VILLAGE OF LISBON, OHIO RETURN PART 1 - KEEP PART 2 FOR YOUR RECORDS
FORM Q-1 12/90 Quarterly Notice of Installment Due on Estimated Tax Declared
This Statement MUST Accompany Your Remittance To:
MAKE CHECK OR MONEY ORDER TO:
VILLAGE OF LISBON - INCOME TAX DEPT. MAIL VILLAGE OF LISBON, OHIO
PAID CHECK WILL BE YOUR RECEIPT ➧ INCOME TAX DEPARTMENT AMOUNT
TO P.O. BOX 42
If receipt is desired, return both copies of this statement with a self- LISBON, OHIO 44432-0042 ENCLOSED $
addressed, stamped envelope.
DO NOT REMIT CASH BY MAIL
ESTIMATED TAX CREDITS AND/OR PAYMENTS AMOUNT OF QUARTERLY
DECLARED DATE OF CREDIT TOTAL AMOUNT CREDITED UNPAID BALANCE INSTALLMENT DUE

IF THIS STATEMENT DOES NOT REFLECT PAYMENT RECENTLY MADE,  PLEASE ADVISE - INCOME TAX OFFICE - PROMPTLY

DUE ON OR BEFORE
LYLE PRINTING & PUBLISHING CO., SALEM, OH 337-3419

NOTIFY INCOME TAX DEPARTMENT PROMPTLY OF ANY CHANGE IN OWNERSHIP OR NAME AND ADDRESS SHOWN ABOVE.