Form Qrtly Decl Pymt - Quarterly Payment On Declaration Of Estimated Income - 2017

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City of Sharonville
Income Tax Office
11641 Chester Road - Sharonville, OH 45246
Phone: (513) 563-1169 FAX: (513) 588-3969
QUARTERLY PAYMENT ON DECLARATION OF ESTIMATED INCOME
Estimated taxes of more than $200 (annually) are due in quarterly payments on the
15th day of the 4th, 6th, 9th & 12th months after the beginning of the taxable year.
THE UNDERSIGNED DECLARES THIS TO BE A TRUE, CORRECT AND COMPLETE
FID# / SS#
ACCT #
DECLARATION OF ESTIMATED INCOME TAX FOR THE PERIOD STATED.
NAME
SIGNATURE
ADDRESS
DATE
TITLE, IF SIGNING FOR A BUSINESS
CITY
STATE
ZIP
PHONE #
DECLARATION FOR FISCAL YEAR 20________
FYE: (MONTH) __________
ESTIMATED TAX DUE FOR YEAR (1.5%)
$ _______________
1st Quarter
LESS PAYMENTS THIS YEAR
-
_______________
2nd Quarter
LESS CREDITS FROM PRIOR YEARS
-
_______________
3rd Quarter
TOTAL YET TO PAY THIS YEAR
= $ _______________
4th Quarter
$
TOTAL OF THIS PAYMENT
_______________
CITY OF SHARONVILLE TAX
MAKE YOUR CHECK OR MONEY ORDER TO:
PLEASE NOTE: If upon the filing of the annual return, the taxpayer has not paid 90% of the current year's tax liability or
100% of the prior year's tax liability by December 15th, or the 15th day of the month prior to the close of the fiscal year,
you may be subject to interest and penalties.
PLEASE MAKE A PHOTOCOPY OF THIS RETURN & RETAIN FOR YOUR RECORDS.
FOR OFFICE USE ONLY
Date: ____________________
Check #: ____________________
Amount: $ ___________________
Form Qrtly Decl Pymt, Rev 1-17

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