Form ES-40 2013 Estimated Tax Payment Voucher

If you think the amount withheld will not be enough to pay your tax liability and Please make your check or money order payable to: Indiana Department of Revenue Will not have Indiana tax withheld or You expect to owe more than $1 000 when you file your tax return then you should pay estimated tax (R11 / 9 12) *14912111694* *24100000000* 1 State tax due from line J of worksheet State Tax 1 00 14912111694 1st Installment payment due April 15 2013 2nd Installment payment due June 17 2013 2 From line K of worksheet: 24100000000 3 From line L of worksheet: 3rd Installment payment due Sept 16 2013 4th Installment payment due Jan 15 2014 4 Add lines 1 2b and 3b Estimated Tax Installment Payment 4 00 a Enter spouse s county code (if different from yours) a Enter your county code A Total estimated income for 2013 A b Enter county tax Your County Tax 2b 00 b Enter spouse s county tax Spouse s County Tax 3b 00 B Total exemption amount B C Amount subject to tax (line A minus line B) C Complete the worksheet on the back of this form to figure your estimated tax payment county code Enter on Line 3 L county) estimated county tax due Enter 2 digit county code (from county tax chart) Enter on Line 2 K D Amount of state income tax due (line C x 034) D E Amount of county income tax due (line C x the appropriate county tax rate(s)) E ES 40 Estimated Tax Designation and Payment Area Estimated Tax Payment Form F Anticipated state and county tax due for 2013 (add line D and line E) F For more information about estimated tax get Income Tax Information Bulletin #3 at www in gov/dor/3650 htm G Total anticipated credits (including anticipated 2013 state and county income tax withheld) G H Amount due (line F minus line G) H I Each installment payment due for 2013 (divide line H by 4) Enter on Line 4 I If filing a joint return spouse s first name If you expect to have income during the 2013 tax year that: Indiana Department of Revenue Indianapolis IN 46206 6102 Initial Installment Period Information Instructions for Form ES 40 J Enter portion of line I that represents your estimated state tax due Enter on Line 1 J K Enter portion of line I that represents your (and spouse s if same L Enter portion of line I that represents spouse s estimated county Last name Line B Multiply the number of exemptions claimed on your federal tax return by $1 000 Add $1 500 for each eligible dependent child If you are 65 years or older and/or blind add $1 000 for each additional exemption Limitation: If you are a nonresident alien (not a U S citizen and does not meet the green card test) you may claim only one $1 000 exemption (even if married filing jointly and/or with dependents) Line E Multiply amount on line C by the appropriate county tax rate(s) Find your rate on the back of Schedule CT 40 (County Tax Schedule) or at Line I This is your estimated tax installment payment Enter this amount on line 4 Estimated Tax Installment Payment at the top of the form Lines J K and L If you are paying only the amount of estimated Indiana income tax due enter the amount from line I on line 1 State Tax Due at the top of the form If the amount on line I also includes estimated county tax enter the portion on lines 2 and/or 3 at the top of the form Only break out your spouse s estimated county tax if your spouse owes tax to a county other than yours Mail entire form and payment to: Note: Do Not mail Form ES 40 if paying by credit card or eCheck P O Box 6102 Pay the amount due on or before the installment due date Enclose your check or money order made payable to the Indiana Department of Revenue Write your Social Security number on the check or money order Note: All payments must be made with U S funds Place an X in the appropriate box to show which payment you are making: Present address (number and street or rural route) Security Number See instructions for other payment options Spouse s Social State State Form 46005 tax due if for a different county than the one on line K Enter 2 digit To make an estimated tax payment online log on towww in gov/dor/4340 htm To pay by using your American Express Card Discover Card MasterCard or VISA call 1 800 2 PAY TAX (1 800 272 9829) A convenience fee will be charged by the credit card processor based on the amount you are paying You will be told what the fee is and you will have the option to either cancel or continue the credit card transaction Use the worksheet below to determine how much you ll owe The first installment payment is due April 15 2013 The remaining three payments are due June 17 and Sept 16 2013 and Jan 15 2014 Use this form to make an estimated tax payment We suggest that first time estimated income taxpayers make a copy of the blank form This is in case the vouchers that are automatically issued (after we receive your first payment) don t get to you by the next payment s due date Worksheet to figure your 2013 estimated tax due see instructions below www in gov/dor/4658 htm Your first name Your Social Zip/Postal code