Formct-1040v - Connecticut Electronic Filing Payment Voucher - 2012
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1Department of Revenue Services
State of Connecticut
CT-1040V
(Rev. 12/12)
2012 Connecticut Electronic Filing Payment Voucher
You must pay in full the total amount of tax due. If payment is not made on or before April 15, 2013, the tax due
is subject to penalty and interest.
Balance Due Payment Options
A. Pay Electronically: Visit to use the Taxpayer Service Center (TSC) to make a direct tax
payment. After logging into the TSC, select the Make Payment Only option and choose a tax type from the
drop down box. Using this option authorizes the Department of Revenue Services (DRS) to electronically
withdraw a payment from your bank account (checking or savings) on a date you select up to the due date.
As a reminder, even if you pay electronically you must still fi le your return by the due date. Tax not paid on or
before the due date will be subject to penalty and interest.
B. Pay by Credit Card or Debit Card: You may elect to pay your 2012 tax liability using a credit card (American
Express
®
, Discover
®
, MasterCard
®
, VISA
®
) or comparable debit card. A convenience fee will be charged by
the service provider. You will be informed of the amount of the fee and may elect to cancel the transaction. At
the end of the transaction, you will be given a confi rmation number for your records.
There are three ways to pay by credit card or comparable debit card:
•
Log in to your account in the TSC and select Make Payment by Credit Card;
•
Visit and select State Payments; or
•
Call Offi cial Payments Corporation toll-free at 800-2PAY-TAX (800-272-9829) and follow the instructions.
You will be asked to enter the Connecticut Jurisdiction Code: 1777.
Your payment will be effective on the date you make the charge.
C. Pay by Mail: Make your check payable to Commissioner of Revenue Services. To ensure payment is
applied to your account, write “CT-1040V efi le” and your Social Security Number (SSN), optional, on the front
of your check. Be sure to sign your check. Do not send cash. DRS may submit your check to your bank
electronically. Return form CT-1040V below with your payment.
Mail to: Department of Revenue Services
State of Connecticut
PO Box 2921
Hartford CT 06104-2921
Separate here and mail voucher to DRS. Make a copy for your records.
Department of Revenue Services
CT-1040V
DRS use only
State of Connecticut
2012 Connecticut Electronic Filing Payment Voucher
112
(Rev. 12/12)
0
1. Enter the amount enclosed $
Check here if this is the fi rst time you
2. Make check payable to Commissioner of Revenue Services.
are fi ling a Connecticut income tax
3. Write your SSN (optional) and “CT-1040V efi le” on your check.
2012
return.
4. Mail to: DRS PO Box 2921, State of Connecticut, Hartford CT 06104-2921
Your fi rst name
Middle initial
Last name
Your SSN
2 0 1 3
M M
D D
Y Y
Y Y
If a joint return, spouse’s fi rst name
Middle initial
Last name
Spouse’s SSN
Home address (number and street)
PO Box
735
City or town
State
ZIP code
ELF
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