Form Nj-1040-V - Nj Gross Income Tax Resident Payment Voucher - 2012

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N J Gross Income Tax
NJ-1040-V
SOCIAL
-
-
SECURITY
Resident Payment Voucher
NUMBER
2012
LAST NAME, FIRST NAME AND INITIAL
STREET ADDRESS
MAKE YOUR CHECK PAYABLE TO ‘STATE OF NEW JERSEY - TGI’.
WRITE YOUR SOCIAL SECURITY # AND TAX YEAR ON YOUR CHECK.
CITY, STATE, ZIP CODE
RETURN THIS VOUCHER WITH YOUR PAYMENT
State of New Jersey
Enter amount of payment here:
Division of Taxation
Revenue Processing Center
$
, ,
, ,
. .
PO Box 111
Trenton, NJ 08645-0111
01309000000000000000001212060000000000
Please cut on dotted lines

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