2006 Declaration Of Estimated Tax Worksheet - City Of Gallipolis Page 2
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2CITY OF GALLIPOLIS INCOME TAX DEPT. –– DECLARATION OF ESTIMATED TAX
518 SECOND AVENUE; GALLIPOLIS, OH 45631-1219
SECOND QUARTER, 2006
TAX OFFICE USE ONLY
1. Total Estimated Tax ............................................................................................ $_________________
TOTAL PAID $__________________________
2. Amount Enclosed (1/4 of line 1) ......................................................................... $_________________
❑ CASH ❑ CHECK ____________________
RECEIPT# ____________________________
Account # _____________ SS# or FID# ________________________
Name ________________________________________________
Address ________________________________________________
City, State, Zip ________________________________________________
Date ____________ Telephone # _________________________
PLEASE RETURN THIS COPY AND MAKE CHECKS PAYABLE TO THE CITY OF GALLIPOLIS INCOME TAX DEPT.
CITY OF GALLIPOLIS INCOME TAX DEPT. –– DECLARATION OF ESTIMATED TAX
518 SECOND AVENUE; GALLIPOLIS, OH 45631-1219
THIRD QUARTER, 2006
TAX OFFICE USE ONLY
1. Total Estimated Tax ............................................................................................ $_________________
TOTAL PAID $__________________________
2. Amount Enclosed (1/4 of line 1) ......................................................................... $_________________
❑ CASH ❑ CHECK ____________________
RECEIPT# ____________________________
Account # _____________ SS# or FID# ________________________
Name ________________________________________________
Address ________________________________________________
City, State, Zip ________________________________________________
Date ____________ Telephone # _________________________
PLEASE RETURN THIS COPY AND MAKE CHECKS PAYABLE TO THE CITY OF GALLIPOLIS INCOME TAX DEPT.
CITY OF GALLIPOLIS INCOME TAX DEPT. –– DECLARATION OF ESTIMATED TAX
518 SECOND AVENUE; GALLIPOLIS, OH 45631-1219
FOURTH QUARTER, 2006
TAX OFFICE USE ONLY
1. Total Estimated Tax ............................................................................................ $_________________
TOTAL PAID $__________________________
2. Amount Enclosed (1/4 of line 1) ......................................................................... $_________________
❑ CASH ❑ CHECK ____________________
RECEIPT# ____________________________
Account # _____________ SS# or FID# ________________________
Name ________________________________________________
Address ________________________________________________
City, State, Zip ________________________________________________
Date ____________ Telephone # _________________________
PLEASE RETURN THIS COPY AND MAKE CHECKS PAYABLE TO THE CITY OF GALLIPOLIS INCOME TAX DEPT.
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