Form It 1041es - Ohio Estimated Income Tax Payment Coupon For Estates And Trusts - 2011 Page 6

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Ohio IT 1041ES Transmittal Letter
Ohio Department of Taxation
Remittance of Ohio IT 1041ES Payments
Company name: Fast Tax
DSN:
Check and
Make check(s) (one check per tape) pay-
Tape Vol-Ser
Number of Records
Document Amount
able to Ohio Treasurer of State and mail
to:
Ohio Department of Taxation
c/o Mike Cardi
4485 Northland Ridge Blvd.
Columbus, OH 43229
Total
Total of all checks enclosed
Signature
Date
$
Title
Federal Privacy Act Notice
Because we require you to provide us with a Social Security number, the Federal Privacy Act of
1974 requires us to inform you that providing us with your Social Security number is mandatory.
Ohio Revised Code sections 5703.05, 5703.057 and 5747.08 authorize us to request this informa-
tion. We need your Social Security number in order to administer this tax.

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