Estimated Tax Worksheet Page 2

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FORM XQ-1
TAX YEAR
_________
ESTIMATED TAX PAYMENT
CITY OF KENTON
nd
2
Quarter – Due on or before June 15
for office use only
PO Box 220
Kenton, OH 43326-0220
419-673-1355
DATE RECEIVED___________
Payment Enclosed $______________________
PAYMENT TYPE___________
FILING PERIOD______/_____
Taxpayer Social Security Number
Spouse Social Security Number
AMT. REC’D $______________
Taxpayer’s Name & Address
TAX YEAR
FORM XQ-1
_________
ESTIMATED TAX PAYMENT
CITY OF KENTON
for office use only
3rd Quarter – Due on or before Sept 15
PO Box 220
DATE RECEIVED___________
Kenton, OH 43326-0220
419-673-1355
PAYMENT TYPE___________
Payment Enclosed $______________________
FILING PERIOD______/_____
Taxpayer Social Security Number
Spouse Social Security Number
AMT. REC’D $______________
Taxpayer’s Name & Address
TAX YEAR
_________
FORM XQ-1
ESTIMATED TAX PAYMENT
for office use only
CITY OF KENTON
4th Quarter – Due on or before Dec 15
PO Box 220
DATE RECEIVED___________
Kenton, OH 43326-0220
419-673-1355
PAYMENT TYPE___________
Payment Enclosed $______________________
FILING PERIOD______/_____
Taxpayer Social Security Number
Spouse Social Security Number
AMT. REC’D $______________
Taxpayer’s Name & Address

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