Form 1040n-Es - Nebraska Individual Estimated Income Tax Payment Voucher - 2014 Page 7
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8Nebraska Individual Estimated Income Tax
FORM 1040N-ES
2014
Payment Voucher
1 Estimated tax for the year ending
(line 18 of estimated tax worksheet)..................................
1
2 Amount of this installment (line 19 of Estimated Tax
Worksheet) ........................................................................
2
1
3 Amount of overpayment from last year (all or part)
This installment is due on
3
applied to this installment ..................................................
or before April 15, 2014.
4 Amount of this payment (line 2 minus line 3). Enter here
4
and in your Record of Estimated Tax Payments ................
Important: Social Security numbers must be entered below.
Name that will be Shown First on your Income Tax Return Last Name
First Social Security Number on your Income Tax Return
If a Joint Return, Spouse’s First Name and Initial
Last Name
Spouse’s Social Security Number
Current Mailing Address (Number and Street or PO Box)
• File only if you are making a payment of estimated tax.
City
State
Zip Code
• Fiscal year taxpayers — see instructions.
Consider paying electronically. Otherwise, mail this voucher and your check or money order to:
Nebraska Department of Revenue, PO Box 98911, Lincoln, NE 68509-8911
8-014-2013
Nebraska Individual Estimated Income Tax
FORM 1040N-ES
2014
Payment Voucher
1 Estimated tax (or amended estimated tax) (line 18 of
estimated tax worksheet) for the year ending
.
1
Complete if an original or amended computation ..............
2 Amount of this installment (line 19 of Estimated Tax
Worksheet, or line 6 of Amended Computation Schedule)
2
2
3 Amount of overpayment from last year applied to this
This installment is due on
3
installment (and not applied to previous installments) .......
or before June 16, 2014.
4 Amount of this payment (line 2 minus line 3). Enter here
and in your Record of Estimated Tax Payments ................
4
Important: Social Security numbers must be entered below.
Name that will be Shown First on your Income Tax Return Last Name
First Social Security Number on your Income Tax Return
If a Joint Return, Spouse’s First Name and Initial
Last Name
Spouse’s Social Security Number
Current Mailing Address (Number and Street or PO Box)
• File only if you are making a payment of estimated tax.
• Fiscal year taxpayers — see instructions.
City
State
Zip Code
• If your estimated tax needs to be amended, use the Amended
Computation Schedule.
Consider paying electronically. Otherwise, mail this voucher and your check or money order to:
Nebraska Department of Revenue, PO Box 98911, Lincoln, NE 68509-8911
8-014-2013
7
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