Form 1041-V Payment Voucher

OK to print as is

Cumulative Changes

X

OK to print as corrected

2010 Form 1041-V

Changes shown in yellow
(This is a new Form)

Version A, Cycle 3

Department of the Treasury
Internal Revenue Service

What Is Form 1041-V and Do You Have To
Use It?

• Write the estate's or trust's EIN and “2010 Form 1041”
on the check or money order.

It is a statement you
y send with a check or moneyy order
due)) of the estate's
for any
y balance due on Line 27 (Tax
(
or trust's 2010 Form 1041. Using
g Form 1041-V allows us
to process
p
the payment
p y
more accuratelyy and efficiently.
We strongly
g y encourage
g you
y to use Form 1041-V, but
there is no penalty if you do not.

p us process
p
p y
, enter the amount on
• To help
the payment,
g side of the check like this: $ XXX.XX. Do not use
the right
dashes or lines (for example, do not enter “$ XXX—” or
“$ XXX xxx/1100”).

Note. Anyy reference in these instructions to “you” means
the fiduciary of the estate or trust.

How To Fill In Form 1041-V
Line 1. Enter the estate's or trust's employer identification
number (EIN) as shown on its return.
Line 2. Enter the amount you are paying by check or
money order.
Line 3. Enter the name of the estate or trust.
Line 4. Enter your name and title.
address exactlyy as shown on the
Line 5. Enter your
y
estate's or trust's return. Please print clearly.

How To Send In the Estate's or Trust's 2010
Tax Return, Payment, and Form 1041-V
• Detach Form 1041-V along the dotted line.
• Do not staple
p or otherwise attach the payment
p y
or Form
1041-V to the return or to each other. Instead, just put
them loose in an envelope.
• Mail the estate's or trust's 2010 tax return,, payment,
p y
,
and Form 1041-V to the address shown on the back that
applies to you.

DRAFT AS OF
DR
S
September
13, 2010

How To Prepare the Payment

• Make the check or mone
money order payable to the “United
States Treasury.” Do not send cash.
• Make sure the name of the estate or trust appears on
the check or money order.

Form 1041-V
V (2010)

Cat. No. 54561M

Form

d Detach

1041-V

Department of the Treasury
Internal Revenue Service (99)

Here and Mail With Your Payment and Return d

Payment Voucher
a

Do not staple or attach this voucher to your payment or return.

Print or type

1 Employer identification number (EIN)

2 Amount you are
paying by check
or money order

OMB No. 1545-0092

2010
Dollars

Cents

3 Name of estate or trust

4 Name and title of fiduciary

5 Address of fiduciary (number, street, and room or suite no.)

City, state, and ZIP code

For Paperwork Reduction Act Notice, see the Instructions for Form 1041.

Cat. No. 54561M

Version A, Cycle 3
Page 2

Form 1041-V (2010)

Where To File
If you are located in
d

Please mail to the
d

Connecticut,, Delaware,, District of Columbia,, Georgia,
g , Illinois,,
Indiana,, Kentucky,
y, Maine,, Maryland,
y
, Massachusetts,, Michigan,
g
New Hampshire,
p
, New Jersey,
y, New York,, North Carolina,, Ohio,,
Pennsylvania,
y
, Rhode Island,, South Carolina, Tennessee, Vermont,
Virginia, West Virginia, Wisconsin

Department
p
of the Treasury
y
Internal Revenue Service Center
Cincinnati, OH 45999-0148

Alabama,, Alaska,, Arizona,, Arkansas,, California,, Colorado,, Florida,
Hawaii,, Idaho,, Iowa,, Kansas,, Louisiana,, Minnesota,, Mississippi,
Missouri,, Montana,, Nebraska,, Nevada,, New Mexico,, North
Dakota,, Oklahoma,, Oregon, South Dakota, Texas, Utah,
Washington, Wyoming

Department
p
of the Treasury
y
Internal Revenue Service Center
Ogden, UT 84201-0148

A foreign country or a U.S. possession

Internal Revenue Service Center
P.O. Box 409101
Ogden, UT 84409

DRAFT AS OF
September 13, 2010