Quarterly Payment Form On Declaration Of Estimated Income

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City of Sharonville
Income Tax Office
11641 Chester Road - Sharonville, OH 45246
Phone: (513) 563-1169 FAX: (513) 588-3969
QUARTERLY PAYMENT ON DECLARATION OF ESTIMATED INCOME
1st Quarter Declaration Payments are due on or before the 15th day of the month following the end of the quarter.
2nd, 3rd & 4th Quarter Declaration Payments are due on or before the last day of the month following the end of each quarter.
THE UNDERSIGNED DECLARE THIS TO BE A TRUE, CORRECT AND COMPLETE
FID# / SS#
ACCT #
DECLARATION OF ESTIMATED INCOME TAX FOR THE PERIOD STATED.
NAME
SIGNATURE
ADDRESS
DATE
TITLE, IF SIGNING FOR A BUSINESS
CITY
STATE
ZIP
PHONE #
DECLARATION FOR FISCAL YEAR 20________
FYE: (MONTH) __________
ESTIMATED TAX DUE FOR YEAR
$ _______________
1st Quarter
LESS PAYMENTS THIS YEAR
-
_______________
2nd Quarter
LESS CREDITS FROM PRIOR YEARS
-
_______________
3rd Quarter
TOTAL YET TO PAY THIS YEAR
= $ _______________
4th Quarter
$
TOTAL OF THIS PAYMENT
_______________
CITY OF SHARONVILLE TAX
MAKE YOUR CHECK OR MONEY ORDER TO:
PLEASE NOTE: If upon the filing of the annual return, the taxpayer has not paid 90% of the tax liability
by January 31, or the last day of the month following the close of the fiscal year, the difference between
90% of the tax liability and the amount of estimated tax actually paid on or before said date shall
be subject to the interest and penalty provisions of the Sharonville Income Tax Ordinance.
PLEASE MAKE A PHOTOCOPY OF THIS RETURN & RETAIN FOR YOUR RECORDS.
Initials __________
FOR OFFICE USE ONLY
Filed: ____________________
Check #: ____________________
Amount: ____________________
Form Qrtly Decl Pymt, Rev 11-03

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