Yes No
(ex 1 234 567 89)
(R 12/31/2012)
Address
All tax return payments should be mailed on or before the due date of the tax return
Amount Paid
AR1002V
Arkansas State Income Tax
City State Zip
Due Date
Federal Identification Number
FIDUCIARY TAX PAYMENT VOUCHER INSTRUCTIONS
FIDUCIARY TAX RETURN PAYMENT VOUCHER
Fiscal Year End
For assistance call (501) 682 1100
If mailing a paper tax return with payment complete Form AR1002V and include a check or money order Mail the AR1002V payment and your tax return (Form AR1002 or AR1002NR) to the PO Box listed below If this payment is for an amended return mark YES on Form AR1000V in the appropri ate space
IMPORTANT: This voucher must be fully completed and included with any payment made when filing an original or amended tax return Failure to complete a payment voucher could cause a delay in receiving credit for your payment You must also use this payment voucher for filing prior year tax forms
Include Cents
Is Payment for an Amended Return?
Little Rock AR 72203 2144
Note: Write your Federal Identification Number on your check or money order and make payable in U S Dollars to the Department of Finance and Administration
P O Box 2144
Paper Returns
STATE OF ARKANSAS
Tax Year
Telephone #
You must cut along the dotted line or the processing of your payment will be delayed