Form 760es - Estimated Income Tax Worksheet For Individuals - 2004 Page 2
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LOCALITY NO.
2004 FORM 760ES - Voucher 2
FOR OFFICE USE
Check here if this is the first time you
have filed Form 760ES or if this is a
VIRGINIA ESTIMATED INCOME TAX
PAYMENT VOUCHER FOR INDIVIDUALS,
new address.
ESTATES AND TRUSTS
Amount of payment
CALENDAR YEAR FILERS: DUE JUNE 15, 2004 OR
FISCAL YEAR FILERS: BEGINNING MONTH: ______________
.
00000000
3330001 104061
Your social security number or FEIN
Spouse’s social security number
Make your check or money order payable to the
Treasurer of the city or county in which you live.
First Name OR Name of Est ate or Trust
MI Last Name
o
If this is your first payment for this taxable year,
CHECK BOX and mail payment to your Commissioner
Spouse First Name
MI Spouse Last Name
of the Revenue, Director of Finance or Director of Tax
Administration. Addresses are on page 6.
If Estate or Trust, Name and Title of Fiduciary
Mail all other vouchers to the Treasurer. Addresses are
on page 7.
Address (Number and Street) of Taxpayer or Fiduciary
o
Check here if filing for an estate or trust.
City, State and Zip Code
— Do not write below this line. —
Daytime Phone Number
o
LOCALITY NO.
2004 FORM 760ES - Voucher 3
FOR OFFICE USE
Check here if this is the first time you
have filed Form 760ES or if this is a
VIRGINIA ESTIMATED INCOME TAX
PAYMENT VOUCHER FOR INDIVIDUALS,
new address.
ESTATES AND TRUSTS
Amount of payment
CALENDAR YEAR FILERS: DUE SEPTEMBER 15, 2004 OR
FISCAL YEAR FILERS: BEGINNING MONTH: ______________
.
00000000
3330001 104094
Your social security number or FEIN
Spouse’s social security number
Make your check or money order payable to the
Treasurer of the city or county in which you live.
First Name OR Name of Est ate or Trust
MI Last Name
o
If this is your first payment for this taxable year,
CHECK BOX and mail payment to your Commissioner
Spouse First Name
MI
Spouse Last Name
of the Revenue, Director of Finance or Director of Tax
Administration. Addresses are on page 6.
If Estate or Trust, Name and Title of Fiduciary
Mail all other vouchers to the Treasurer. Addresses are
on page 7.
Address (Number and Street) of Taxpayer or Fiduciary
o
Check here if filing for an estate or trust.
City, State and Zip Code
— Do not write below this line. —
Daytime Phone Number
o
LOCALITY NO.
2004 FORM 760ES - Voucher 4
FOR OFFICE USE
Check here if this is the first time you
have filed Form 760ES or if this is a
VIRGINIA ESTIMATED INCOME TAX
PAYMENT VOUCHER FOR INDIVIDUALS,
new address.
ESTATES AND TRUSTS
Amount of payment
CALENDAR YEAR FILERS: DUE JANUARY 15, 2005 OR
FISCAL YEAR FILERS: BEGINNING MONTH: ______________
.
00000000
3330001 105015
Your social security number or FEIN
Spouse’s social security number
Make your check or money order payable to the
Treasurer of the city or county in which you live.
First Name OR Name of Est ate or Trust
MI Last Name
o
If this is your first payment for this taxable year,
CHECK BOX and mail payment to your Commissioner
Spouse First Name
MI Spouse Last Name
of the Revenue, Director of Finance or Director of Tax
Administration. Addresses are on page 6.
If Estate or Trust, Name and Title of Fiduciary
Mail all other vouchers to the Treasurer. Addresses are
on page 7.
Address (Number and Street) of Taxpayer or Fiduciary
o
Check here if filing for an estate or trust.
City, State and Zip Code
— Do not write below this line. —
Daytime Phone Number
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