Form It-201-V (2011) Payment Voucher For E-Filed Income Tax Returns - New York State
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2IT-201-V
New York State Department of Taxation and Finance
Instructions for Form IT-201-V
Payment Voucher for E-Filed Income Tax Returns
Who must use a payment voucher?
separate bill for $50 for each return or other tax document associated with
the returned payment.
If you e-filed a New York State income tax return (on Form IT-201 or
Form IT-203) and you owe tax, you must submit this payment voucher,
Where do I send my payment and payment voucher?
Form IT-201-V below, if you pay by check or money order. If you authorized
the Tax Department to withdraw the payment from your bank account
Send your payment and this payment voucher to:
(electronic funds withdrawal) or paid by credit card, do not file Form IT-201-V.
NYS PERSONAL INCOME TAX
To find out more about your payment options, visit the Tax Department’s
PROCESSING CENTER
Web site (at ).
PO BOX 4124
BINGHAMTON NY 13902-4124
When do I file?
Private delivery services
You must pay the amount you owe by April 17, 2012, to avoid interest and
If you choose, you may use a private delivery service, instead of the U.S.
penalties.
Postal Service, to mail in your form and tax payment. However, if, at a
later date, you need to establish the date you filed or paid your tax, you
How do I prepare my payment?
cannot use the date recorded by a private delivery service unless you
Make your check or money order payable to New York State Income Tax
used a delivery service that has been designated by the U.S. Secretary
for the full amount you owe and write your social security number and 2011
of the Treasury or the Commissioner of Taxation and Finance. (Currently
Income Tax on it.
designated delivery services are listed in Publication 55, Designated Private
Delivery Services. See Need help? on the back page of these instructions
How do I prepare the payment voucher?
for information on obtaining forms and publications.) If you have used a
Step 1
designated private delivery service and need to establish the date you
filed your form, contact that private delivery service for instructions on
Enter your name, social security number (SSN), and address in the spaces
how to obtain written proof of the date your form was given to the delivery
provided; if you filed a joint return, include your spouse’s name and SSN in
service for delivery. If you use any private delivery service, whether it is a
the spaces provided. Do not include your spouse’s name and SSN if you
designated service or not, send the forms covered by these instructions
filed separate returns or if you filed Form IT-203-C.
to: JPMorgan Chase, NYS Tax Processing – Estimated Tax, 33 Lewis Rd.,
Foreign addresses — Enter the information in the following order: city,
Binghamton NY 13905-1040.
province or state, and then country (all in the City, village, or post office
box). Follow the country’s practice for entering the postal code. Do not
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abbreviate the country name.
The Commissioner of Taxation and Finance may collect and maintain
personal information pursuant to the New York State Tax Law, including but
Step 2
not limited to, sections 5-a, 171, 171-a, 287, 308, 429, 475, 505, 697, 1096,
Enter the amount of your payment in the space provided (enter only whole
1142, and 1415 of that Law; and may require disclosure of social security
dollar amounts).
numbers pursuant to 42 USC 405(c)(2)(C)(i).
Step 3
This information will be used to determine and administer tax liabilities
and, when authorized by law, for certain tax offset and exchange of tax
Detach the payment voucher at the line indicated below.
information programs as well as for any other lawful purpose.
Step 4
Information concerning quarterly wages paid to employees is provided
Enclose your check or money order with your voucher. Please do not staple
to certain state agencies for purposes of fraud prevention, support
or clip your check to your voucher. Detach any check stubs.
enforcement, evaluation of the effectiveness of certain employment and
training programs and other purposes authorized by law.
Fee for payments returned by banks — The law allows the Tax Department
to charge a $50 fee when a check, money order, or electronic payment
Failure to provide the required information may subject you to civil or criminal
is returned by a bank for nonpayment. However, if an electronic payment
penalties, or both, under the Tax Law.
is returned as a result of an error by the bank or the department, the
This information is maintained by the Manager of Document Management,
department won’t charge the fee. If your payment is returned, we will send a
NYS Tax Department, W A Harriman Campus, Albany NY 12227;
telephone (518) 457-5181.
Detach here
IT-201-V
New York State Department of Taxation and Finance
Payment Voucher for E-Filed Income Tax Returns
Make your check or money order payable to New York State Income Tax for the full amount you owe and write your social security
number and 2011 Income Tax on it. Mail voucher and payment to: NYS Personal Income Tax, Processing Center, PO Box 4124,
Binghamton NY 13902-4124.
Your first name and middle initial
Your last name
Your social security number (SSN)
( for a joint return, enter spouse’s name on line below )
Spouse’s first name and middle initial
Spouse’s last name
Spouse’s SSN
(enter only if filing a joint return)
Mailing address
Apartment number
( number and street or rural route; see instructions )
Dollars
Cents
City, village or post office
State
ZIP code
00
Balance due
E-mail:
0401110094
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