Declaration Of Estimated Tax - City Of Fairfield, Ohio Income Tax - 2015

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2
2015 CITY OF FAIRFIELD DECLARATION OF ESTIMATED TAX
2ND QUARTER STATEMENT DUE BY 7/31/2015
VISA/MasterCard/Discover Accepted
Please insert Name & Address
Address Change
Account, Social Security or Federal ID #:
Name:
Card #
_________________________________
_________________________________
C/O:
Exp. Date
Annual/Amended Estimate: $ _____________
_________________________________
Address:
Name on Card
Amount Paid this Quarter:
$ _____________
_________________________________
City:
Signature
State/Zip:
_________________________________
To determine if this transaction will be
MAKE REMITTANCE PAYABLE TO FAIRFIELD INCOME TAX,
treated as a cash advance when paid to
701 WESSEL DRIVE, FAIRFIELD, OH 45014-3611 • (513) 867-5327
CITY OF FAIRFIELD TAX, please check
NOTE: It is the taxpayer’s responsibility to file the declaration and make payments by the specified due dates.
with your credit card issuing company.
penalty
Failure to meet the 90% requirement by January 31, 2016 will result in the assessment of a $50
---------------------------------------------------------------------------------------------------------------- ----------------------------------------------------------
3
2015 CITY OF FAIRFIELD DECLARATION OF ESTIMATED TAX
3RD QUARTER STATEMENT DUE BY 10/31/2015
VISA/MasterCard/Discover Accepted
Please insert Name & Address
Address Change
Account, Social Security or Federal ID #:
Name:
Card #
_________________________________
_________________________________
C/O:
Exp. Date
Annual/Amended Estimate: $ _____________
_________________________________
Address:
Name on Card
Amount Paid this Quarter:
$ _____________
_________________________________
City:
Signature
State/Zip:
_________________________________
To determine if this transaction will be
MAKE REMITTANCE PAYABLE TO FAIRFIELD INCOME TAX,
treated as a cash advance when paid to
701 WESSEL DRIVE, FAIRFIELD, OH 45014-3611 • (513) 867-5327
CITY OF FAIRFIELD TAX, please check
NOTE: It is the taxpayer’s responsibility to file the declaration and make payments by the specified due dates.
with your credit card issuing company.
penalty
Failure to meet the 90% requirement by January 31, 2016 will result in the assessment of a $50
----------------------------------------------------------------------------------------------------------------------------- ---------------------------------------------
4
2015 CITY OF FAIRFIELD DECLARATION OF ESTIMATED TAX
4TH QUARTER STATEMENT DUE BY 1/31/2016
VISA/MasterCard/Discover Accepted
Please insert Name & Address
Address Change
Account, Social Security or Federal ID #:
Name:
Card #
_________________________________
_________________________________
C/O:
Exp. Date
Annual/Amended Estimate: $ _____________
_________________________________
Address:
Name on Card
Amount Paid this Quarter:
$ _____________
_________________________________
City:
Signature
State/Zip:
_________________________________
MAKE REMITTANCE PAYABLE TO FAIRFIELD INCOME TAX,
To determine if this transaction will be
701 WESSEL DRIVE, FAIRFIELD, OH 45014-3611 • (513) 867-5327
treated as a cash advance when paid to
NOTE: It is the taxpayer’s responsibility to file the declaration and make payments by the specified due dates.
CITY OF FAIRFIELD TAX, please check
penalty
Failure to meet the 90% requirement by January 31, 2016 will result in the assessment of a $50
with your credit card issuing company.

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