Form 207hcc Esa - First Installment - Estimated Health Care Center Tax Payment Coupon - Department Of Revenue Services Of State Of Connecticut
ADVERTISEMENT
1
2207HCC ESA - First Installment
207HCC ESA
Department of Revenue Services
For Calendar Year Ending
Estimated Health Care Center Tax Payment Coupon
PO Box 2990
Hartford CT 06104-2990
(Rev. 12/05)
Connecticut Tax Registration Number
1
Enter 30% (.30) of the tax shown on 2005 Form 207HCC, Line 16.
1
2
Enter amount from Schedule 1, Line 5 (on back).
2
Date Received (DRS Use Only)
3
Enter the lesser of Line 1 or Line 2.
3
Federal Employer ID Number
4
Enter overpayment from prior year applied to estimated tax for current year.
4
5
Payment due with this coupon (Subtract Line 4 from Line 3.)
5
Please change
Due Date:
March 15, 2006
name or
mailing
Make Checks Payable To:
address, or
Commissioner of Revenue Services
both,
Mail To:
Department of Revenue Services
if shown
Processing Section
incorrectly
PO Box 2990
at right
Hartford CT 06104-2990
207HCC ESB
207HCC ESB - Second Installment
Department of Revenue Services
PO Box 2990
For Calendar Year Ending
Estimated Health Care Center Tax Payment Coupon
Hartford CT 06104-2990
(Rev. 12/05)
Connecticut Tax Registration Number
1
Enter 60% (.60) of the tax shown on 2005 Form 207HCC, Line 16.
1
2
Enter amount from Schedule 1, Line 5 (on back).
2
Date Received (DRS Use Only)
3
Enter the lesser of Line 1 or Line 2.
3
4
Enter amount paid with Form 207HCC ESA plus overpayment from prior year
Federal Employer ID Number
applied to estimated tax for current year.
4
5
Payment due with this coupon (Subtract Line 4 from Line 3.)
5
Please change
Due Date:
June 15, 2006
name or
mailing
Make Checks Payable To:
address, or
Commissioner of Revenue Services
both,
Mail To:
Department of Revenue Services
if shown
Processing Section
incorrectly
PO Box 2990
at right
Hartford CT 06104-2990
207HCC ESC
207HCC ESC - Third Installment
Department of Revenue Services
PO Box 2990
For Calendar Year Ending
Estimated Health Care Center Tax Payment Coupon
Hartford CT 06104-2990
(Rev. 12/05)
Connecticut Tax Registration Number
1
Enter 80% (.80) of the tax shown on 2005 Form 207HCC, Line 16.
1
2
Enter amount from Schedule 1, Line 5 (on back).
2
Date Received (DRS Use Only)
3
Enter the lesser of Line 1 or Line 2.
3
4
Enter amount paid with Forms 207HCC ESA and 207HCC ESB plus
Federal Employer ID Number
overpayment from prior year applied to estimated tax for current year.
4
5
Payment due with this coupon (Subtract Line 4 from Line 3.)
5
Please change
Due Date:
September 15, 2006
name or
mailing
Make Checks Payable To:
address, or
Commissioner of Revenue Services
both,
Mail To:
Department of Revenue Services
if shown
Processing Section
incorrectly
PO Box 2990
at right
Hartford CT 06104-2990
207HCC ESD
207HCC ESD - Fourth Installment
Department of Revenue Services
PO Box 2990
For Calendar Year Ending
Estimated Health Care Center Tax Payment Coupon
Hartford CT 06140-2990
(Rev. 12/05)
Connecticut Tax Registration Number
1
Enter the tax shown on 2005 Form 207HCC, Line 16.
1
2
Enter amount from Schedule 1, Line 5 (on back).
2
Date Received (DRS Use Only)
3
Enter the lesser of Line 1 or Line 2.
3
4
Enter amount paid with Forms 207HCC ESA, 207HCC ESB, and 207HCC ESC
Federal Employer ID Number
plus overpayment from prior year applied to estimated tax for current year.
4
5
Payment due with this coupon (Subtract Line 4 from Line 3.)
5
Please change
Due Date:
December 15, 2006
name or
mailing
Make Checks Payable To:
address, or
Commissioner of Revenue Services
both,
Mail To:
Department of Revenue Services
if shown
Processing Section
incorrectly
PO Box 2990
at right
Hartford CT 06104-2990
\\Mccormickl\workingdirectory\Projects\Form 207HCC Estimates\Form 207HCC Estimates 20051130.pmd
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Financial