PPPP 265 1040vmockup

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Form 1040-V2020

Department of the Treasury


Internal Revenue Service

What Is Form 1040-V Use blue ink.


It’s a statement you send with your check or money order for
any balance due on the “Amount you owe” line of your 2020 Write your full SSN.
Form 1040, 1040-SR, or 1040-NR.
Leave the amount blank.
Write ACCEPTED across the 1040v in red
DO NOT FILE THIS MOCKUP. ink, and in blue ink in the lower right, write
GET THE LATEST 1040V FORM FROM By: and your autograph.
https://www.irs.gov/pub/irs-pdf/f1040v.pdf Using red ink, write across the back of it:
Settlement for Closure and Recourse
IMPORTANT:
Cat. No. 20975C Form 1040-V (2020)
▼ Detach
Here and Mail With Your Payment and Return ▼

1040-V
Form

Payment Voucher OMB No. 1545-0074

2020
Department of the Treasury ▶ Do not staple or attach this voucher to your payment or return.
Internal Revenue Service (99)
Go to www.irs.gov/Payments for payment options and information.
1 Your social security number (SSN)
(if a joint return, SSN shown first on your return) 2 If a joint return, SSN shown second 3 Amount you are paying by check or Dollars Cents
on your return money order. Make your check or
money order payable to “United
WRITE YOUR FULL SSN States Treasury”
4 Your first name and middle initial Last name
JOSHUA C COUNCIL

If a joint return, spouse’s first name and middle initial Last name

Home address (number and street) Apt. no. City, town, or post office. If you have a foreign address, also complete spaces State ZIP code
1376 HAIGHT ST below. SAN FRANCISCO CA 94117
Foreign country name Foreign province/state/county Foreign postal code

For Paperwork Reduction Act Notice, see your tax return instructions. Cat. No. 20975C

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