Quarterly Notice Of Installment Due On Estimated Tax Declared Form - City Of Ontario, Ohio

RETURN PART 1 – KEEP PART 2 FOR YOUR RECORDS

C C I I T T Y Y O O F F O O N N T T A A R R I I O O , , O O H H I I O O , , Q Q U U A A R R T T E E R R L L Y Y N N O O T T I I C C E E O O F F I I N N S S T T A A L L L L M M E E N N T T D D U U E E O O N N E E S S T T I I M M A A T T E E D D T T A A X X D D E E C C L L A A R R E E D D

CITY OF ONTARIO, OHIO

MAIL

Check or money orders should be payable to:

P.O. BOX 166

AMOUNT

TO

C C I I T T Y Y O O F F O O N N T T A A R R I I O O , , I I N N C C O O M M E E T T A A X X

ONTARIO, OHIO 44862

ENCLOSED $

Do not remit cash by mail.

Postage stamps not accepted as payment.

CREDITS AND/OR PAYMENTS

AMOUNT OF

ESTIMATED TAX

QUARTERLY

UNPAID BALANCE

DECLARED

INSTALLMENT DUE

DATE OF LAST CREDIT

TOTAL AMOUNT CREDITED

IF THIS STATEMENT DOES NOT REFLECT PAYMENT RECENTLY MADE, PLEASE ADVISE – INCOME TAX OFFICE – PROMPTLY

DUE ON OR BEFORE

NOTIFY INCOME TAX DEPARTMENT PROMPTLY OF ANY CHANGE IN OWNERSHIP OR NAME AND ADDRESS SHOWN ABOVE.