2012
RI-1040C-V
Rhode Island Composite Return Payment Voucher
What Is Form RI-1040C-V and Do You Need To Use It?
How To Prepare Your Payment
Make your check or money order payable to the "R.I. Division
It is a statement you send with your payment of any
of Taxation." Do not send cash. Make sure the name and
balance due on line 21 of your Form RI-1040C. Using Form RI-
address appears on the check or money order. Write "Form RI-
1040C-V allows us to process your payment more accurately and
1040C-V," daytime phone number and federal Identification
efficiently. We strongly encourage you to use Form RI-1040C-V,
Number on your check or money order.
but there is no penalty if you do not do so.
How To Fill In Form RI-1040C-V
How To Send In Your Return, Payment, and RI-1040C-V
RHODE ISLAND COMPOSITE PAYMENT VOUCHER
RI-1040C-V
2012
Division of Taxation - One Capitol Hill, Providence, RI 02908-5807
Retain the top portion of this form for your records. Detach and
return the lower portion with your payment. DO NOT staple or
DO NOT STAPLE OR ATTACH THIS VOUCHER TO YOUR PAYMENT
NAME
otherwise attach your payment of Form RI-1040C-V to your
1
ADDRESS
return or to each other. Instead, just put them loose in an enve-
RI-1040C-V
CITY, STATE & ZIP CODE
lope.
Mail
your
tax
return,
payment
and
Form
3
RI-1040C-V to the Rhode Island Division of Taxation, One
2
FEDERAL EMPLOYER IDENTIFICATION NUMBER
0 0
4. ENTER
$
AMOUNT
ENCLOSED
Capitol Hill, Providence, RI 02908-5807.
Box 1. Enter the name and addresses as shown on your
return.
Box 2. Enter the Federal Identification Number in the box
provided.
Box 3. Enter the amount of the payment you are making.
Also enter below for your records.
Date Paid
Check Number
Amount
DO NOT USE THIS VOUCHER TO MAKE A PAYMENT ON
YOUR PERSONAL INCOME TAX RETURN. THIS VOUCHER
IS TO BE USED BY AN ENTITY FILING A COMPOSITE TAX
RETURN.
DETACH HERE AND MAIL WITH YOUR PAYMENT
RHODE ISLAND COMPOSITE PAYMENT VOUCHER
RI-1040C-V
2012
Division of Taxation - One Capitol Hill, Providence, RI 02908-5807
DO NOT STAPLE OR ATTACH THIS VOUCHER TO YOUR PAYMENT
NAME
ADDRESS
RI-1040C-V
CITY, STATE & ZIP CODE
FEDERAL EMPLOYER IDENTIFICATION NUMBER
ENTER
$
0 0
AMOUNT
ENCLOSED