VERMONT
*151141100*
2017
Form IN-114
Individual Income Estimated
* 1 5 1 1 4 1 1 0 0 *
Tax Payment Voucher
Use blue or black ink to write entries
Taxpayer’s Last Name
First Name
Initial
Taxpayer’s Social Security Number
Spouse or CU Partner Last Name
First Name
Initial
Spouse or CU Partner Social Security Number
Mailing Address (Number and Street/Road or PO Box)
City, Town
State
ZIP Code
-
Form IN-114
5432
.0 0
Amount of this payment $ ____________________________
Rev. 09/13
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Mail voucher to:
Payment Due Dates
1st Quarter
APR 15, 2017
2nd Quarter
JUN 15, 2017
Vermont Department of Taxes
3rd Quarter
SEP 15, 2017
PO Box 1779
4th Quarter
JAN 15, 2018
Montpelier, VT
05601-1779
Did you know? You can make your estimated income tax payment online using ACH debit
or your credit card. Visit us on the web at and click on the “Pay your
income taxes online” box.
Make corrections directly on the voucher. Mail payment with completed voucher to the address below. Record your payment on the Taxpayer Worksheet.
QUESTIONS? Contact your tax preparer for advice on filing estimated income tax payments. Please see the Vermont Department of Taxes website
to find answers to many of your taxpayer questions at . Contact the Vermont Department of Taxes for other assistance.
Vermont Department of Taxes
E-mail:
tax.IndividualIncome@vermont.gov
Taxpayer Services Division-Income Tax
Telephone:
(802) 828-2865 (local and out-of-state)
PO Box 1779
(866) 828-2865 (toll-free in Vermont)
Montpelier, VT 05601-1779
Fax:
(802) 828-2720
PLEASE READ INSTRUCTIONS BEFORE COMPLETING THIS FORM