OMB No. 1545-0140 Underpayment of

Estimated Tax by Individuals, Estates, and Trusts Form 2210

 See separate instructions. Department of the Treasury

Internal Revenue Service

Attachment

 Attach to Form 1040, 1040A, 1040NR, 1040NR-EZ, or 1041. Sequence No. 06

Name(s) shown on tax return Identifying number

Required Annual Payment

Enter your 2002 tax after credits (see page 2 of the instructions) 2

Other taxes (see page 2 of the instructions)

2

3

Add lines 2 and 3

3

4

Earned income credit

4

5 5

Credit for Federal tax paid on fuels 7

Add lines 5 through 8

6

Current year tax. Subtract line 9 from line 4

7

9

Multiply line 10 by 90% (.90)

8

Withholding taxes. Do not include any estimated tax payments on this line (see page 2 of the

instructions)

9

11

Subtract line 12 from line 10. If less than $1,000, stop here; you do not owe the penalty. Do not

file Form 2210

10

12

Enter the tax shown on your 2001 tax return (112% of that amount if the adjusted gross income

shown on that return is more than $150,000, or, if married filing separately for 2002, more than

$75,000). Caution: See page 2 of the instructions

11

13

Required annual payment. Enter the smaller of line 11 or line 14

12

14

13

For Paperwork Reduction Act Notice, see page 5 of separate instructions. Form 2210 (2002)

In most cases, you do not need to file Form 2210. The IRS will figure any penalty you owe and send you a bill.

File Form 2210 only if one or more boxes in Part I apply to you. If you do not need to file Form 2210, you still

may use it to figure your penalty. Enter the amount from Part III, line 22, or Part IV, line 36, on the penalty line

of your return, but do not attach Form 2210.

Reasons for Filing—If 1a, 1b, or 1c below applies to you, you may be able to lower or eliminate your

penalty. But you must check the boxes that apply and file Form 2210 with your tax return. If 1d below

applies to you, check that box and file Form 2210 with your tax return.

1 Check whichever boxes apply (if none apply, see the text above Part I and do not file Form 2210):

a You request a waiver. In certain circumstances, the IRS will waive all or part of the penalty. See Waiver of Penalty on

page 1 of the instructions.

b You use the annualized income installment method. If your income varied during the year, this method may reduce the

amount of one or more required installments. See page 4 of the instructions.

c You had Federal income tax withheld from wages and, for estimated tax purposes, you treat the withheld tax as paid on

the dates it was actually withheld, instead of in equal amounts on the payment due dates. See the instructions for

line 23 on page 2.

d

Cat. No. 11744P

Part I

Part II

Short Method (Caution: See page 2 of the instructions to find out if you can use the short method. If

you checked box 1b or 1c in Part I, skip this part and go to Part IV.)

Enter the amount, if any, from line 12 above 16

Enter the total amount, if any, of estimated tax payments you made

15

17

Add lines 16 and 17

16

Total underpayment for year. Subtract line 18 from line 15. If zero or less, stop here; you do

not owe the penalty. Do not file Form 2210 unless you checked box 1d above

17

18

19

Multiply line 19 by .03713 

18

● If the amount on line 19 was paid on or after 4/15/03, enter -0-.

19

● If the amount on line 19 was paid before 4/15/03, make the following computation to find the

amount to enter on line 21. Number of days paid

before 4/15/03

Amount on

line 19  

20

.00014

20

Penalty. Subtract line 21 from line 20. Enter the result here and on Form 1040, line 74; Form

1040A, line 48; Form 1040NR, line 73; Form 1040NR-EZ, line 26; or Form 1041, line 26, but do

not file Form 2210 unless you checked one or more of the boxes in Part I above 

21

22

21

Part III

Your required annual payment (line 15 below) is based on your 2001 tax and you filed or are filing a joint return for either

2001 or 2002 but not for both years.

If line 12 is equal to or more than line 15, stop here; you do not owe the penalty.

Do not file Form 2210 unless you checked box 1d above.

Additional child tax credit 6

14

2002

Health insurance credit for eligible recipients

22

15

8

10
Form 2210 (2002) Page 2

Regular Method (See page 2 of the instructions if you are filing Form 1040NR or 1040NR-EZ.)

Payment Due Dates

Section A—Figure Your Underpayment (d)

1/15/03

(c)

9/15/02

(b)

6/15/02

(a)

4/15/02

Required installments. If box 1b applies, enter the

amounts from Schedule AI, line 25. Otherwise, enter

25% (.25) of line 15, Form 2210, in each column

Complete lines 25 through 31 of one column

before going to the next column.

23

Estimated tax paid and tax withheld (see page 2 of

the instructions). For column (a) only, also enter the

amount from line 24 on line 28. If line 24 is equal to

or more than line 23 for all payment periods, stop

here; you do not owe the penalty. Do not file Form

2210 unless you checked a box in Part I

23

24

Enter amount, if any, from line 31 of previous column

24

25

Add lines 24 and 25

25

Add amounts on lines 29 and 30 of the previous

column

26 26

27

Subtract line 27 from line 26. If zero or less, enter -0-.

