Business Declaration Of Estimated Tax - Etna Twp. Jedz-I

Business Declaration Of Estimated Tax - Etna Twp. Jedz-I - 2009 Page 2

REV 6/2008

2009 Etna Twp. JEDZ-I

Business Declaration of Estimated Tax

Administered by City of Newark Income Tax Department, 40 W. Main St. Newark OH 43055 Phone: 740-670-7580 Fax: 740-670-7581

(EXTENSION OF TIME TO FILE ESTIMATE IS NOT ALLOWED, FILE BY 4/15/09 OR BY THE 15

DAY OF THE 4

MO. AFTER FISCAL YEAR END)

City ID:

Name:

EIN:

Address:

Phone:

Contact:

E-mail:

Fax:

1. ESTIMATED INCOME SUBJECT TO ETNA TWP. JEDZ-I TAX……………

1 $

2. MULTIPLY LINE 1 BY 1.75%, if $100 or more, quarterly payments required..

ESTIMATED TAX

2 $

3. QUARTER PAYMENT DUE (minimum payment due is 22.5% of line 2)...… ..

3 $

4. CREDIT FROM PRIOR YEAR OVERPAYMENT ……………………………

4 $ (

)

5. AMOUNT DUE FOR 1

QUARTER (Line 3 less line 4)………………………

QUARTER PAYMENT

5 $

6. Penalty $

Interest $

(See instructions) ……………………

6 $

PENALTY/INTEREST

7. ESTIMATED PAYMENT DUE (Line 5 plus line 6)………………………..….

BALANCE DUE

7 $

MAKE CHECK OR MONEY ORDER PAYABLE TO:

ETNA TWP JEDZ I—CITY OF NEWARK

MAY REMIT BY VISA OR MASTERCARD NO. _________________________________________ EXP.DATE_______________

CVS:

AUTHORIZED SIGNATURE OF CARDHOLDER: _______________________________________________________

________

MAIL FORM AND PAYMENT TO: ETNA TWP. JEDZ I

PO BOX 327 NEWARK OH 43058-0327

Business Declaration Of Estimated Tax - Etna Twp. Jedz-I - 2009 Page 2

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