Form Q-1 - Declaration Of Estimated Income Tax - State Of Ohio

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Eastlake Declaration
11/17/2000
4:28 PM
Page 1
QUARTERLY STATEMENT
DECLARATION OF ESTIMATED INCOME TAX
FORM Q-1
FID/SSN
MAKE CHECK OR MONEY ORDER TO:
AMOUNT ENCLOSED
CITY OF EASTLAKE TAX DEPARTMENT
DUE ON OR BEFORE
P.O. BOX 72485
$
CLEVELAND, OHIO 44192-0485
PAY THIS AMOUNT
ESTIMATED TAX
AMOUNT CREDITED FROM PRIOR
AMOUNT OF
AMENDED
NEW ESTIMATED
DECLARED
YEAR PLUS CURRENT YEARS PYMTS
UNPAID BALANCE
ESTIMATED TAX
BALANCE
IF THIS STATEMENT DOES NOT REFLECT PAYMENT RECENTLY MADE, PLEASE ADVISE - INCOME TAX OFFICE - PROMPTLY
USE THIS SPACE FOR ANY STATEMENTS ABOUT YOUR ESTIMATE
NOTIFY INCOME TAX DEPARTMENT PROMPTLY OF ANY CHANGE IN OWNERSHIP OR NAME AND ADDRESS ABOVE

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