Form Ri-1040v - Payment Voucher - State Of Rhode Island - 2005
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12005
RI-1040V
Rhode Island Payment Voucher
WHAT IS FORM RI-1040V AND DO YOU NEED
HOW TO PREPARE YOUR PAYMENT
TO USE IT?
Make your check or money order payable to the “RI Division of
Taxation.” Do not send cash. Make sure your name and address
it is a statement you send with your payment of any balance due on
appear on your check or money order. Write “Form RI-1040V,” your
Form RI-1040EZ, line 11; Form RI-1040, line 19 or Form RI-
daytime phone number and social security number on your check or
1040NR, line 19. Using Form RI-1040V allows us to process your
money order. If you are filing a joint return, enter the social security
payment more accurately and efficiently. We strongly encourage
shown first on your return.
you to use Form RI-1040V, but there is no penalty if you do not do
so.
HOW TO SEND IN YOUR RETURN, PAYMENT
HOW TO FILL IN FORM RI-1040V
AND RI-1040V
Retain the top portion of this form for your records. Detach and
2005
RI-1040V
STATE OF RHODE ISLAND Payment Voucher
return the lower portion with your payment. DO NOT staple or oth-
DIVISION OF TAXATION * ONE CAPITOL HILL, PROVIDENCE, RI 02908-5806
erwise attach your payment of RI-1040V to your return or to each
other. Instead, just put them loose in the envelope. If an envelope
DO NOT STAPLE OR ATTACH THIS VOUCHER TO YOUR PAYMENT
came with your tax package, please use it to mail your tax return,
1. NAME(S)
3. ENTER THE FIRST FOUR
1
3
LETTERS OF YOUR LAST
NAME
payment and Form RI-1040V. If you do not have that envelope or
ADDRESS
RI-1040V
CITY
STATE
ZIP
you used a paid preparer, mail your return, payment and Form RI-
4
2. YOUR SOCIAL SECURITY NUMBER
1040V to:
2
4. ENTER
$
SPOUSE’S SOCIAL SECURITY NUMBER, IF JOINT PAYMENT
0 0
AMOUNT
The Rhode Island Division of Taxation
ENCLOSED
One Capitol Hill
Providence, RI 02908-5806
Box 1.
Enter your name(s) and address as shown on your
return.
PAYMENT BY CREDIT CARD
Box 2. Enter your social security number and your spouse’s social
security number in the boxes provided.
Box 3. Enter the first four letters of your last name. See examples
below.
Name...................................... Enter
John Brown ............................ BROW
Contact the service provider listed on this page and follow their
Juan DeJesus ........................ DEJE
instructions. Enter on page 1 of Form RI-1040EZ, RI-1040 or RI-
Joan A. Lee ............................ LEE
1040NR in the upper left corner the confirmation number you were
Nancy McCarthy .................... MCCA
given at the end of the transaction and the amount of your tax pay-
Helen O’Neill .......................... ONEI
ment (not including the convenience fee).
Pedro Torres-Lopez .............. TORR
Telephone: 1-800-2PAY-TAX (1-800-272-9829)
Box 4. Enter the amount of the payment you are making. Also enter
below for your records.
Internet:
Date Paid
Check Number
Amount
$
DETACH HERE AND MAIL WITH YOUR PAYMENT
STATE OF RHODE ISLAND Payment Voucher
RI-1040V
2005
DIVISION OF TAXATION * ONE CAPITOL HILL, PROVIDENCE, RI 02908-5806
DO NOT STAPLE OR ATTACH THIS VOUCHER TO YOUR PAYMENT
1. Name(s)
3. ENTER THE FIRST FOUR
LETTERS OF YOUR LAST
NAME
Address
RI-1040V
City
State
Zip
2. Your Social Security Number
Spouse’s Social Security Number, if joint payment
4. ENTER
$
0 0
AMOUNT
ENCLOSED
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