Individual Income Tax Return - Cillage Of Greenwich, 2015 Page 3

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DECLARATION OF INDIVIDUAL ESTIMATED TAX FOR YEAR 2016
VOUCHER # 1 - DUE APRIL 15, 2016
NAME________________________________________ SOC. SEC. #_____________________
ADDRESS________________________________________________________________________________
1) Total income subject to tax $__________________ (Multiply by
1%
).................$____________________
2) Less income tax withheld by other city (Credit limited to
1%
) ............................$____________________
3) Total declaration (line 1 minus line 2) ........................................................................$____________________
4) Payment amounts (line 3 times 0.25)..........................................................................$____________________
5) Overpayment from previous year (if not refunded) ....................................................$____________________
6) 1st payment amount (line 4 minus line 5) ..................................................................$____________________
cUT LInE
INDIVIDUAL ESTIMATED TAX
VOUCHER # 2 - DUE JUNE 15, 2016 -
NAME________________________________________ SOC. SEC. #_____________________
ADDRESS ________________________________________________________________________________
1) Payment enclosed ................................$___________________
2) Check #________________________
3) Prior amount paid ................................$___________________
4) Remaining Balance $_____________
Contact person______________________________________________ Phone #________________________
SEND PAYMENT TO: VILLAGE OF GREENWICH, INCOME TAX DEPT., 45 MAIN STREET
GREENWICH, OHIO 44837 PHONE# (419) 752-2441
cUT LInE
INDIVIDUAL ESTIMATED TAX
VOUCHER # 3 - DUE SEPTEMBER 15, 2016 -
NAME________________________________________ SOC. SEC. #_____________________
ADDRESS ________________________________________________________________________________
1) Payment enclosed ................................$___________________
2) Check #________________________
3) Prior amount paid ................................$___________________
4) Remaining Balance $_____________
Contact person______________________________________________ Phone #________________________
SEND PAYMENT TO: VILLAGE OF GREENWICH, INCOME TAX DEPT., 45 MAIN STREET
GREENWICH, OHIO 44837 PHONE# (419) 752-2441
cUT LInE
INDIVIDUAL ESTIMATED TAX
VOUCHER # 4 - DUE DECEMBER 15, 2016 -
NAME________________________________________ SOC. SEC. #_____________________
ADDRESS ________________________________________________________________________________
1) Payment enclosed ................................$___________________
2) Check #________________________
3) Prior amount paid ................................$___________________
4) Remaining Balance $_____________
Contact person______________________________________________ Phone #________________________
SEND PAYMENT TO: VILLAGE OF GREENWICH, INCOME TAX DEPT., 45 MAIN STREET
GREENWICH, OHIO 44837 PHONE# (419) 752-2441

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