Individual Declaration Of Estimated Tax Form - City Of Dublin
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1INDIVIDUAL DECLARATION OF ESTIMATED TAX
For Tax Year ___________
Name: ________________________________________________ Social Security Number: ______ - _____ - ______
Street: __________________________________ City:____________________ State: ______ Zip: _____________
1. Total income subject to tax $__________ Multiply by tax rate of 2% (.02).................................1
$
2. Subtract any estimated income tax to be withheld or paid to other cities.................................. 2
$
3. Estimated tax due before credits. Subtract Line 2 from Line 1 ............................................... 3
$
4. Credits Carried Forward............................................................................................................. 4
$
5. Net estimated tax due. Subtract Line 4 from Line 3.................................................................. 5
$
6. Amount Paid (Not Less than 22.5% of Line 5)........................................................................... 6
$
Signature: _________________________________________ Date: _______________
Make check payable to: City of Dublin and remit to City of Dublin, Income Tax Division, PO Box 9062, Dublin, OH 43017-0962
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