Form 1040-V - Payment Voucher - 2001


Department of the Treasury
Form 1040-V
Internal Revenue Service
What Is Form 1040-V and Do You Have To
How To Send In Your Return, Payment, and
Use It?
Form 1040-V
● Detach Form 1040-V along the dotted line.
It is a statement you send with your check or money
order for any balance due on line 70 of your 2001
● Do not staple or otherwise attach your payment or
Form 1040. Using Form 1040-V allows us to process
Form 1040-V to your return or to each other. Instead,
your payment more accurately and efficiently. We
just put them loose in the envelope.
strongly encourage you to use Form 1040-V, but there
● If an envelope came with your tax package, please
is no penalty if you do not do so.
use it to mail your 2001 tax return, payment, and
Form 1040-V.
How To Fill In Form 1040-V
● If you do not have that envelope or you moved or
Line 1. Enter your social security number (SSN). If you
used a paid preparer, mail your tax return, payment,
are filing a joint return, enter the SSN shown first on
and Form 1040-V to the Internal Revenue Service at
your return.
the address shown on the back that applies to you.
Line 2. If you are filing a joint return, enter the SSN
shown second on your return.
Paperwork Reduction Act Notice. We ask for the
information on Form 1040-V to help us carry out the
Line 3. Enter the amount you are paying by check or
Internal Revenue laws of the United States. If you use
money order.
Form 1040-V, you must provide the requested
Line 4. Enter your name(s) and address exactly as
information. Your cooperation will help us ensure that
shown on your return. Please print your name(s)
we are collecting the right amount of tax.
You are not required to provide the information
requested on a form that is subject to the Paperwork
How To Prepare Your Payment
Reduction Act unless the form displays a valid OMB
● Make your check or money order payable to the
control number. Books or records relating to a form or
“United States Treasury.” Do not send cash.
its instructions must be retained as long as their
● Make sure your name and address appear on your
contents may become material in the administration of
check or money order.
any Internal Revenue law. Generally, tax returns and
● Enter “2001 Form 1040,” your daytime phone
return information are confidential, as required by
number, and your SSN on your check or money order.
Internal Revenue Code section 6103.
If you are filing a joint return, enter the SSN shown
The time needed to complete and mail Form 1040-V
first on your return.
will vary depending on individual circumstances. The
● To help us process your payment, enter the amount
estimated average time is 19 minutes. If you have
on the right side of your check like this: $ XXX.XX. Do
comments about the accuracy of this time estimate or
not use dashes or lines (for example, do not enter
suggestions for making Form 1040-V simpler, we
“$ XXX—” or “$ XXX
would be happy to hear from you. See the Instructions
for Form 1040.
Cat. No. 20975C
Detach Here and Mail With Your Payment and Return
OMB No. 1545-0074
Payment Voucher
Department of the Treasury
Do not staple or attach this voucher to your payment or return.
Internal Revenue Service
Your social security number (SSN)
If a joint return, SSN shown second
Amount you are
on that return
paying by check
or money order
Your first name and initial
Last name
If a joint return, spouse’s first name and initial
Last name
Home address (number and street)
Apt. no.
City, town or post office, state, and ZIP code
Cat. No. 20975C


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