A voucher is printed at the bottom of this page.

NOTE: This is a new scannable voucher approved by the IRS for filing of the 1040-V for the year 2016.
This is different than the voucher that is on the IRS website.

Use this voucher when making a payment with Form 1040.

to Do not staple this voucher or your payment to Form 1040.
10. Make your check or money order payable to the "United Stat reasu
0. Write your Social Security Number (SSN) on your check o ney order.

MO payment to:
INTERNAL REVENUE SERW
PO BOX 7704
SAN FRANCISCO CA 4l2O7704

For Privacy Act ondTP,ap,erwprjAduction Act Notice, see separate instructions. V DETACH HERE V Form 1040-V (2016)
16 1040VS1 BWF io4o Form Software Copyright 1996— 2017 HRB Tax Group, Inc.

0404V4 6i/416111.i .OUC

PO' Use this voucher when making a payment with Form 1040.
III' Do not staple this voucher or your payment to Form 1040. Enter the amount
OP' Make your check or money order payable to the "United States Treasury". of your payment
0" Write your Social Security Number (SSN) on your check or money order. 3,043
2029
MARY JANE KRUSE INTERNAL REVENUE SERVICE
328 W CASPER DR PO BOX 7704
PUEBLO WEST CO 81007 SAN FRANCISCO CA 94120-7704

485568330 IK KRUS 30 0 201612 610