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Form
1040-ES
Department of the Treasury
Internal Revenue Service
20
13
Estimated Tax
Payment
Voucher
2
OMB No. 1545-0074
File only if you are making a payment of estimated tax by check or money order. Mail this
voucher with your check or money order payable to
“United States Treasury.”
Write your
social security number and “2013 Form 1040-ES” on your check or money order. Do not send
cash. Enclose, but do not staple or attach, your payment with this voucher.
Calendar year—Due June 17, 2013
Amount of estimated tax you are paying
by check or
money order.
Dollars
Cents
Print or type
Your first name and initial
Your last name
Your social security number
If joint payment, complete for spouse
Spouse’s first name and initial
Spouse’s last name
Spouse’s social security number
Address (number, street, and apt. no.)
City, state, and ZIP code. (If a foreign address, enter city, also complete spaces below.)
Foreign country name
Foreign province/county
Foreign postal code
For Privacy Act and Paperwork Reduction Act Notice, see instructions.
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