Form Q-1 - Quarterly Statement - Declaration Of Estimated Income Tax - State Of Ohio

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QUARTERLY STATEMENT – DECLARATION OF ESTIMATED INCOME TAX
(FORM Q-1)
AMOUNT ENCLOSED
MAKE CHECK OR MONEY ORDER TO:
FID/SSN
CITY OF BEDFORD TAX DEPARTMENT
P.O. BOX 92636-T
$
CLEVELAND, OHIO 44190-2636
DUE ON OR BEFORE
(888) 232-1600 or (440) 735-6505
PAY THIS AMOUNT
ESTIMATED TAX
AMOUNT CREDITED FROM PRIOR
AMOUNT OF
AMENDED
NEW ESTIMATED
DECLARED
YEAR PLUS CURRENT YEARS PYMTS
UNPAID BALANCE
ESTIMATED TAX
BALANCE
IF THIS STATEMENT DOES NOT REFLECT PAYMENT RECENTLY MADE, PLEASE ADVISE - INCOME TAX OFFICE - PROMPTLY
DO NOT USE THIS SPACE
NOTIFY INCOME TAX DEPARTMENT PROMPTLY OF ANY CHANGE IN OWNERSHIP OR NAME AND ADDRESS ABOVE
ORIGINAL – RETURN THIS COPY WITH PAYMENT
QUARTERLY STATEMENT – DECLARATION OF ESTIMATED INCOME TAX
(FORM Q-1)
AMOUNT ENCLOSED
MAKE CHECK OR MONEY ORDER TO:
FID/SSN
CITY OF BEDFORD TAX DEPARTMENT
P.O. BOX 92636-T
$
CLEVELAND, OHIO 44190-2636
DUE ON OR BEFORE
(888) 232-1600 or (440) 735-6505
PAY THIS AMOUNT
ESTIMATED TAX
AMOUNT CREDITED FROM PRIOR
AMOUNT OF
AMENDED
NEW ESTIMATED
DECLARED
YEAR PLUS CURRENT YEARS PYMTS
UNPAID BALANCE
ESTIMATED TAX
BALANCE
IF THIS STATEMENT DOES NOT REFLECT PAYMENT RECENTLY MADE, PLEASE ADVISE - INCOME TAX OFFICE - PROMPTLY
DO NOT USE THIS SPACE
NOTIFY INCOME TAX DEPARTMENT PROMPTLY OF ANY CHANGE IN OWNERSHIP OR NAME AND ADDRESS ABOVE
DUPLICATE – TAXPAYER’S COPY

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