Form Ir - Income Tax Return - City Of Forest Park - Income Tax Division (Page 2 of 5) in pdf

DECLARATION OF ESTIMATED TAX FOR YEAR 2017

Was a declaration of estimated tax for 2017 made with a request for extension of time to file the 2016 tax return?

Yes

If a declaration has been made, the declaration below need only be completed if you wish to amend what was filed previously.

10. TOTAL ESTIMATED 2017 INCOME $

MULTIPLIED BY TAX RATE OF 1.5% = TOTAL 2017 ESTIMATED TAX PRIOR TO CREDITS . . . . . . . . . . . . . $

11. ESTIMATED TAX CREDITS:

A. ESTIMATED TOTAL TAXES TO BE WITHHELD BY EMPLOYER(S)

FOR CITY OF FOREST PARK . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . $

B. ESTIMATED 2017 FOREST PARK TAX CREDIT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $

(See instructions, not to exceed .375% of income taxed) Go to this link for a tool to help calculate your return:

C. PAYMENT MADE WITH REQUEST FOR EXTENSION . . . . . . . . . . . . . . . . . . . . . . . . . $

D. TOTAL ESTIMATED TAX PAYMENTS AND CREDITS (Total Lines 11A, 11B and 11C) . . . . . . . . . . . . . . . . . . . . $

12. TOTAL ESTIMATED TAX DUE AND PAYABLE TO FOREST PARK DURING 2017

(Subtract Line 11D from Line 10) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $

If line 12 is $200 or more, you MUST pay quarterly estimated payments to avoid a penalty.

13. AMOUNT TO BE PAID WITH THIS DECLARATION (1/4 of Line 12 due by 4/18/2017) . . . . . . . . . . . . . . . . . . . . . . . . . $

14. TAX OVERPAYMENT FROM PREVIOUS TAX YEAR: ENTER AMOUNT FROM LINE 9 . . . . . . . . . . . . . . . . . . . . . . . . $

15. CONTRIBUTION TO ENVIRONMENTAL AWARENESS PROGRAM . . . . . . . . . . . . . . . . $

CONTRIBUTION TO HOME IMPROVEMENT PROGRAM . . . .. . . . . . . . . . . . . . . . . . . . . $

16. TOTAL: LINE 8 $

PLUS LINE 13 $

MINUS LINE 14 $

PLUS LINE 15 $

= AMOUNT ENCLOSED

17. IF OVERPAYMENT GREATER THAN $10 -REFUND $

_________________ OR APPLY TO NEXT YEAR’S ESTIMATE $ _____________________

DECLARATION AND RETURN PAYMENT CALENDAR

APRIL 18, 2017

JUNE 15, 2017

SEPT. 15, 2017

DEC. 15, 2017

APRIL 15, 2018

File 2016 Return,

Make 2nd

Make 3rd

Make 4th

File 2017 Return,

File 2017 Declaration,

quarter 2017 payment

File 2018 Declaration

and make 1st

quarter payment

PAYING TAX DUE BY CREDIT CARD

Circle One:

MasterCard

Visa

Discover

Account Number (16 Digits):

3. Expiration Date:

Three Digit Verification Code:

Amount To Be Paid: $

plus applicable service fee

Your Signature For Authorization

Date:

I CERTIFY THAT I HAVE EXAMINED THIS RETURN (INCLUDING ACCOMPANYING SCHEDULES AND STATEMENTS) AND TO THE BEST OF MY

KNOWLEDGE AND BELIEF IT IS TRUE, CORRECT AND COMPLETE. IF PREPARED BY A PERSON OTHER THAN TAXPAYER, THE DECLARATION IS

BASED ON ALL INFORMATION OF WHICH PREPARER HAS ANY KNOWLEDGE.

May we discuss your taxes with your preparer?

YES

Signature of Person Preparing if Other Than Taxpayer

Date

Signature of Taxpayer or Agent (Required)

Date

Address

Signature of Taxpayer or Agent (Required)

Date

Telephone Number

and

e-mail address

Telephone Number

and

e-mail address

NOTE: Unless this tax form is signed and accompanied by payment of the tax due (Line 16), it is not a legal and FINAL return.

FOR ADDITIONAL ASSISTANCE CALL (513) 595-5211

Form Ir - Income Tax Return - City Of Forest Park - Income Tax Division Page 2

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