QUARTERLY STATEMENT OF ESTIMATED TAXES DUE 
                            City of Vandalia Income Tax Office •PO Box 727, Vandalia, OH 45377                         • (937) 415-2240 
SSN OR FED ID# (LAST 4) SPOUSE SSN (LAST 4)                       ACCOUNT NUMBER 
                                                                                                                                              VOUCHER 1 
                                                                                                      City of Brookville                      Due on or before APR 15 
NAME AND ADDRESS 
                                                                                                      
                                                                                                     Amount Paid                 $ _______________ 
                                                                                                      
                                                                                                     Check #                       ________________ 
NOTICE: To avoid penalty and interest assessments, at least 90% of the current year tax liability or 
100% of the previous year liability must be paid by January 15th. 

If paying by credit card or electronic check, please refer to the website, www.vandaliaohio.org, to access the online payment center.  • Make checks payable to City of Vandalia. 

                        QUARTERLY STATEMENT OF ESTIMATED TAXES DUE 
                                       City of Vandalia Income Tax Office •PO Box 727, Vandalia, OH 45377                • (937) 415-2240 
SSN OR FED ID# (LAST 4) SPOUSE SSN (LAST 4)                       ACCOUNT NUMBER 
                                                                                                                                              VOUCHER 2 
                                                                                                      City of Brookville                      Due on or before JUN 15 
NAME AND ADDRESS 
                                                                                                      
                                                                                                     Amount Paid                 $ _______________ 
                                                                                                      
                                                                                                     Check #                       ________________ 
NOTICE: To avoid penalty and interest assessments, at least 90% of the current year tax liability or 
100% of the previous year liability must be paid by January 15th. 
If paying by credit card or electronic check, please refer to the website, www.vandaliaohio.org, to access the online payment center.  • Make checks payable to City of Vandalia. 

                        QUARTERLY STATEMENT OF ESTIMATED TAXES DUE 
                                       City of Vandalia Income Tax Office •PO Box 727, Vandalia, OH 45377                • (937) 415-2240 
SSN OR FED ID# (LAST 4) SPOUSE SSN (LAST 4)                       ACCOUNT NUMBER 
                                                                                                                                              VOUCHER 3 
                                                                                                      City of Brookville                      Due on or before SEP 15 
NAME AND ADDRESS 
                                                                                                      
                                                                                                     Amount Paid                 $ _______________ 
                                                                                                      
                                                                                                     Check #                       ________________ 
NOTICE: To avoid penalty and interest assessments, at least 90% of the current year tax liability or 
100% of the previous year liability must be paid by January 15th. 
If paying by credit card or electronic check, please refer to the website, www.vandaliaohio.org, to access the online payment center.  • Make checks payable to City of Vandalia. 

                        QUARTERLY STATEMENT OF ESTIMATED TAXES DUE 
                                       City of Vandalia Income Tax Office •PO Box 727, Vandalia, OH 45377                • (937) 415-2240 
SSN OR FED ID# (LAST 4) SPOUSE SSN (LAST 4)                       ACCOUNT NUMBER 
                                                                                                                                              VOUCHER 4 
                                                                                                      City of Brookville                      Due on or before JAN 15 
NAME AND ADDRESS 
                                                                                                      
                                                                                                     Amount Paid                 $ _______________ 
                                                                                                      
                                                                                                     Check #                       ________________ 
NOTICE: To avoid penalty and interest assessments, at least 90% of the current year tax liability or 
100% of the previous year liability must be paid by January 15th. 
If paying by credit card or electronic check, please refer to the website, www.vandaliaohio.org, to access the online payment center.  • Make checks payable to City of Vandalia.