Estimated Taxpayment Form - City Of Brook Park - Department Of Taxation
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1CITY OF BROOK PARK -- DEPARTMENT OF TAXATION
STATEMENT OF ESTIMATED TAX DUE 6161 ENGLE RD. BROOK PARK, OH 44142 216-433-1533
PAYMENT CAN BE MADE BY CASH, CHECK, MASTERCARD, VISA OR ELECTRONIC FUNDS TRANSFER.
MASTER CARD AND VISA CREDIT CARD PAYMENTS ARE NOW ACCEPTED OVER THE INTERNET. VISIT
, CLICK ON TAX DEPARTMENT AND SELECT "TAX CONNECT".
INDIVIDUALS OR BUSINESS ENTITIES WISHING
TO SUBMIT ESTIMATED TAX PAYMENTS VIA
ELECTRONIC FUNDS TRANSFER, PLEASE CHECK
THE REGISTRATION BOX ON THE REMITTANCE
FORM BELOW. THIS CONVENIENT TOUCH TONE
TELEPHONE METHOD PROCESSES ESTIMATED
TAX PAYMENTS AS WELL AS AMENDMENTS TO
THE ORIGINAL DECLARATION. BUSINESSES
PREFERRING TO INITIATE ELECTRONIC
TRANSACTIONS CAN ALSO PAY VIA THIS
SYSTEM. ACH CREDIT TRANSFERS REQUIRE
USAGE OF AN APPROVED ADDENDUM FORMAT.
IMPORTANT INFORMATION FOR ESTIMATED TAXPAYERS
YEAR
ACCOUNT NUMBER
It is the taxpayers responsibility to maintain the accuracy of the declaration of income by
amending the estimated tax due as required by changing circumstances.
A declaration of estimated tax for the current year must be filed on or before the due date
TOTAL AMOUNT
of the final return for the previous year accompanied by a payment of at least 22.5% of
DUE
$
the estimated tax. At least a similar amount shall be paid on or before July 31, October 31
1
PRIOR YEAR
and January 31 of each year.
CREDIT
$
(FISCAL YEAR TAXPAYERS WILL SUBSTITUTE THEIR CORRESPONDING DATES)
2
PAYMENTS
An assessment will be made if you have not paid at least 90% of the actual tax due by the
TO DATE
$
end of the thirteenth month after the start of the fiscal year or, alternatively, at least an
3
amount equal to the amount paid for the prior year based on a twelve month-period.
UNPAID
BALANCE
$
4
MAKE CHECK OR MONEY ORDER PAYABLE TO:
AMOUNT
CITY OF BROOK PARK DEPARTMENT OF TAXATION
NOW DUE
$
5
6161 ENGLE ROAD
AMOUNT PAID
BROOK PARK, OH 44142
HEREWITH
$
6
MASTER CARD AND VISA CREDIT CARD PAYMENTS ARE NOW ACCEPTED OVER
THE INTERNET. VISIT , CLICK ON TAX DEPARTMENT
KEEP THIS PORTION
FOR YOUR RECORDS
AND SELECT "TAX CONNECT".
RETAIN THIS PORTION ABOVE PERFORATION FOR YOUR RECORDS
RETURN ONLY THIS PART BELOW PERFORATION
BQ1
AMEND HERE
CITY OF BROOK PARK
IF YOUVE MOVED OUT OF BROOK PARK
USE THIS BOX ONLY FOR ADJUSTING YOUR ORIGINAL DECLARATION
INCOME TAX DEPARTMENT
PLEASE AMEND YOUR ORIGINAL DECLARATION
216-433-1533
AND COMPLETE THE FOLLOWING INFORMATION
AMENDED ESTIMATED INCOME
MOVE OUT DATE: ________/________/________
YEAR
ACCOUNT NUMBER
AMENDED DUE OTHER CITY
AMENDED ESTIMATED TAX DUE
NEW ADDRESS:
TOTAL AMOUNT
ACCOUNT NUMBER
DUE ON OR BEFORE
DUE
$
1
PRIOR YEAR
CREDIT
$
PLEASE REGISTER ME FOR THE NEW
2
ESTIMATED TAX PAYMENT PROGRAM.
PAYMENTS
TO DATE
I UNDERSTAND THE CITY OF BROOK
$
CHECK
3
PARK WILL SEND AN INFORMATION
UNPAID
PACKET IN THE MAIL SO I CAN
BALANCE
$
BEGIN UTILIZING THIS SAFE AND
4
EASY PAYMENT PROCEDURE.
AMOUNT
NOW DUE
$
5
AMOUNT PAID
HEREWITH
$
6
SIGNATURE
DATE
I certify I have reviewed this form and understand the laws governing estimated tax.
RETURN THIS PART
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