3576 Form Fillable Pending Audit Tax Deposit Voucher for Individuals
(all forms fillable on Windows, Mac, Android tablets, and iPad using Adobe Reader XI)

FRANCHISE TAX BOARD Mail the tax deposit voucher below with the payment to the address listed Mail your protest or appeal request to the PO Box listed on the NPA Make a tax deposit payment to stop the accumulation of interest Protest or appeal the notice within the period explained in the notice (NOA) and will: 1241143 2014 Instructions for Form FTB 3576 3576 (PIT) a specific taxable year In general individuals make tax deposits to stop the a tax deposit only if you have filed a return for that taxable year For more accrual of underpayment interest The FTB will consider your payment as Address (number and street PO Box or PMB no ) Apt no /Ste no address below: Amount of payment an immediate payment or schedule payments up to a year in advance Go to and FTB 3576 A penalty may be imposed if the payment is returned by below if paying with a check or money order payment only blue ink CALIFORNIA FORM Caution: You may be required to pay electronically See instructions Check or Money Order Using black or blue ink make the check or money City State ZIP Code complete the first line as applicable DETACH HERE Do not use this voucher if you are paying your estimated tax or for automatic DO NOT USE THIS VOUCHER TO PAY ESTIMATED DO NOT USE THIS VOUCHER TO PAY ESTIMATED TAX OR FOR AUTOMATIC EXTENSION Enclose but do not staple the payment and the voucher and mail to the Enter all the information requested on the tax deposit voucher using black or Enter the four digit taxable year in the box at the top of the voucher and enter the Social Security Numbers (SSN) or Individual Taxpayer Identification extension Instead use Form 540 ES Estimated Tax for Individuals or form first then the box number Example: 111 Main Street PMB 123 Fiscal year filers enter year ending month (mm) year (yyyy) for Individuals For Privacy Notice get FTB 1131 ENG/SP Franchise Tax Board (FTB) receives tax deposits from individuals who FTB 3519 Payment for Automatic Extension for Individuals FTB 3576 2014 ftb ca gov for more information General Information If joint payment spouse s/RDP s first name Initial Last name Spouse s/RDP s SSN or ITIN If the taxpayer is required to make payments electronically the taxpayer If there is a final balance due on your account the FTB will first apply the If you are filing an amended tax return to report a federal adjustment do not If you received a Notice of Proposed Assessment (NPA) or Notice of Action Important Information Individuals can make payments electronically at the FTB s website using Web Information for Registered Domestic Partners information go to ftb ca gov and search for FTB Notice 2005 6 Instructions made in anticipation of additional tax due to a federal audit a state audit or make a tax deposit payment for previously filed tax returns if you anticipate Mandatory Electronic Payments must also remit the tax deposit payment electronically Numbers (ITIN) and the amount of the payment in the spaces provided or NOA order payable to the Franchise Tax Board On the check or money order other reasons other reasons See When to File for more information Use the voucher otherwise specified For more information on RDP get FTB Pub 737 Tax owing an additional California tax due to a federal audit a state audit or Pay for Individuals After a one time online registration taxpayers can make Payment due to Check the box to identify whether the payment is being Payment due to: Federal audit CA audit Other payment to satisfy any final balance due for the same taxable year Any Pending Audit Tax Deposit Voucher Pending Audit Tax Deposit Voucher for Individuals PO BOX 942867 previously filed their tax returns and expect to owe a future tax liability for Private Mail Box (PMB) Include the PMB in the address field Write PMB Registered Domestic Partners (RDP) For purposes of California income remaining amount will be held as a tax deposit SACRAMENTO CA 94267 0008 Submit a separate form FTB 3576 and payment for each taxable year TAX OR FOR AUTOMATIC EXTENSION tax references to a spouse husband or wife also refer to a RDP unless TAXABLE YEAR Then do both of the following: To ensure timely and proper application of the payment to your account U S dollars and drawn against a U S financial institution under Where to File Use form FTB 3576 Pending Audit Tax Deposit Voucher for Individuals to use the voucher below Attach the payment to the amended return Web Pay When to File Where to File write your SSN or ITIN the taxable year the voucher is being submitted for your bank for insufficient funds Make all checks or money orders payable in Your first name Initial Last name Your SSN or ITIN