Form 1040 ES/OCR Estimated Tax for Individuals (Optical Character Recogni

Form 1040-ES (OCR)
Department of the Treasury
Internal Revenue Service
䊳
䊳
䊳

2011
OMB No. 1545-0074

Estimated Tax

Make your check or money order payable to “United States Treasury.”
Enter your SSN and “2011 Form 1040-ES” on your payment.
If your name, address, or SSN is incorrect, see instructions.

Payment
Voucher

1

Amount of estimated tax you are
paying by check or money order.

Calendar year—
Due April 18, 2011
Dollars

Cents

For Privacy Act and Paperwork Reduction Act Notice, see instructions.

Form 1040-ES (OCR)
Department of the Treasury
Internal Revenue Service
䊳
䊳
䊳

2011
OMB No. 1545-0074

Estimated Tax

Make your check or money order payable to “United States Treasury.”
Enter your SSN and “2011 Form 1040-ES” on your payment.
If your name, address, or SSN is incorrect, see instructions.

Payment
Voucher

2

Amount of estimated tax you are
paying by check or money order.

Calendar year—
Due June 15, 2011
Dollars

Cents

For Privacy Act and Paperwork Reduction Act Notice, see instructions.

Form 1040-ES (OCR)
Department of the Treasury
Internal Revenue Service
䊳
䊳
䊳

2011
OMB No. 1545-0074

Estimated Tax

Make your check or money order payable to “United States Treasury.”
Enter your SSN and “2011 Form 1040-ES” on your payment.
If your name, address, or SSN is incorrect, see instructions.

Payment
Voucher

3

Amount of estimated tax you are
paying by check or money order.

Calendar year—
Due Sept. 15, 2011
Dollars

Cents

For Privacy Act and Paperwork Reduction Act Notice, see instructions.

Form 1040-ES (OCR)
Department of the Treasury
Internal Revenue Service
䊳
䊳
䊳

2011

OMB No. 1545-0074

Estimated Tax

Make your check or money order payable to “United States Treasury.”
Enter your SSN and “2011 Form 1040-ES” on your payment.
If your name, address, or SSN is incorrect, see instructions.

Payment
Voucher

4

Amount of estimated tax you are
paying by check or money order.

Cat. No. 61900V

Calendar year—
Due Jan. 17, 2012
Dollars

Cents

For Privacy Act and Paperwork Reduction Act Notice, see instructions.