EFTA01222571.pdf

Form 1040-V Page 2 IF you live in ... THEN use this address to send in your payment ... Florida, Louisiana, Mississippi, Texas Internal Revenue Service P.O. Box 1214 Charlotte, NC 28201-1214 Alaska, Arizona, California, Colorado, Hawaii, Idaho, Nevada, Internal Revenue Service New Mexico, Oregon, Utah, Washington, Wyoming P.O. Box 7704 San Francisco, CA 94120-7704 Arkansas, Illinois, Indiana, Iowa, Kansas, Michigan, Minnesota, Internal Revenue Service Montana, Nebraska, North Dakota, Ohio, Oklahoma, P.O. Box 802501 South Dakota, Wisconsin Cincinnati. OH 45280-2501 Alabama, Georgia, Kentucky, New Jersey, North Carolina, Internal Revenue Service South Carolina, Tennessee, Virginia P.O. Box 931000 Louisville. ICY 40293-1000 Delaware, Maine, Massachusetts, Missouri, New Hampshire, Internal Revenue Service New York, Vermont P.O. Box 37008 Hartford, CT 06176-7008 Connecticut, District of Columbia, Maryland, Pennsylvania, Internal Revenue Service Rhode Island, West Virginia P.O. Box 37910 Hartford, CT 06176-7910 A foreign country, American Samoa, or Puerto Rico (or are Internal Revenue Service excluding income under Internal Revenue Code 933), or use an P.O. Box 1303 APO or FPO address, or file Form 2555, 2555-EZ, or 4563, or are Charlotte, NC 28201-1303 a dual-status alien or nonpermanent resident of Guam or the U.S. Virgin Islands. ♦ Detach Horo and Mail With Your Payment and Return • row) 1040-V Department of the Treasury Internal Revenue Service (99) Form 1040-V Payment Voucher G Use this voucher when snaking a payment with Form 1040. G Do not staple this voucher or your payment to Form 1040. G Make your cheek cy money order payable to the 'United slates Treasury.' Enter the amount G Write your social securely number (55N) on your cheek or money order. of your payment ci EFTA01222571