FORM Q1                                                                     RETURN WITH PAYMENT 
                                     BUSINESS QUARTERLY ESTIMATE 20__ 
 MAKE CHECK OR MONEY ORDER TO:                                                                                AMOUNT 
           CITY OF READING                                                       CITY OF READING 
                                     MAIL                                        EARNINGS TAX ACCOUNT         ENCLOSED $....................... 
  PAID CHECK WILL BE YOUR RECEIPT    TO:                                         LOCATION 0863                Check No: 
                                                                                 CINCINNATI  OH  45264-0863 
  DO NOT REMIT CASH BY MAIL                                                                                    _____ Quarter 20__ 
                                             Phone 513-733-0300   Fax 513-842-1016 
  ESTIMATED TAX     TOTAL UNDER PAID                                               TOTAL AMOUNT               AMOUNT OF         QUARTERLY 
        DECLARED    ESTIMATE PENALTY                                               CREDITED                   UNPAID BALANCE    INSTALLMENT DUE 
                                                                                                                              
   NAME                                                                                                        DUE ON OR BEFORE                          
 
    AND 
 
   ADDRESS 
                                                                                                               TAX ID                            
                                                                                 
                 NOTIFY INCOME TAX DEPARTMENT OF ANY CHANGE IN EMPLOYMENT, OWNERSHIP AND ADDRESS SHOW ABOVE 
                 IF THIS STATEMENT DOES NOT REFLECT PAYMENT RECENTLY MADE, PLEASE ADVISE INCOME TAX OFFICE PROMPTLY 
                                                                                    
FORM Q1                                                                    KEEP FOR YOUR RECORDS 
                                         BUSINESS QUARTERLY ESTIMATE 20__ 
 MAKE CHECK OR MONEY ORDER TO:                                                                                AMOUNT 
           CITY OF READING                                                       CITY OF READING 
                                     MAIL                                        EARNINGS TAX ACCOUNT         ENCLOSED $....................... 
  PAID CHECK WILL BE YOUR RECEIPT    TO:                                         LOCATION 0863                Check No: 
                                                                                 CINCINNATI  OH  45264-0863 
  DO NOT REMIT CASH BY MAIL                                                                                    _____ Quarter 20__ 
                                             Phone 513-733-0300   Fax 513-842-1016 
  ESTIMATED TAX     TOTAL UNDER PAID                                               TOTAL AMOUNT               AMOUNT OF         QUARTERLY 
        DECLARED    ESTIMATE PENALTY                                               CREDITED                   UNPAID BALANCE    INSTALLMENT DUE 
                                                                                                                              
   NAME                                                                                                        DUE ON OR BEFORE                          
 
    AND 
 
   ADDRESS 
                                                                                                               TAX ID                            
                                                                                 
                 NOTIFY INCOME TAX DEPARTMENT OF ANY CHANGE IN EMPLOYMENT, OWNERSHIP AND ADDRESS SHOW ABOVE 
                 IF THIS STATEMENT DOES NOT REFLECT PAYMENT RECENTLY MADE, PLEASE ADVISE INCOME TAX OFFICE PROMPTLY 
                                                                                    
                                         CREDIT CARD AUTHORIZATION: 
__ VISA     __ MASTERCARD 
Print Name: ________________________________________ 
 
Signature:  ________________________________________ 
 
Account Number 
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Expiration Date: _____ / _____             CVC_____ 3 digit security code on back of card