CITY OF MANSFIELD, OHIO 
                                         DECLARATION OF ESTIMATED TAX FOR YEAR 2024 
                                2024 ESTIMATED TAX VOUCHER #1 – Due 15th day of 4th fiscal month 
                                                                                     
       Name:  _________________________________________________                                FEIN # _____________________________ 
       Address: _________________________________________________________________________________________ 
        
          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 stpayment 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 15th day of 6th  fiscal month 
                                                                                     
       Name:  _________________________________________________                                FEIN # _____________________________ 
       Address:  _________________________________________________________________________________________ 
        
        1. Payment Enclosed                $                                         2. Check #              
                                                                                        ……………… 
        3. Prior amount paid            $                                            4. Remaining Balance   $ 
        Contact Person………                                                            Phone # …………………..   

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                                2023 ESTIMATED TAX VOUCHER #3 – Due 15th day of 9th fiscal month 
                                                                                     
       Name:  _________________________________________________                                FEIN # _____________________________ 
       Address:  _________________________________________________________________________________________ 
        
        1. Payment Enclosed                $                                         2. Check #              
                                                                                        ……………… 
        3. Prior amount paid            $                                            4. Remaining Balance   $ 
        Contact Person………                                                            Phone # …………………..   

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                           2023 ESTIMATED TAX VOUCHER #4 – Due 15th day of 12th fiscal month 
                                                                                     
       Name:  _________________________________________________                                FEIN # _____________________________ 
       Address:  _________________________________________________________________________________________ 
        
        1. Payment Enclosed                $                                         2. Check #              
                                                                                        ……………… 
        3. Prior amount paid            $                                            4. Remaining Balance   $ 
        Contact Person………                                                            Phone # …………………..   
        
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       MAIL PAYMENTS TO:                     CITY OF MANSFIELD, INCOME TAX DIVISION 
                                             P.O. BOX 577 
                                             MANSFIELD, OHIO   44901-0577