FORM 760-PFF
2012 PAYMENT COUPON FOR FARMERS,
FISHERMEN AND MERCHANT SEAMEN
If you file your return electronically, pay your tax online through e-File, It is the fastest, most efficient
way to pay the tax due. Visit our website at for additional information.
TO BE SURE YOUR PAYMENT IS APPLIED CORRECTLY,
FOLLOW THESE INSTRUCTIONS:
If you filed a 2012 Form 760, Form 760PY or Form 763 and owe tax, but did not send in your payment
with the return, use this form to send in your payment on or before the due date.
This form can be used to make a payment for taxable year 2012 electronic or paper returns.
To avoid underpayment penalty, farmers, fishermen and merchant seamen must file Form 760 and
pay the entire tax due by March 1, 2013.
Please do not send a paper copy of your return with your payment. If a paper copy of the return is
sent, the payment will not be properly posted to the account.
COMPLETE THE PAYMENT COUPON BY
INCLUDINg THE FOLLOWINg INFORMATION:
Your Social Security Number and Spouse’s Social Security Number (if filing a joint return). This must
match the information on your return.
Your name and spouse’s name (if filing a joint return), address, and phone number.
The amount of the enclosed payment.
Make sure that your Social Security Number is written on the check. Mail your payment and the
payment coupon below to:
Virginia Department of Taxation
P. O. Box 1478
Richmond, VA 23218-1478
Due Date: Please note that if your full payment is not postmarked by May 1, 2013, you will be sent
a bill for tax, penalty and interest.
A qualifying farmer, fisherman or merchant seaman, must make payment by March 1, 2013, to avoid
underpayment penalty. For additional information visit: or call (804) 367-8031.
Detach Form 760-PFF here. Complete this form and mail it with your check to the address shown on the form.
760-PFF Va. Dept. of Taxation 02/12
Form 760-PFF
2012 Payment Coupon for Farmers, Fishermen and Merchant Seamen
Your Social Security Number
Spouse’s Social Security Number
(DOC ID 764)
Please do not staple
To
Be Used For Payments On Previously
Filed 2012
Individual Income Tax Returns Only
0000000000 7648888 112003
Mail Payment To:
VA Department of Taxation
P.O. Box 1478
Name(s)
Richmond, VA 23218-1478
Address
Make your check payable to the
Virginia Department of Taxation
City
State
ZIP
Amount of
0 0
.
Daytime Phone Number
Payment