Form In-114 - Individual Income Estimated Tax Payment Voucher - 2012 Page 2
ADVERTISEMENT
1
2
32012
VERMONT
*121141199*
Form IN-114
Individual Income Estimated
Use blue or black
* 1 2 1 1 4 1 1 9 9 *
Tax Payment Voucher
ink to write entries
Taxpayer’s Social Security Number
Spouse/CU Partner Social Security Number
Taxpayer’s Last Name
First Name
Initial
Spouse/CU Partner Last Name
First Name
Initial
Mailing Address (Number and Street, including Rural Route)
City, Town, or Post Office
State
Zip Code
Form IN-114
. 0 0
Amount of this payment $
5454
Rev. 12/11
Mail voucher to:
Payment Due Dates
1st Quarter
APR 15, 2012
2nd Quarter
JUN 15, 2012
Vermont Department of Taxes
3rd Quarter
SEP 15, 2012
PO Box 1779
4th Quarter
JAN 15, 2013
Montpelier, VT
05601-1779
Taxpayer’s Worksheet
- Keep for your records
Line 1: Estimated 2012 Vermont taxable income: See definition on back . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1.
$ ___________________________
Line 2: Estimated 2012 Vermont tax: Use 2012 preliminary tax schedules in this booklet . . . . . . . . . . . . . . . . . .2.
$ ___________________________
Line 3: Estimated income adjustment: See instructions for Form IN-111, Line 21 in 2011 Vermont income tax booklet.* . . . 3. ___________________%
Line 4: Adjusted Vermont tax (Multiply Line 2 by Line 3) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4.
$ ___________________________
4a. Less expected 2012 Vermont tax withholdings . . . . . . . . . . . . . . . . . . . . . . 4a.
$ ______________________
4b. Less expected credits: See 2011 Income tax return Form IN-111, Line 25 4b.
$ ______________________
4c. Total credits: Add Lines 4a and 4b . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4c.
$ ___________________________
Line 5: ESTIMATED TAX LIABILITY: Subtract Line 4c from Line 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5.
$ ___________________________
*2011 Vermont income tax booklet is posted on our website at
RECORD of 2012 ESTIMATED PAYMENTS
TOTAL ESTIMATE
LESS 2011 INCOME TAX
AMOUNT OF
DATE PAID
BALANCE DUE
AMOUNT PAID
ORIGINAL OR AMENDED
REFUND APPLIED
INSTALLMENT DUE
_______________
$______________________
APRIL 15 (1/4) $_______________
$_______________________
$___________________ $___________________
_______________
$______________________
JUNE 15 (1/4) $_______________
$_______________________
$___________________ $___________________
_______________
$______________________
SEPT 15 (1/4) $_______________
$_______________________
$___________________ $___________________
_______________
$______________________
JAN 15 (FULL)$_______________
$_______________________
$___________________ $___________________
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Financial