Declaration Of Estimated Tax Form - 2017
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12
2017 CITY OF FAIRFIELD DECLARATION OF ESTIMATED TAX
2ND QUARTER STATEMENT DUE BY 6/15/17 or by the 15
th
day of the sixth month of the fiscal year ________(date)
VISA/MasterCard/Discover Accepted
Please insert Name & Address
Address Change
Account, Social Security or Federal ID #:
Name:
_________________________________
_________________________________
C/O:
Card #
Annual/Amended Estimate: $ _____________
_________________________________
Address:
Exp. Date (mm/yyyy)
Code
_________________________________
Amount Paid this Quarter:
$ _____________
City:
Name on Card
_________________________________
State/Zip:
Signature
To determine if this transaction will be
MAKE REMITTANCE PAYABLE TO FAIRFIELD INCOME TAX,
treated as a cash advance when paid to
701 WESSEL DRIVE, FAIRFIELD, OH 45014-3611 • (513) 867-5327
CITY OF FAIRFIELD TAX, please check
NOTE: It is the taxpayer’s responsibility to file the declaration and make payments by the specified due dates.
with your credit card issuing company.
Failure to meet the 45% requirement by June 15, 2017 will result in the assessment of interest.
----------------------------------------------------------------------------------------------------------------------------- ---------------------------------------------
3
2017 CITY OF FAIRFIELD DECLARATION OF ESTIMATED TAX
th
3RD QUARTER STATEMENT DUE BY 9/15/17 or by the 15
day of the ninth month of the fiscal year _________(date)
VISA/MasterCard/Discover Accepted
Please insert Name & Address
Address Change
Account, Social Security or Federal ID #:
Name:
_________________________________
_________________________________
C/O:
Card #
Annual/Amended Estimate: $ _____________
_________________________________
Address:
Exp. Date (mm/yyyy)
Code
_________________________________
Amount Paid this Quarter:
$ _____________
City:
Name on Card
_________________________________
State/Zip:
Signature
To determine if this transaction will be
MAKE REMITTANCE PAYABLE TO FAIRFIELD INCOME TAX,
treated as a cash advance when paid to
701 WESSEL DRIVE, FAIRFIELD, OH 45014-3611 • (513) 867-5327
CITY OF FAIRFIELD TAX, please check
NOTE: It is the taxpayer’s responsibility to file the declaration and make payments by the specified due dates.
with your credit card issuing company.
interest.
Failure to meet the 67 1/2% requirement by September 15, 2017 will result in the assessment of
----------------------------------------------------------------------------------------------------------------------------- ---------------------------------------------
2017 CITY OF FAIRFIELD DECLARATION OF ESTIMATED TAX
4
th
4TH QUARTER STATEMENT DUE BY 12/15/17 or by the 15
day of the twelfth month of the fiscal year ________(date)
VISA/MasterCard/Discover Accepted
Please insert Name & Address
Address Change
Account, Social Security or Federal ID #:
Name:
_________________________________
_________________________________
C/O:
Card #
Annual/Amended Estimate: $ _____________
_________________________________
Address:
Exp. Date (mm/yyyy)
Code
_________________________________
Amount Paid this Quarter:
$ _____________
City:
Name on Card
_________________________________
State/Zip:
Signature
MAKE REMITTANCE PAYABLE TO FAIRFIELD INCOME TAX,
To determine if this transaction will be
701 WESSEL DRIVE, FAIRFIELD, OH 45014-3611 • (513) 867-5327
treated as a cash advance when paid to
NOTE: It is the taxpayer’s responsibility to file the declaration and make payments by the specified due dates.
CITY OF FAIRFIELD TAX, please check
Failure to meet the 90% requirement by December 15, 2017 will result in the assessment of interest..
with your credit card issuing company.
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