For column (a) only, enter the amount from line 24

27

If the amount on line 28 is zero, subtract line 26 from

line 27. Otherwise, enter -0-

28

28

Underpayment. If line 23 is equal to or more than

line 28, subtract line 28 from line 23. Then go to line

25 of next column. Otherwise, go to line 31 

29

29

Overpayment. If line 28 is more than line 23, subtract

line 23 from line 28. Then go to line 25 of next column

30

30

Section B—Figure the Penalty (Complete lines 32 through 35 of one column before going to the next column.)

4/15/02 6/15/02

Days: Days: Number of days from the date shown above

line 32 to the date the amount on line 30 was

paid or 12/31/02, whichever is earlier

31

31

Number of

days on line 32

32

Underpayment on line 30

(see page 3 of

the instructions) .06

365 $ $

32

33

33

Part IV

  

12/31/02 12/31/02

Days: Days: Number of days from the date shown above

line 34 to the date the amount on line 30 was

paid or 4/15/03, whichever is earlier

Number of

days on line 34

34

Underpayment on line 30

(see page 4 of

the instructions) .05

365 $ $

34

Penalty. Add all amounts on lines 33 and 35 in all columns. Enter the total here and on Form 1040,

line 74; Form 1040A, line 48; Form 1040NR, line 73; Form 1040NR-EZ, line 26; or Form 1041,

line 26, but do not file Form 2210 unless you checked one or more of the boxes in Part I 

35

36 $

35

  

36

12/31/02

Days:

$

Rate Period 1 Rate Period 2

April 16, 2002—December 31, 2002

January 1, 2003—April 15, 2003

Form 2210 (2002)

$

$

9/15/02

Days:

1/15/03

Days:
Schedule AI—Annualized Income Installment Method (See pages 4 and 5 of the instructions.)

(d)

1/1/02–12/31/02

(c)

1/1/02–8/31/02

(b)

1/1/02–5/31/02

(a)

1/1/02–3/31/02

Estates and trusts, do not use the period ending dates shown to the right.

Instead, use the following: 2/28/02, 4/30/02, 7/31/02, and 11/30/02.

Enter your adjusted gross income for each period (see instructions).

(Estates and trusts, enter your taxable income without your

exemption for each period.)

1

1

2 Annualization amounts. (Estates and trusts, see instructions.) 2 4 2.4 1.5 1

3 Annualized income. Multiply line 1 by line 2 3

4 Enter your itemized deductions for the period shown in each column.

If you do not itemize, enter -0- and skip to line 7. (Estates and trusts,

enter -0-, skip to line 9, and enter the amount from line 3 on line 9.) 4

5 Annualization amounts 5 4 1 2.4 1.5

6 Multiply line 4 by line 5 (see instructions if line 3 is more than $68,650) 6

7

In each column, enter the full amount of your standard deduction

from Form 1040, line 38, or Form 1040A, line 24 (Form 1040NR or

1040NR-EZ filers, enter -0-. Exception: Indian students and

business apprentices, enter standard deduction from Form 1040NR,

line 36, or Form 1040NR-EZ, line 11.)

7

8 Enter the larger of line 6 or line 7 8

9 Subtract line 8 from line 3 9

In each column, multiply $3,000 by the total number of exemptions

claimed (see instructions if line 3 is more than $103,000). (Estates

and trusts and Form 1040NR or 1040NR-EZ filers, enter the

exemption amount shown on your tax return.)

10

10

11 Subtract line 10 from line 9 11

12 Figure your tax on the amount on line 11 (see instructions) 12

Form 1040 filers only, complete Part II and enter your

self-employment tax from line 34 below

13

14 Enter other taxes for each payment period (see instructions) 14

15 Total tax. Add lines 12, 13, and 14 15

16 For each period, enter the same type of credits as allowed on Form

2210, lines 2 and 9 (see instructions) 16

17 Subtract line 16 from line 15. If zero or less, enter -0- 17

18 Applicable percentage 18 22.5% 45% 67.5% 90%

19 Multiply line 17 by line 18 19

20 Add the amounts in all previous columns of line 25 20

21 Subtract line 20 from line 19. If zero or less, enter -0- 21

22 Enter 25% (.25) of line 15 on page 1 of Form 2210 in each column 22

23

Subtract line 25 of the previous column from line 24 of the previous

column

23

24 Add lines 22 and 23 and enter the total 24

Enter the smaller of line 21 or line 24 here and on Form 2210,

line 23 

25

25

Annualized Self-Employment Tax

26 Net earnings from self-employment for the period (see instructions)

27 Prorated social security tax limit $21,225 $35,375 $56,600 $84,900

Enter actual wages for the period subject to social security tax or

the 6.2% portion of the 7.65% railroad retirement (tier 1) tax

28

29

30

31

32

33

34

Multiply line 30 by the smaller of line 26 or line 29

Multiply line 26 by line 32

Add lines 31 and 33. Enter the result here and on line 13 above 

Annualized Income Installments

26

27

28

29

30

31

32

33

34

Part I

Part II

Form 2210 (2002) Page 3

13

Caution: Complete lines 20–25 of one column before going to the

next column.

Annualization amounts

Subtract line 28 from line 27. If zero or less, enter -0-

Annualization amounts

0.496 0.2976 0.186 0.124

0.116 0.0696 0.0435 0.029

Form 2210 (2002)