Fillable 2021 Estimated Tax Payment Record (Minnesota Department of Revenue)

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2021 Estimated Tax Payment Record (Minnesota Department of Revenue)

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This payment record is for your convenience
• Please update this payment record as you make your payments
• Keep this payment record with your 2021 tax records
B
C
Date of Amount of
A
Check or
confirmation number
payment of payment
1 2020 refund amount applied to your 2021
estimated tax (from line 29 of your 2020 Form M1) ................ 1
2 First installment due April 15, 2021 ............................ 2
3 Second installment due June 15, 2021 .......................... 3
4 Third installment due September 15, 2021 ....................... 4
5 Fourth installment due January 15, 2022 ........................ 5
6 Total estimated tax payments for 2021 (add lines 1-5, column C) ..... 6
7 If you file your 2021 Form M1 after April 15, 2022, and you
made a payment for 2021, enter that amount here ................ 7
8 Total: Add lines 6 and 7, column C. Enter the result here and
on the Minnesota estimated tax line of your 2021 Form M1 ......... 8
Do not include:
• Payments made to the United States Treasury to be applied toward your federal taxes
• Payments for a balance due on previous years’ Minnesota income tax returns
• Payments made on an audit report or amended return
• Payments made for penalties or interest
Keep this worksheet for your records. Do not send it with your return. Use this payment record
when you prepare your 2021 Form M1. If your tax preparer will be completing your 2021 income
tax return, be sure to provide him or her with a copy of this payment record.
2021 Estimated Tax Payment Record
Need Help?
If you need help to determine estimated tax or if you have questions, you may:
• Find the needed information on our website at www.revenue.state.mn.us
• Email the individual income tax assistance unit at individual.incometax@state.mn.us
• Call the department at 651-296-3781 or 1-800-652-9094
• Write to: Minnesota Department of Revenue
Individual Income Tax and Withholding Division
Mail Station 5510
600 N. Robert St.
St. Paul, MN 55146-5510
This information is available in alternate formats.
Estimated Tax Payment Record
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2021 Estimated Tax Payment Record (Minnesota Department of Revenue)

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Completed 5 April 2022

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