Form 760es - Virginia Estimated Income Tax Payment Vouchers For Individuals - 2012 Page 5
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72012 FORM 760ES - Voucher 2
LOCALITY NO.
FOR OFFICE USE
Check here if this is the first time you
Doc ID 762
have filed Form 760ES or if this is a
VIRGINIA ESTIMATED INCOME TAX
new address.
PAYMENT VOUCHER FOR INDIVIDUALS
CALENDAR YEAR FILERS: DUE JUNE 15, 2012 OR
FISCAL YEAR FILERS: BEGINNING MONTH: ______________
Make your check payable to the Treasurer of the city or
0000000000 7620000 112062
county in which the individual qualified.
If this is your first payment for this taxable year,
CHECK BOX and mail payment to your Commissioner
Your Social Security Number
Spouse’s Social Security Number
of the Revenue, Director of Finance or Director of Tax
Administration.
First Name
MI Last Name
Mail all other vouchers to the Treasurer.
Addresses are at the end of this document.
Spouse's First Name
MI Spouse's Last Name
Amount of payment
Address (Number and Street) of Taxpayer
00
.
City, State and ZIP Code
Daytime Phone Number
2012 FORM 760ES - Voucher 3
LOCALITY NO.
FOR OFFICE USE
Check here if this is the first time you
Doc ID 762
have filed Form 760ES or if this is a
VIRGINIA ESTIMATED INCOME TAX
new address.
PAYMENT VOUCHER FOR INDIVIDUALS
CALENDAR YEAR FILERS: DUE SEPTEMBER 15, 2012 OR
FISCAL YEAR FILERS: BEGINNING MONTH: ______________
Make your check payable to the Treasurer of the city or
0000000000 7620000 112097
county in which the individual qualified.
If this is your first payment for this taxable year,
CHECK BOX and mail payment to your Commissioner
Your Social Security Number
Spouse’s Social Security Number
of the Revenue, Director of Finance or Director of Tax
Administration.
First Name
MI Last Name
Mail all other vouchers to the Treasurer.
Addresses are at the end of this document.
Spouse's First Name
MI Spouse's Last Name
Amount of payment
Address (Number and Street) of Taxpayer
00
.
City, State and ZIP Code
Daytime Phone Number
2012 FORM 760ES - Voucher 4
LOCALITY NO.
FOR OFFICE USE
Check here if this is the first time you
Doc ID 762
have filed Form 760ES or if this is a
VIRGINIA ESTIMATED INCOME TAX
new address.
PAYMENT VOUCHER FOR INDIVIDUALS
CALENDAR YEAR FILERS: DUE JANUARY 15, 2013 OR
FISCAL YEAR FILERS: BEGINNING MONTH: ______________
Make your check payable to the Treasurer of the city or
0000000000 7620000 113018
county in which the individual qualified.
If this is your first payment for this taxable year,
CHECK BOX and mail payment to your Commissioner
Your Social Security Number
Spouse’s Social Security Number
of the Revenue, Director of Finance or Director of Tax
Administration.
First Name
MI Last Name
Mail all other vouchers to the Treasurer.
Spouse's First Name
MI Spouse's Last Name
Addresses are at the end of this document.
Amount of payment
Address (Number and Street) of Taxpayer
00
City, State and ZIP Code
.
Daytime Phone Number
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