CITY OF MANSFIELD, OHIO 
                        DECLARATION OF ESTIMATED TAX FOR YEAR 2023 
                                                               
                        2023 ESTIMATED TAX VOUCHER #1   DUE APRIL 18, 2023–                
                                                               
Name:  _________________________________________________          Soc. Sec. # _____________________________ 
Address:  ____________________________________________________________Phone # ______________________ 
 
 1. Total income subject to tax……………………………………… $_______________________ (Multiply by .02)        $ 
 2. Less income tax withheld by other city (Credit limited to 1%)………………………………………………………………………………… $ 
 3. Total Declaration (line 1 minus line 2) …………………………………………………………………………………………………………………….  $ 
 4. Payment amounts (line 3 times 0.225) …………………………………………………………………………………………………………………..           $ 
 5. Overpayment from previous year (if not refunded) ……………………………………………………………………………………………….       $ 
 6. 1  st payment amount (line 4 minus line 5) ……………………………………………………………………………………………………………….       $ 
                       90% OF BALANCE TO BE PAID IN FOUR EQUAL INSTALLMENTS 

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                        2023 ESTIMATED TAX VOUCHER #2   DUE JUNE 15, 2023 –
                                                               
Name:  _________________________________________________          Soc. Sec. # _____________________________ 
Address:  ____________________________________________________________Phone # ______________________ 
 
 1. Payment Enclosed  $                                        2. Check # ……………………..   
 3. Prior amount paid $                                        4. Remaining Balance        $ 
                                                                                            
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                       2023 ESTIMATED TAX VOUCHER #3   DUE SEPTEMBER 15, 2023 –
                                                               
Name:  _________________________________________________          Soc. Sec. # _____________________________ 
Address:  ____________________________________________________________Phone # ______________________ 
 
 1. Payment Enclosed  $                                        2. Check # ……………………..   
 3. Prior amount paid $                                        4. Remaining Balance        $ 
                                                                                            
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                        2023 ESTIMATED TAX VOUCHER #4   DUE JANUARY 15, 2024 –
                                                               
Name:  _________________________________________________          Soc. Sec. # _____________________________ 
Address:  ____________________________________________________________Phone # ______________________ 
 
 1. Payment Enclosed  $                                        2. Check # ……………………..   
 3. Prior amount paid $                                        4. Remaining Balance        $ 

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MAIL PAYMENTS TO: CITY OF MANSFIELD, P.O. BOX 577, MANSFIELD, OHIO   44901-0577 
 
PAY BY PHONE: 419-755-9711 OPTION 2 OR PAY ONLINE AT WWW.CI.MANSFIELD.OH.US