Form 500v - Virginia Corporation Income Tax Payment Voucher

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Attention: The payment for the total due on Form 500 must be 
made through the e-File system when filing the return or with an 
ACH Credit from your bank. 
Use this voucher only if you have an approved waiver. To request 
a waiver, follow the instructions at: 
(804) 440-2541 to obtain a waiver request form.
FORM
Virginia Corporation Income Tax Payment Voucher
500V
Virginia Department of Taxation
(DOC ID 500)
PO Box 1500, Richmond, VA 23218-1500
For Information Call (804) 367-8037.
Attention: Payment must be made electronically.
0000000000000000 5050000 000000
Use this voucher only if you have an approved waiver.
Month Ending Year Ending
To receive credit for your payment in the correct tax year, please enter the ending month (numerical) and year.
12
Calendar year:
OR;
 
Federal Employer ID Number                                        
 
Fiscal year:
OR;
  Name of corporation
                                                                                                   First 4 letters of corp. name 
Short taxable year:
  Address (Number and Street)
  Address continued
Amount of this payment 
  City, State and ZIP Code
•
0 0
.
$
  Date 
Telephone Number
VA DEPT OF TAXATION 2601205 500V (REV. 7/13)

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