2009 Estimated Tax Worksheet - City Of Gallipolis Page 2
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2CITY OF GALLIPOLIS INCOME TAX DEPT. –– ESTIMATED TAX
518 SECOND AVENUE; GALLIPOLIS, OH 45631-1219
SECOND QUARTER, 2009
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. –– ESTIMATED TAX
518 SECOND AVENUE; GALLIPOLIS, OH 45631-1219
THIRD QUARTER, 2009
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. –– ESTIMATED TAX
518 SECOND AVENUE; GALLIPOLIS, OH 45631-1219
FOURTH QUARTER, 2009
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 - B&I Tax Sta7 7
12/3/08 7:52:22 AM
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