1. Adjusted Estimated Taxable Income for year... $ _________________
To amend your Declaration of Estimated taxes, complete
2. Estimated Tax Due - 2.25% of Line 1......... $ _________________
the worksheet section to the right and enter the amount
calculated on Line 5 to the front of the form (Line 1).
3. Credits
A. Payments already made this year.............. $ _________________
Check the box
on the top of the form, then sign and
date the declaration below.
B. Overpayment from prior year .................... $ _________________
C. Other (Specify___________________) .. $ _________________
I declare that this Amended Declaration has been examined by me,
and to the best of my knowledge and belief it is correct, true and
D. Total Credits (Add Lines 3A, 3B & 3C) ..... $ _________________
complete.
4. Balance of Estimated Tax ............................... $ _________________
____________________________________________
(Subtract Line 3D from Line 2)
SIGNATURE
AND
TITLE
DATE
5. Payment to be made with this Amended ....... $ _________________
Declaration (Divide Line 4 by the number of remaining payments.)
1. Adjusted Estimated Taxable Income for year... $ _________________
To amend your Declaration of Estimated taxes, complete
the worksheet section to the right and enter the amount
2. Estimated Tax Due - 2.25% of Line 1......... $ _________________
calculated on Line 5 to the front of the form (Line 1).
3. Credits
A. Payments already made this year.............. $ _________________
Check the box
on the top of the form, then sign and
date the declaration below.
B. Overpayment from prior year .................... $ _________________
C. Other (Specify___________________) .. $ _________________
I declare that this Amended Declaration has been examined by me,
and to the best of my knowledge and belief it is correct, true and
D. Total Credits (Add Lines 3A, 3B & 3C) ..... $ _________________
complete.
4. Balance of Estimated Tax ............................... $ _________________
____________________________________________
(Subtract Line 3D from Line 2)
SIGNATURE
AND
TITLE
DATE
5. Payment to be made with this Amended ....... $ _________________
Declaration (Divide Line 4 by the number of remaining payments.)
1. Adjusted Estimated Taxable Income for year.. $ _________________
To amend your Declaration of Estimated taxes, complete
2. Estimated Tax Due - 2.25% of Line 1......... $ _________________
the worksheet section to the right and enter the amount
calculated on Line 5 to the front of the form (Line 1).
3. Credits
A. Payments already made this year.............. $ _________________
Check the box
on the top of the form, then sign and
B. Overpayment from prior year .................... $ _________________
date the declaration below.
C. Other (Specify___________________)... $ _________________
I declare that this Amended Declaration has been examined by me,
and to the best of my knowledge and belief it is correct, true and
D. Total Credits (Add Lines 3A, 3B & 3C) ..... $ _________________
complete.
4. Balance of Estimated Tax ............................... $ _________________
____________________________________________
(Subtract Line 3D from Line 2)
SIGNATURE
AND
TITLE
DATE
5. Payment to be made with this Amended ....... $ _________________
Declaration (Divide Line 4 by the number of remaining payments.)