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INSTALLMENT SCHEDULE FOR ESTIMATED PAYMENTS
2023 – ESTIMATE TAX FORM 1st Qtr January, February, March 25% due April 15th
2nd Qtr April, May, June 50% due June 15th
3rd Qtr July, August, September 75% due September 15th
CCA – DIVISION OF TAXATION 4th Qtr October, November, December 100% due January 15th
205 W SAINT CLAIR AVE When the 15th falls on a Saturday, Sunday or legal holiday, payment is considered
CLEVELAND OH 44113-1503 timely if made on or before the next succeeding day that is not a Saturday, Sunday
216.664.2070 800.223.6317 or legal holiday.
www.ccatax.ci.cleveland.oh.us If you estimate that you will owe at least $200.00 in municipal income tax (after
subtracting your estimated withholding and credits), you should make quarterly
Check box if AMENDED. Estimates may be amended if a significant estimated payments. You may be charged penalty and interest if you fail
increase or decrease in income occurred during the current tax year. to timely pay quarterly estimated payments totaling at least 90% of the current tax
year liability or 100% of the prior year tax liability.
IF MOVED DURING THE YEAR, SHOW PRIOR ADDRESS BELOW
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Name Social Security No. Name Name
— —
Name of spouse if joint return Social Security No. Prior address Prior address
Current address City State Zip City State Zip
City State Zip Date of Move Date of Move
EMPLOYMENT / PROFIT TAX ESTIMATE
IF EMPLOYMENT TAX IS WITHHELD GO TO RESIDENCE TAX SECTION
Column 1 – List CCA municipalities where employment, business or rental property is located
Column 2 – Enter estimated taxable income
Column 3 – Enter tax rate: CCA Member municipality tax rates are listed on the back of this form
Column 4 – Multiply Col. 2 estimated taxable income by Col. 3 tax rate and enter amount as estimated tax due
Column 5 – Enter installment due. Multiply Col. 4 by quarterly percentage. Refer to INSTALLMENT SCHEDULE FOR ESTIMATED PAYMENTS
Column 6 – Enter prior year credit
Column 7 – Enter tax paid to date for current year estimate
Column 8 – Enter balance due. Col. 5 minus (Col. 6 plus Col. 7). If negative enter zero. Add all figures and enter total.
COLUMN 1 COLUMN 2 COLUMN 3 COLUMN 4 COLUMN 5 COLUMN 6 COLUMN 7 COLUMN 8
CCA Employment City Estimated Tax Rate Estimated Installment Prior Year Prior Estimate Balance Due
Taxable Income Employment/Profit Tax Due Due Credit Payments
TOTAL ( A )
RESIDENCE TAX ESTIMATE
COMPLETE SCHEDULE R WORKSHEET ON REVERSE OF FORM
Column 9 – Enter residence city name
Column 10 – Enter total from Schedule R Worksheet Col. 5
Column 11 – Enter installment due. Multiply Col.10 by quarterly percentage. Refer to INSTALLMENT SCHEDULE FOR ESTIMATED PAYMENTS
Column 12 – Enter prior year credit
Column 13 – Enter tax paid to date for current year estimate
Column 14 – Enter balance due. Col. 11 minus (Col. 12 plus Col. 13). Add all figures and enter total.
COLUMN 9 COLUMN 10 COLUMN 11 COLUMN 12 COLUMN 13 COLUMN 14
Residence City Estimated Residence Installment Due Prior Year Credit Prior Estimate Balance Due
Tax Due Payments
TOTAL ( B )
TOTAL ( A + B )
TAX DUE WITH THIS RETURN
MAIL COMPLETED FORM WITH PAYMENT TO CCA - DIVISION OF TAXATION AT THE ABOVE ADDRESS. MAKE CHECK PAYABLE TO CCA - DIVISION OF TAXATION.
I HAVE EXAMINED THIS DECLARATION AND TO THE BEST OF MY KNOWLEDGE IT IS CORRECT Do you authorize your preparer to contact us regarding this return? YES NO
@ @
Signature of Taxpayer Signature of Spouse Date Signature of Preparer, if not taxpayer Date
CCA FORM 120-202ES (Rev. 12/22)
