2012 Estimated Tax Worksheet - City Of Gallipolis

IMPOSITION OF TAX FOR ESTIMATES

This is your 2012 estimated tax package. Included are four installment forms to be led by:

INDIVIDUALS: April 15, July 31, October 31 and January 31.

CORPORATIONS: April 15, June 15, September 15, December 15.

For your convenience, a worksheet to determine if you are required to le a declaration of estimated tax is

listed below.

2012 ESTIMATED TAX WORKSHEET

1.

Total income subject to Gallipolis Tax..........................................................................................................................................................................$_________________

2

Gallipolis income tax –– 1% of line 1 amount .............................................................................................................................................................$_________________

3

Less: Gallipolis tax withheld by employers .................................................................................................................................. $_____________

4

Less: Overpayment on previous year’s return ............................................................................................................................. $_____________

5

Less: Income taxes paid to City of ________________ Not to exceed 1% of that city’s income ................................................ $_____________

6

Net estimated tax due (line 2 minus line 3, 4 and 5 .....................................................................................................................................................$_________________

PAYMENT RECORD

Date

Check #

Amount Paid

NO NOTICE OF

Quarter 1

$

TOTAL PAYMENTS

Quarter 2

$

WILL BE SENT

Quarter 3

$

Quarter 4

$

Credit from prior year ...................................... $

Enter this amount on line 8 of your 2012 City Tax Return.

To avoid a penalty: (a) each installment must equal at least 25% of the lesser of 90% of the tax shown

on the current year’s tax return or 100% of the tax shown on the return for the preceding tax year, (b) the

amount of tax for the current year would be less than fty dollars ($50.00).

Page 6

CITY OF GALLIPOLIS INCOME TAX DEPT. –– ESTIMATED TAX

LOCATION: 848 THIRD AVENUE, GALLIPOLIS, OH 45631

MAIL TO: PO BOX 339

FIRST QUARTER, 2012

TAX OFFICE USE ONLY

1. Total Estimated Tax ............................................................................................ $_________________

TOTAL PAID $ ________________________

2. Amount Enclosed (1/4 of line 1) ......................................................................... $_________________

qCASH q CHECK ________________________

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.