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1040EZ or IT 1040 If you are sending ONLY this voucher and paper check or money order
2013 Ohio IT 40P
5703 05 5703 057 and 5747 08 authorize us to request
Address
AMOUNT OF
Because we require you to provide us with a Social Security
City state ZIP code
DO NOT SEND CASH
DO NOT STAPLE
Electronic Payment Available
Federal Privacy Act Notice
First name
If you are sending this voucher and paper check or money order (payable to Ohio Treasurer
Income Tax Payment Voucher
Last name
last name (only if joint filing)
number
number is mandatory Ohio Revised Code sections
number the Federal Privacy Act of 1974 requires
of State) with your income tax return mail to the address shown on page 2 of Ohio form IT
OHIO IT 40P Do NOT fold check or voucher
order to administer this tax
our electronic payment methods Go to our Web site at
P O Box 182131 Columbus OH 43218 2131
PAYMENT $
Please use UPPERCASE letters
Security
Security number(only if joint filing)
separately from the return then mail this voucher and payment to Ohio Department of Taxation
Spouse s first name (only if joint filing)
Spouse s last name
Spouse s Social
tax ohio gov for all electronic payment options
Taxable Year
Taxpayer s
this information We need your Social Security number in
THIS VOUCHER
to print the first three letters of
us to inform you that providing us with your Social Security
You can eliminate writing a paper check by using any of
YOUR PAYMENT TO
Your Social
