Form 1040-Es - Estimated Tax For Individuals - 2013 Page 10
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11Record of Estimated Tax Payments (Farmers, fishermen, and fiscal
year taxpayers, see page 3 for payment due dates.)
Keep for Your Records
(c) Check or
(d) Amount paid
Payment
(e) 2012
(f) Total amount
(a) Amount
(b) Date
money order number, or
(do not include
due
overpayment
paid and credited
due
paid
credit or debit card
any convenience
date
credit applied
(add (d) and (e))
confirmation number
fee)*
1
4/15/2013
2
6/17/2013
3
9/16/2013
4
1/15/2014**
Total .
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* You can deduct the convenience fee charged by the service provider in 2013 as a miscellaneous itemized deduction (subject to the 2%-of-AGI
limit) on your 2013 income tax return.
** You do not have to make this payment if you file your 2013 tax return by January 31, 2014, and pay the entire balance due with your return.
Tear off here
4
1040-ES
2013 Estimated Tax
Payment
Department of the Treasury
Voucher
OMB No. 1545-0074
Internal Revenue Service
Calendar year—Due Jan. 15, 2014
File only if you are making a payment of estimated tax by check or money order. Mail this
Amount of estimated tax you are paying
voucher with your check or money order payable to “United States Treasury.” Write your
by check or
social security number and “2013 Form 1040-ES” on your check or money order. Do not send
Dollars
Cents
money order.
cash. Enclose, but do not staple or attach, your payment with this voucher.
Your first name and initial
Your last name
Your social security number
If joint payment, complete for spouse
Spouse’s first name and initial
Spouse’s last name
Spouse’s social security number
Address (number, street, and apt. no.)
City, state, and ZIP code. (If a foreign address, enter city, also complete spaces below.)
Foreign postal code
Foreign country name
Foreign province/county
Form 1040-ES (2013)
For Privacy Act and Paperwork Reduction Act Notice, see instructions.
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