FORM Q1 12                                                            RETURN  WITH  PAYMENT
                                                                      QUARTERLY ESTIMATE
MAKE CHECK OR MONEY ORDER TO:                                         VILLAGE OF EVENDALE                                                                                                                                                AMOUNT
       VILLAGE OF EVENDALE                                       MAIL 10500 READING RD                                                                                                                                                   ENCLOSED $
                                                                 TO } EVENDALE  OH   45241-2574
PAID CHECK WILL BE YOUR RECEIPT
If receipt is desired, return both copies of this statement with                                                                                                                                                                         Check No:
a self-addressed stamped envelope.
                                                                      Voice  513-563-2671   Fax  513-563-4636                                                                                                                            _____QuarterQTR YEAR2006
   DO NOT REMIT CASH BY MAIL
ESTIMATED TAX                     TOTAL UNDER PAID                    TOTAL AMOUNT CREDITED      AMOUNT OF                                                                                                                                        QUARTERLY
   DECLARED                       ESTIMATE PENALTY                                             UNPAID BALANCE                                                                                                                                  INSTALLMENT DUE

Name                                                                                        AMENDED ESTIMATED TAX                                                                                                                              DUE ON OR BEFORE

And

Address
                                                                                                                                                                                                                                         TAX ID

                                  IF THIS STATEMENT DOES NOT REFLECT PAYMENT RECENTLY MADE, PLEASE ADVISE - INCOME TAX OFFICE - PROMPTLYNOTIFY INCOME TAX DEPARTMENT PROMPTLY OF ANY CHANGE IN OWNERSHIP OR NAME AND ADDRESS SHOWN ABOVE.

FORM Q1 12                                                            KEEP FOR YOUR RECORDS
                                                                      QUARTERLY ESTIMATE
MAKE CHECK OR MONEY ORDER TO:                                         VILLAGE OF EVENDALE                                                                                                                                                AMOUNT
       VILLAGE OF EVENDALE                                       MAIL 10500 READING RD                                                                                                                                                   ENCLOSED $
                                                                 TO } EVENDALE  OH   45241-2574
PAID CHECK WILL BE YOUR RECEIPT
If receipt is desired, return both copies of this statement with                                                                                                                                                                         Check No:
a self-addressed stamped envelope.
                                                                      Voice  513-563-2671   Fax  513-563-4636                                                                                                                            _____QuarterQTRQTYYEARYEAR2006
   DO NOT REMIT CASH BY MAIL
ESTIMATED TAX                     TOTAL UNDER PAID                    TOTAL AMOUNT CREDITED      AMOUNT OF                                                                                                                                        QUARTERLY
   DECLARED                       ESTIMATE PENALTY                                             UNPAID BALANCE                                                                                                                                  INSTALLMENT DUE

Name                                                                                        AMENDED ESTIMATED TAX                                                                                                                              DUE ON OR BEFORE

And

Address
                                                                                                                                                                                                                                         TAX ID

                                  IF THIS STATEMENT DOES NOT REFLECT PAYMENT RECENTLY MADE, PLEASE ADVISE - INCOME TAX OFFICE - PROMPTLYNOTIFY INCOME TAX DEPARTMENT PROMPTLY OF ANY CHANGE IN OWNERSHIP OR NAME AND ADDRESS SHOWN ABOVE.

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