Declaration Of Estimated Income Tax/quarterly Statement - City Of Flint - 2011 Page 2

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FORMS OR INFORMATION
Forms or information may be obtained from the Income Tax Department section of the City of
Flint website, , via telephone by calling (810) 766-7015 or from the City of Flint
Income Tax Department, 1101 S. Saginaw St, Flint, MI 48502.
WORKSHEET FOR 2011 DECLARATION OF ESTIMATED INCOME TAX
(KEEP FOR YOUR RECORDS)
1. TOTAL FLINT INCOME EXPECTED IN 2011 OR TOTAL INCOME FROM 2010
00
2. EXEMPTIONS ($600 FOR EACH EXEMPTION; DOES NOT APPLY TO CORPORATIONS)
00
3. ESTIMATED FLINT TAXABLE INCOME (SUBTRACT LINE 2 FROM LINE1)
00
4. ESTIMATED FLINT INCOME TAX BEFORE CREDITS (NON-RESIDENT INDIVIDUALS
MULTIPLY LINE 3 BY 1/2% (.005), ALL OTHER TAXPAYERS MULTIPLY LINE 3 BY 1% (.01)
00
5. AMOUNT OF FLINT INCOME TAX WITHHELD OR OTHER CREDIT EXPECTED IN 2011
00
6. ESTIMATED INCOME TAX DUE (SUBTRACT LINE 5 FROM LINE 4)--DECLARATION AMOUNT
00
7. INSTALLMENT AMOUNT (DIVIDE LINE 6 BY 4)
00
VOUCHER
DATE PAID
CHECK NUMBER
AMOUNT PAID
1
2
3
4
-----------------------------------------------------------------------------------CUT ALONG LINE-----------------------------------------------------------------------------------------------
CITY OF FLINT INCOME TAX DEPARTMENT
DECLARATION OF ESTIMATED INCOME TAX/QUARTERLY
DUE DATE
VOUCHER
2011
STATEMENT OF ACCOUNT FOR CALENDAR YEAR OR FISCAL
JANUARY 31,
YEAR ENDING______________________, 20____
2012
NO. 4
SOCIAL SECURITY NUMBER OR FEDERAL I.D. NUMBER
SPOUSE SOCIAL SECURITY NUMBER
TAXPAYER'S NAME AND ADDRESS
ESTIMATED TAX
PAYMENT AMOUNT
00
.00
$___________.
$___________
MAKE CHECKS PAYABLE AND MAIL TO: TREASURER, CITY OF FLINT – P.O. BOX 99, FLINT, MI 48501

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