Individual Income Tax Return - Puerto Rico Department Of The Treasury - 2002 Page 5

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2002
Ä
0249
John Doe
Jane Doe
Calle Principal # 19
Ponce PR 00731
______________
PAY TO THE
$
ORDER OF
DOLLARS
Route/
Account
ANY BANK
Transit
Do not
Number
include the
Any Place, Ponce PR 00731
Number
check number
FOR
021601244
012
244400
0249
Part 5
AUTORIZATION FOR THE DIRECT DEPOSIT OF THE REFUND
Route/transit number
Type of account
Account number
x
q
q
0 2
1 6
0
1
2
4 4
0 1 2 2 4 4 4 0 0
Checks
Savings
J o h n
D o
e
Account in the name of
and
J a n e
D o e
(Complete name in print letter as it appears on your account. If married and filing jointly, include your spouse's name)

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