Form Ct-1040es - Estimated Connecticut Income Tax Payment Coupon For Individuals - 2014 Page 7
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7CT-1040ES
2014
Estimated Connecticut Income Tax Payment
Your Social Security Number
Spouse’s Social Security Number
Due date
• •
• •
• •
• •
___ ___ ___ ___ ___ ___ ___ ___ ___
___ ___ ___ ___ ___ ___ ___ ___ ___
• •
• •
• •
• •
Your fi rst name and middle initial
Last name
1. Payment amount
00
Spouse’s fi rst name and middle initial
Last name
Mailing address (number and street), Apartment number, PO Box
Send completed coupon and payment to :
Department of Revenue Services
City, town, or post offi ce
State
ZIP code
PO Box 2932
Hartford CT 06104-2932
• See Payment Options above.
• Print all information. Include your spouse’s SSN, if married fi ling jointly.
• Cut along dotted line and mail coupon and payment to the address printed on the coupon.
• Make your check payable to Commissioner of Revenue Services.
• DRS may submit your check to your bank electronically.
• To ensure proper posting, write your SSN(s) (optional) and “2014 Form CT-1040ES” on your check.
..................................................................................................................... Cut Here .............................................................................................................
CT-1040ES
2014
Estimated Connecticut Income Tax Payment
Your Social Security Number
Spouse’s Social Security Number
Due date
• •
• •
• •
• •
___ ___ ___ ___ ___ ___ ___ ___ ___
___ ___ ___ ___ ___ ___ ___ ___ ___
• •
• •
• •
• •
Your fi rst name and middle initial
Last name
1. Payment amount
00
Spouse’s fi rst name and middle initial
Last name
Mailing address (number and street), Apartment number, PO Box
Send completed coupon and payment to :
Department of Revenue Services
City, town, or post offi ce
State
ZIP code
PO Box 2932
Hartford CT 06104-2932
• See Payment Options above.
• Print all information. Include your spouse’s SSN, if married fi ling jointly.
• Cut along dotted line and mail coupon and payment to the address printed on the coupon.
• Make your check payable to Commissioner of Revenue Services.
• DRS may submit your check to your bank electronically.
• To ensure proper posting, write your SSN(s) (optional) and “2014 Form CT-1040ES” on your check.
..................................................................................................................... Cut Here .............................................................................................................
CT-1040ES
2014
Estimated Connecticut Income Tax Payment
Your Social Security Number
Spouse’s Social Security Number
Due date
• •
• •
• •
• •
___ ___ ___ ___ ___ ___ ___ ___ ___
___ ___ ___ ___ ___ ___ ___ ___ ___
• •
• •
• •
• •
Your fi rst name and middle initial
Last name
1. Payment amount
00
Spouse’s fi rst name and middle initial
Last name
Mailing address (number and street), Apartment number, PO Box
Send completed coupon and payment to :
Department of Revenue Services
City, town, or post offi ce
State
ZIP code
PO Box 2932
Hartford CT 06104-2932
• See Payment Options above.
• Print all information. Include your spouse’s SSN, if married fi ling jointly.
• Cut along dotted line and mail coupon and payment to the address printed on the coupon.
• Make your check payable to Commissioner of Revenue Services.
• DRS may submit your check to your bank electronically.
• To ensure proper posting, write your SSN(s) (optional) and “2014 Form CT-1040ES” on your check.
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