L-1040es-Ach, L-1120es-Ach - Electronic Estimated Income Tax Payment Authorization

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Tax Year __________ 
L‐1040ES‐ACH 
 
L‐1120ES‐ACH 
City of Lapeer  
Electronic Estimated Income Tax Payment Authorization 
 
To have your estimated taxes automatically withdrawn from your account each quarter, please fill out this form.  The estimated 
payments will be withdrawn according to the due dates published. 
 
Taxpayer’s Name 
Taxpayer’s Account Number 
Bank Routing Number 
Bank Account Number
Bank Account Type
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 Checking  
Savings
Payment Amount
 
Round cents up to the 
.00 
next dollar. 
 
First Quarter Payment Due April 30 
Payment Amount
 
Round cents up to the 
.00 
next dollar. 
 
Second Quarter Payment Due June 30 
Payment Amount
 
Round cents up to the 
.00 
next dollar. 
 
Third Quarter Payment Due September 30 
Payment Amount
 
Round cents up to the 
.00 
next dollar. 
 
Fourth Quarter Payment Due January 31 
 
For your convenience, quarterly estimated payments can now be automatically withdrawn from your checking or savings account 
for.  Just fill out the new L‐1040ES‐ACH/L‐1120ES‐ACH form and we will do the rest of the work for you. 
•
No more dates to remember 
•
Save on postage 
•
Payments automatically withdrawn and applied to your tax account each quarter. 
 
X
Signature of Taxpayer Authorizing Withdrawal from Listed Bank Account:  
______________________________________________ 
 
Please send this form to the City of Lapeer, Income Tax Department, 576 Liberty Park, Lapeer, MI  48446 

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