Form 2210 (2005) Page 3. Summary: This is an example of Form 2210 (2005), page 3, for Figure 4-C, Annualized Income Method—Illustrated (Betty Beige) (Continued). The completed line items are:

Under “Section A--Figure Your Underpayment”:

	Payment Due Dates: (a) 4/15/05	Payment Due Dates: (b) 6/15/05	Payment Due Dates: (c) 9/15/05	Payment Due Dates: (d) 1/15/06
“18. Required installments. If box C in Part II applies, enter the amounts from Schedule AI, line 25. Otherwise, enter 25% (.25) of line 9, Form 2210, in each column”	317	1,711	1,363	2,068
“19. Estimated tax paid and tax withheld (see page 3 of the instructions). For column (a) only, also enter the amount from line 19 on line 23. If line 19 is equal to or more than line 18 for all payment periods, stop here; you do not owe the penalty. Do not file Form 2210 unless you checked a box in Part II”	807	807	807 + 1,000 = 1,807	807 + 1,000 = 1,807
“20. Enter amount, if any, from line 26 in previous column”	(shaded area)	490	(blank text field)	30
“21. Add lines 19 and 20”	(shaded area)	1,297	1,807	1,837
“22. Add amounts on line 24 and 25 in previous column”	(shaded area)	0	414	0
“23. Subtract line 22 from line 21. If zero or less, enter 0. For column (a) only, enter the amount from line 19”	807	1,297	1,393	1,837
“24. If line 23 is zero, subtract line 21 from line 22. Otherwise, enter 0”	(shaded area)	0	0	(shaded area)
“25. Underpayment. If line 18 is equal to or more than line 23, subtract line 23 from line 18. Then go to line 20 of the next column. Otherwise, go to line 26”	(blank text field)	9/2 414	(blank text field)	231
“26. Overpayment. If line 23 is more than line 18, subtract line 18 from line 23. Then go to line 20 of next column”	490	(blank text field)	30	(shaded area)

Under “Section B--Figure the Penalty”:

“Rate Period 1: April 16, 2005--June 30, 2005”

“27. Number of days from the date shown above line 27 to the date the amount on line 25 was paid or 9/30/05, whichever is earlier”

“6/15/02 Days:” field contains 79

“28. Underpayment on line 25 (see page 4 of the instructions) multiplied by (number of days on line 27 divided by 365) multiplied by .06”

“6/15/02” field contains $5.38

“Rate Period 2: October 1, 2005--April 15, 2006”

“29. Number of days from the date shown above line 29 to the date the amount on line 25 was paid or 4/15/06, whichever is earlier”

“1/15/06 Days:” field contains 90

“30. Underpayment on line 25 (see page 4 of the instructions) multiplied by (number of days on line 29 divided by 365) multiplied by .07”

“1/15/06” field contains $3.99

“31. Penalty. Add all amounts on lines 28 and 30 in all columns. Enter the total here and on Form 1040, line 76; Form 1040A, line 48; Form 1040N.R., line 74; Form 1040N.R.-E.Z., line 26; or Form 1041, line 26, but do not file Form 2210 unless you checked a box in Part II” field contains $9.37