Form 20 - Declaration Of Estimated Municipal Tax On Net Profits And / Or Application For Extension Of Time To File

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5
REGIONAL INCOME TAX AGENCY
FORM
FORM
Declaration of Estimated Municipal Tax on Net Profits
20
EXTEN
and / or Application for Extension of Time to File
Fed. ID #: _________________________ Tax Year Ending (mm/dd/yy): _______________________
Name: _____________________________________________________________________________
Address #: __________________ Street: ________________________________ Suite: _________
City: ________________________________ State: ____________ Zip: ______________________
Computation of Estimated Tax:
1. Total Estimated Tax (from distribution below) …………………………. $ __________________.00
2. Less Prior Year Credit ………………………………………………………. $ __________________.00
3. Total Tax Due …………………………………………………………………. $ __________________.00
4. Amount Paid (make check payable to RITA) ……………………………. $ __________________.00
(not less than 1/4 of estimated tax) CHECK #: ___________________
5. Distribute Estimated Tax from Line 1 above (if additional space is needed, attach a schedule)
►
Municipality:
Amount:
________________________________________________
$ __________________.00
________________________________________________
$ __________________.00
________________________________________________
$ __________________.00
________________________________________________
$ __________________.00
________________________________________________
$ __________________.00
________________________________________________
$ __________________.00
________________________________________________
$ __________________.00
________________________________________________
$ __________________.00
________________________________________________
$ __________________.00
________________________________________________
$ __________________.00
I HAVE EXAMINED THIS RETURN, AND TO THE BEST OF MY KNOWLEDGE, IT IS CORRECT.
NAME
TITLE
DATE
PHONE: ____________________________
REMIT TO:
REGIONAL INCOME TAX AGENCY
P.O. BOX 89475
CLEVELAND, OH 44101-6475

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