Form 207hcc Esa - First Installment - Estimated Health Care Center Tax Payment Coupon - Department Of Revenue Services Of State Of Connecticut Page 2

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Required Annual Payment
Who Must File This Coupon
For estimated health care center tax purposes, a health care center’s
Each health care center whose health care center tax, after the application of
required annual payment is the lesser of:
general business tax credits (as defined in Special Notice 2003(16), 2003
Legislation Affecting the Health Care Center Tax), for calendar year 2006 will
90% (.90) of the tax that will be shown on its 2006 Form 207HCC (after
be $1,000 or more must file this coupon.
the application of general business tax credits); or
Interest
100% of the tax shown on your 2005 Form 207HCC, Line 16.
If the payment due with this coupon is not made on or before the due date of
this coupon, interest will accrue at the rate of 1% (.01) per month, or fraction
of a month, on the amount not paid from the due date of this coupon until the
date of payment.
Schedule 1
1 Enter estimated health care center tax due for calendar year 2006 prior to the application of general
business tax credits.
00
2 Multiply Line 1 by 70% (.70).
00
3 Enter estimated general business tax credits against the health care center tax due for calendar year 2006.
(May not exceed amount entered on Line 2)
00
4 Subtract Line 3 from Line 1.
00
5 Multiply Line 4 by 27% (.27).
00
207HCC ESA Back (Rev. 12/05)
Required Annual Payment
Who Must File This Coupon
For estimated health care center tax purposes, a health care center’s
Each health care center whose health care center tax, after the application of
required annual payment is the lesser of:
general business tax credits (as defined in Special Notice 2003(16), 2003
Legislation Affecting the Health Care Center Tax), for calendar year 2006 will
90% (.90) of the tax that will be shown on its 2006 Form 207HCC (after
be $1,000 or more must file this coupon.
the application of general business tax credits); or
Interest
100% of the tax shown on your 2005 Form 207HCC, Line 16.
If the payment due with this coupon is not made on or before the due date of
this coupon, interest will accrue at the rate of 1% (.01) per month, or fraction
of a month, on the amount not paid from the due date of this coupon until the
date of payment.
Schedule 1
1 Enter estimated health care center tax due for calendar year 2006 prior to the application of general
business tax credits.
00
2 Multiply Line 1 by 70% (.70).
00
3 Enter estimated general business tax credits against the health care center tax due for calendar year 2006.
(May not exceed amount entered on Line 2)
00
4 Subtract Line 3 from Line 1.
00
5 Multiply Line 4 by 54% (.54).
00
207HCC ESB Back (Rev. 12/05)
Required Annual Payment
Who Must File This Coupon
For estimated health care center tax purposes, a health care center’s
Each health care center whose health care center tax, after the application of
required annual payment is the lesser of:
general business tax credits (as defined in Special Notice 2003(16), 2003
Legislation Affecting the Health Care Center Tax), for calendar year 2006 will
90% (.90) of the tax that will be shown on its 2006 Form 207HCC (after
be $1,000 or more must file this coupon.
the application of general business tax credits); or
Interest
100% of the tax shown on your 2005 Form 207HCC, Line 16.
If the payment due with this coupon is not made on or before the due date of
this coupon, interest will accrue at the rate of 1% (.01) per month, or fraction
of a month, on the amount not paid from the due date of this coupon until the
date of payment.
Schedule 1
1 Enter estimated health care center tax due for calendar year 2006 prior to the application of general
business tax credits.
00
2 Multiply Line 1 by 70% (.70).
00
3 Enter estimated general business tax credits against the health care center tax due for calendar year 2006.
(May not exceed amount entered on Line 2)
00
4 Subtract Line 3 from Line 1.
00
5 Multiply Line 4 by 72% (.72).
00
207HCC ESC Back (Rev. 12/05)
Required Annual Payment
Who Must File This Coupon
For estimated health care center tax purposes, a health care center’s
Each health care center whose health care center tax, after the application of
required annual payment is the lesser of:
general business tax credits (as defined in Special Notice 2003(16), 2003
Legislation Affecting the Health Care Center Tax), for calendar year 2006 will
90% (.90) of the tax that will be shown on its 2006 Form 207HCC (after
be $1,000 or more must file this coupon.
the application of general business tax credits); or
Interest
100% of the tax shown on your 2005 Form 207HCC, Line 16.
If the payment due with this coupon is not made on or before the due date of
this coupon, interest will accrue at the rate of 1% (.01) per month, or fraction
of a month, on the amount not paid from the due date of this coupon until the
date of payment.
Schedule 1
1 Enter estimated health care center tax due for calendar year 2006 prior to the application of general
business tax credits.
00
2 Multiply Line 1 by 70% (.70).
00
3 Enter estimated general business tax credits against the health care center tax due for calendar year 2006.
(May not exceed amount entered on Line 2)
00
4 Subtract Line 3 from Line 1.
00
5 Multiply Line 4 by 90% (.90).
00
207HCC ESD Back (Rev. 12/05)

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