Form Xq-1 (B) - Estimated Tax Payment (Business) - 2012
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1
2FORM XQ-1 (B)
TAX YEAR
ESTIMATED TAX PAYMENT (Business)
CITY OF XENIA
2012
PO Box 490
nd
2
Quarter – Due on or before July 15, 2012 for calendar yr filers
Xenia, OH 45385-0490
for office use only
th
or due 15
of seventh month of fiscal year
937-376-7248
NOTE: TAX RATE FOR 2012 IS 2.25%
DATE RECEIVED___________
Payment Enclosed $______________________
2
PAYMENT TYPE_____
_____
Federal ID Number
/
FILING PERIOD__02__
_2012
AMT. REC’D $______________
Taxpayer’s Name & Address
FORM XQ-1 (B)
ESTIMATED TAX PAYMENT (Business)
CITY OF XENIA
TAX YEAR
PO Box 490
rd
2012
3
Quarter – Due on or before October 15, 2012 for calendar yr filers
Xenia, OH 45385-0490
th
or due 15
of tenth month of fiscal year
937-376-7248
NOTE: TAX RATE FOR 2012 IS 2.25%
for office use only
DATE RECEIVED___________
Payment Enclosed $______________________
Federal ID Number
2
PAYMENT TYPE_____
_____
/
FILING PERIOD__03__
_2012
Taxpayer’s Name & Address
AMT. REC’D $______________
FORM XQ-1 (B)
TAX YEAR
ESTIMATED TAX PAYMENT (Business)
CITY OF XENIA
2012
PO Box 490
th
4
Quarter – Due on or before January 15, 2013 for calendar yr filers
Xenia, OH 45385-0490
th
or due 15
of thirteenth month of fiscal year
for office use only
937-376-7248
NOTE: TAX RATE FOR 2012 IS 2.25%
DATE RECEIVED___________
Payment Enclosed $______________________
2
PAYMENT TYPE_____
_____
Federal ID Number
/
FILING PERIOD__04__
_2012
Taxpayer’s Name & Address
AMT. REC’D $______________
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