Arizona Form Az-140v - Arizona Individual Income Tax Payment Voucher For Electronic Filing - 2015

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EPV
Arizona Individual Income Tax
Arizona Form
AZ-140V
2015
Payment Voucher for Electronic Filing
Your First Name and Middle Initial
Last Name
Your Social Security Number
Enter
1
your
Spouse’s First Name and Middle Initial
Last Name
Spouse’s Social Security No.
SSN(s).
1
Current Home Address - number and street, rural route
Apt. No.
Daytime Phone (with area code)
2
94
City, Town or Post Office
State
ZIP Code
REVENUE USE ONLY. DO NOT MARK IN THIS AREA.
88
3
Check the box if you are a first time Arizona income tax return filer.
81 PM
80 RCVD
Enter the amount of payment enclosed..............................................................................
$
00
To ensure proper application of this payment, be sure that you:
Do not send cash.
Make your check or money order payable to Arizona Department of Revenue.
Write your SSN and “2015 Tax” on your payment.
Include your payment with this form.
Mail to Arizona Department of Revenue, PO Box 29085, Phoenix, AZ 85038-9085.
You can make this 140V payment by eCheck or credit card!
American Express  Visa  Discover Card  MasterCard
Click on “Make a Payment” and select “140V” as the Payment Type.
NOTE: To avoid interest and penalties you must pay the full amount of your tax by April 18, 2016. You will not
receive an additional notice from the Arizona Department of Revenue unless an error exists with your return.
Print Form
ADOR 10944 (15)

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