Ohio Form It 1040es - Individual Estimated Income Tax - 2012
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62012 Ohio IT 1040ES, Voucher 1 – Due April 17, 2012
Federal Privacy Act Notice
Because we require you to provide us with a Social Se-
curity number, the Federal Privacy Act of 1974 requires
us to inform you that providing us with your Social Secu-
rity number is mandatory. Ohio Revised Code sections
5703.05, 5703.057 and 5747.08 authorize us to request
this information. We need your Social Security number in
order to administer this tax.
Reset Form
DO NOT USE PENCIL
Please cut on the dotted lines.
to complete this form.
OHIO IT 1040ES
Do NOT fold check or voucher.
Individual Estimated Income Tax
Rev. 6/11
2012ES
Please use UPPERCASE letters
(Voucher 1) Due April 17, 2012
to print the fi rst three letters of
Taxpayer’s
Spouse’s last name
First name
M.I.
Last name
last name
(only if joint fi ling)
Spouse’s fi rst name (only if joint fi ling)
M.I.
Last name
Your Social
Address
Security
number
Spouse’s Social
City, state, ZIP code
Security number
(only if joint fi ling)
DO NOT STAPLE OR OTHERWISE ATTACH YOUR CHECK OR CHECK
Amount of
STUB TO THIS COUPON. DO NOT SEND CASH. Return this coupon with
0 0
$
check or money order made payable to OHIO TREASURER OF STATE and
Payment
mail to OHIO DEPARTMENT OF TAXATION, P.O. BOX 1460, Columbus,
Ohio 43216-1460.
400
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