Form 559 - Virginia Tax
Form 559
COMMONWEALTH OF VIRGINIA
County or City of , Virginia Declaration Number
MEMORANDUM ASSESSMENT OF ESTIMATED STATE INCOME TAX FOR TAXABLE YEAR
|FOR USE BY THE COMMISSIONER |Voucher | Amount |
| |Number | |
| | | | |
Declaration Payment Received
(First Payment received for taxable year)
(mm/dd/yyyy)
Form Preparation Date (mm/dd/yyyy)
|FOR USE BY THE TREASURER | Amount |
| | | |
| | | |
| | | |
| | | |
| | | |
Primary Social Security Number Secondary Social Security Number
FEIN (For Estate or Trust)
Fiscal Year: Beginning Date Ending Date
VA Dept of Taxation 2604014 (Rev 09/06)
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Form 559
COMMONWEALTH OF VIRGINIA
County or City of , Virginia Declaration Number
MEMORANDUM ASSESSMENT OF ESTIMATED STATE INCOME TAX FOR TAXABLE YEAR
|FOR USE BY THE COMMISSIONER |Voucher | Amount |
| |Number | |
| | | | |
Declaration Payment Received
(First Payment received for taxable year)
(mm/dd/yyyy)
Form Preparation Date (mm/dd/yyyy)
|FOR USE BY THE TREASURER | Amount |
| | | |
| | | |
| | | |
| | | |
| | | |
Primary Social Security Number Secondary Social Security Number
FEIN (For Estate or Trust)
Fiscal Year: Beginning Date Ending Date
VA Dept of Taxation 2604014 (Rev 09/06)
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