CF-1120ES-EFT                                                   Grand Rapids                                            2019  EST  01Q
                            ESTIMATED INCOME TAX EFT PAYMENT VOUCHER
                             FIRST QUARTER - PAYMENT DUE APRIL 30, 2019 

Taxpayer Name:                                                   Bank Routing Number:

FEIN                                                             Bank Account Number:

Due on or Before:         04/30/2019, for tax year 2019*         Type of Bank Account:                         Checking          Savings

Payment:                  $                                      ElectiveWithdrawalDate:       

Payment Method:           DO NOT SEND CASH OR ANY OTHER FORM OF PAYMENT WITH PAYMENT VOUCHER BELOW.
                          The payment voucher is authorization for city to directly withdraw your payment from your bank account. 

Additional Information: The spouse of a joint filing taxpayer may use this payment voucher to make estimated income tax 
                          payments under his or her own social security number by listing their name and social security number as 
                          the taxpayer on this payment voucher.

Address for Payment:      Grand Rapids Income Tax Office
                          PO Box 109
                          Grand Rapids, MI  49501-0109

* Due Date                If the due date falls on a Saturday, Sunday or holiday, the due date is the next business day.

Taxpayer Records:         Amount Paid: 
                          Date Mailed: 

       KEEP TOP PORTION FOR YOUR RECORDS.  SEND BOTTOM PORTION WITH YOUR PAYMENT 
                                                                v   DETACH HERE  v
CF-1120ES-EFT                                                   Grand Rapids                                            2019  EST  01Q
                            FIRST QUARTER ESTIMATED INCOME TAX PAYMENT VOUCHER
                            Mail  To:  Grand Rapids Income Tax Office
                                                      PO Box 109
NACTP #                                               Grand Rapids, MI  49501-0109
EFIN #                                                          ESTIMATED PAYMENT VOUCHER 1                         Due Date:  04/30/2019
Taxpayer's name                                                 Taxpayer's FEIN           Bank routing number           Type of  Checking
                                                                                                                        account  Savings
                                                                                          Bank account number           Elective withdrawal date

Address line 1                                        Apt. no.  Payment voucher 2D barcode

Address line 2 (P.O. Box address for mailing use only)

City, town or post office   State                     Zip code

Foreign country name, province/county, postal code              Amount of estimated tax you are authorizing the city to Round to nearest dollar
                                                                deduct from your bank account                                                   .00

{SCAN LINE} (see Appendix L, Scan Line Specifications)