Form Ct-990t Esa - Estimated Unrelated Business Income Tax - Payment Coupon - 2014
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1
22014
Department of Revenue Services
Check here
if closing month has
CT-990T ESA
PO Box 5014
changed and attach explanation.
Payment Coupon - First Installment
Hartford CT 06102-5014
Estimated Unrelated Business Income Tax
FOR INCOME YEAR ENDING
A
Complete in blue or black ink only
(Rev. 12/13)
Connecticut Tax Registration Number
00
1. Tax shown on prior year return (including surtax) before any tax credits, multiplied by 30% (.30)
1.
00
2. Current year fi rst installment from Schedule 1, Line 4
2.
DRS use only
00
3. First installment due: Lesser of Line 1 or Line 2
3.
–
– 20
00
4. Overpayment from prior year (see Informational Publication 2013(18))
4.
Federal Employer ID Number
00
5. Payment due with this coupon: Subtract Line 4 from Line 3.
5.
See instructions on reverse.
Due Date: 15th day of the 3rd month of the income year.
If the due date falls on a Saturday, Sunday, or legal
holiday, the next business day is the due date.
Please
Visit to pay this return electronically.
correct name
Make Check Payable To:
and mailing
Commissioner of Revenue Services
address
if shown
Mail To:
Department of Revenue Services
incorrectly.
PO Box 5014
Hartford CT 06102-5014
2014
Department of Revenue Services
Check here
if closing month has
CT-990T ESB
PO Box 5014
changed and attach explanation.
Payment Coupon - Second Installment
Hartford CT 06102-5014
Estimated Unrelated Business Income Tax
FOR INCOME YEAR ENDING
B
Complete in blue or black ink only.
(Rev. 12/13)
Connecticut Tax Registration Number
00
1. Tax shown on prior year return (including surtax) before any tax credits, multiplied by 70% (.70)
1.
00
2. Current year second installment from Schedule 1, Line 4
2.
DRS use only
00
3. Second installment due: Lesser of Line 1 or Line 2
3.
–
– 20
00
4. Amount paid with Form CT-990T ESA, plus overpayment from prior year
4.
Federal Employer ID Number
00
5. Payment due with this coupon: Subtract Line 4 from Line 3.
5.
See instructions on reverse.
Due Date: 15th day of the 6th month of the income year.
If the due date falls on a Saturday, Sunday, or legal
holiday, the next business day is the due date.
Please
Visit to pay this return electronically.
correct name
and mailing
Make Check Payable To:
Commissioner of Revenue Services
address
if shown
Mail To:
Department of Revenue Services
incorrectly.
PO Box 5014
Hartford CT 06102-5014
2014
Department of Revenue Services
Check here
if closing month has
CT-990T ESC
PO Box 5014
changed and attach explanation.
Payment Coupon - Third Installment
Hartford CT 06102-5014
Estimated Unrelated Business Income Tax
FOR INCOME YEAR ENDING
C
Complete in blue or black ink only.
(Rev. 12/13)
Connecticut Tax Registration Number
00
1. Tax shown on prior year return (including surtax) before any tax credits, multiplied by 80% (.80)
1.
00
2. Current year third installment from Schedule 1, Line 4
2.
DRS use only
00
–
– 20
3. Third installment due: Lesser of Line 1 or Line 2
3.
Amount paid with Form CT-990T ESA and Form CT-990T ESB, plus overpayment
00
4.
4.
Federal Employer ID Number
from prior year
00
5. Payment due with this coupon: Subtract Line 4 from Line 3.
5.
See instructions on reverse.
Due Date: 15th day of the 9th month of the income year.
If the due date falls on a Saturday, Sunday, or legal
holiday, the next business day is the due date.
Please
Visit to pay this return electronically.
correct name
and mailing
Make Check Payable To:
address
Commissioner of Revenue Services
if shown
Mail To:
Department of Revenue Services
incorrectly.
PO Box 5014
Hartford CT 06102-5014
2014
Department of Revenue Services
Check here
if closing month has
CT-990T ESD
PO Box 5014
changed and attach explanation.
Payment Coupon - Fourth Installment
Hartford CT 06102-5014
Estimated Unrelated Business Income Tax
FOR INCOME YEAR ENDING
D
Complete in blue or black ink only.
(Rev. 12/13)
Connecticut Tax Registration Number
00
1. Tax shown on prior year return (including surtax) before any tax credits, multiplied by 100% (1.00)
1.
00
2. Current year fourth installment from Schedule 1, Line 4
2.
DRS use only
00
3. Fourth installment due: Lesser of Line 1 or Line 2
3.
–
– 20
Amount paid with Form CT-990T ESA, Form CT-990T ESB, and Form CT-990T ESC,
00
4.
4.
Federal Employer ID Number
plus overpayment from prior year
00
5. Payment due with this coupon: Subtract Line 4 from Line 3.
5.
See instructions on reverse.
Due Date: 15th day of the 12th month of the income year.
If the due date falls on a Saturday, Sunday, or legal
holiday, the next business day is the due date.
Please
Visit to pay this return electronically.
correct name
Make Check Payable To:
and mailing
address
Commissioner of Revenue Services
if shown
Mail To:
Department of Revenue Services
incorrectly.
PO Box 5014
Hartford CT 06102-5014
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