Quarterly Statement Of Estimated Income Tax Form (Page 5 of 5) in pdf

Quarterly Statement Of Estimated Income Tax Form Page 5

PAGE 2 - FORM TR/D/B

1. Enter amount of taxable income from your Federal return. ATTACH COPIES OF ALL APPLICABLE

FEDERAL FORMS.

2. Adjustments from attached Schedule X.

3. Taxable income to Bellefontaine before allocation. Subtract or add Line 2, as applicable from Line 1

to determine taxable income.

4. Allocation Percentage from attached Schedule Y used to determine the percentage of income

generated within and/or outside the City of Bellefontaine.

5. Bellefontaine taxable income: Line 3 multiplied by Line 4.

6. Bellefontaine income tax due. Multiply Line 5 by 1.333%.

7. (a) Payments made on Declaration of Estimated Tax

(b) Other Credits (explain)

8. Balance due: Line 6 minus Line 7(c)

9. Add Interest and Penalty, if applicable

10. Add Late Filing Fee, if applicable

11. Total Amount due.

12. Overpayment Claimed if Line 7(c) exceeds Line 6. Indicate choice of disposition of overpayment. No

refund or carry-over will be made under $5.00.

Bellefontaine does not allow Net Operating Losses to be carried forward.

EXTENSIONS WILL BE GRANTED ONLY IF A COPY OF THE FEDERAL EXTENSION IS RECEIVED BY

THE DUE DATE OF THE TAX RETURN.

NOTE: UNLESS THIS TAX RETURN IS SIGNED, DATED AND ACCOMPANIED BY ALL APPLICABLE

SCHEDULES AND PAYMENT IN FULL, IT IS NOT CONSIDERED A LEGAL TAX RETURN.

Quarterly Statement Of Estimated Income Tax Form Page 5