DO NOT STAPLE OR TAPE CHECK TO YOUR FORM DO NOT CUT OR DETACH THIS FORM DO NOT SEND PHOTOCOPIES OF THIS FORM
Use this voucher only for Maine individual income tax that is due on your electronically filed tax return
(click on Electronic Services)
*1201601*
Address (number street and apt no )
Amount Paid with this voucher
Augusta ME 04332 9101
be withdrawn on the payment date the taxpayer selects
City/Town State Zip Code
Enter the amount of your check or money order in the space provided
Enter your name(s) social security number(s) telephone number and address in the spaces provided If you are fi ling a
Form 1040ME PV
joint return enter your names and social security numbers in the same order as they appear on your return
Mail your completed payment voucher and payment to:
Maine EZ Pay is an online application that allows Maine taxpayers to make payments online quickly and easily
Maine EZ PayYou may pay your income tax electronically at www maine gov/revenue Electronic payments eliminate
Maine Individual Income Tax
Maine Revenue Services
Make checks payable to Treasurer State of Maine
Payment Voucher
PO Box 9101
Spouse s First Name Initial Area Code Home Phone Number
Spouse s Last Name Area Code Work Phone Number
Taxpayers must pre register online with personal and bank account information and payments will be withdrawn from
the checking or savings account that is set up in the registration For more information see www maine gov/revenue
the necessity of filing forms 1040ME PV (income tax payment vouchers)
To avoid having to make payments earlier than necessary payments may be scheduled in advance and will automatically
To mail your payment follow the instructions below
Your First Name Initial Your Social Security Number
Your Last Name Spouse s Social Security Number
