Form 525 -Tv - 2001- Electronic Payment Voucher
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1How and Where Do I Send in My Payment and Payment
Voucher If I have Filed Electronically?
Ö
Complete the payment voucher
Ö
Include Social Security number on payment
Ö
Do not staple this page and your payment to each other
Ö
Do NOT mail in a paper return with this coupon and your payment (check
or money order). Only mail in the voucher below and your payment.
Ö
Mail your payment (check or money order) and the voucher below:
Georgia Department of Revenue
P.O. Box 740323
Atlanta, Georgia 30374-0323
2001
525-TV
State of Georgia
Electronic
Department of Revenue
Payment Voucher
USE ONLY FOR RETURNS FILED ELECTRONICALLY
1 Enter your Social Security number
2 Enter the first four letters of your last name
3
Enter your payment amount
$
4 If a joint or combined return, enter your
5 Last Name
First Name
spouse’s Social Security number
Mailing Address (Number and Street or P.O. Box)
City, State and ZIP Code
(
)
52500000000000000000000000000000000000000000000000
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Parent category: Financial