Form Cf-1040pv - Income Tax Payment Voucher Template - 2005

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CUT ON DOTTED LINES
Revidsed 09/22/2004
CITY OF (Name of city)
Due Date
CF-1040PV
May 1 2006
INCOME TAX PAYMENT VOUCHER
DATE DUE
SOCIAL SECURITY NUMBER
DOLLARS
CENTS
TAX YEAR
INCOME TAX PAYMENT
2005
May 1, 2006
00
TAXPAYER'S NAME AND ADDRESS
MAKE REMITTANCE PAYABLE TO:
MAIL WITH TAX DUE RETURN
TREASURER, CITY OF (CITY NAME)
PAYMENT VOUCHER AND REMITTANCE MUST
BE ENCLOSED WITH RETURN AND MAILED TO
(List address where TAX RETURN is to be mailed)
Page 68 of 68

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