Form 500es - Virginia Corporation Estimated Income Tax Payment Vouchers - 2015 Page 4
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4Attention:
Payments must be submitted electronically using eForms, Business iFile
or with an ACH Credit from your bank. Use these vouchers only if you have
an approved waiver from the electronic payment requirement. To request a
waiver, follow the instructions at:
Form 500ES
VOUCHER 4
Virginia Estimated Tax Declaration For Corporations
Virginia Department of Taxation
(DOC ID 501)
PO Box 1500, Richmond, VA 23218-1500
(804) 367-8037
Attention: Payment must be made electronically using eForms,
Business iFile or with an ACH credit from your bank. Use this
voucher only if you have an approved waiver.
0000000000000000 5010000 000000 04
35-
VA Account Number
For mo./yr. ending
Name of corporation
FEIN
1. Estimated tax
for the year ...... $
Address (Number and street)
2. Amount of this
Address continued
payment ........... $
v
City, State and ZIP Code
— Do not write below this line. —
I declare that this declaration has been examined by me and to the best of my knowledge and belief, it is true, correct and complete.
Signature
Date
Phone
Form 500ES
Virginia Estimated Tax Declaration For Corporations
VOUCHER 3
Virginia Department of Taxation
(DOC ID 501)
PO Box 1500, Richmond, VA 23218-1500
(804) 367-8037
Attention: Payment must be made electronically using eForms,
Business iFile or with an ACH credit from your bank. Use this
voucher only if you have an approved waiver.
0000000000000000 5010000 000000 03
35-
VA Account Number
For mo./yr. ending
Name of corporation
FEIN
1. Estimated tax
for the year ...... $
Address (Number and street)
2. Amount of this
Address continued
payment ........... $
v
City, State and ZIP Code
— Do not write below this line. —
I declare that this declaration has been examined by me and to the best of my knowledge and belief, it is true, correct and complete.
Signature
Date
Phone
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