the $2,000 that's unpaid after April 15, 2027.
What the examples show
- Line 6 is never negative: if payments are more than the tax, it's -0-.
- Line 7 is optional and can't be more than line 6 on our form.
- Line 5 never includes the line 7 payment.
- Lines 8 and 9 are only for the situations they describe.
Last reviewed: · Based on 1 IRS sources
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