![]() ![]() Attach Form(s) W-2 7 8a 8a Taxable interest. If someone can claim you as a dependent, do not check box 6a Exemptions Spouse b (4) X if child qualifying for Dependents: c (2) Dependent's social security number (3) Dependent's (1) First name Last name If more than four dependents, see instructions and d Total number of exemptions claimed 7 Wages, salaries, tips, etc. ![]() 3 Qualifying widow(er) with dependent child 6a Yourself. 1 Single Filing Status Married filing jointly (even if only one had income) 2 Check only one box. If you have a foreign address, also complete spaces below (see instructions). City, town or post office, state, and ZIP code. 1545-0074, ending Last name Your first name and initial Your social security number Last name Spouse's social security number If a joint return, spouse's first name and initial Home address (number and street). 7,596.00 DEBRA SIMON 1400 SAND DOLLAR CIRCLE SANDVILLE, FL 33868 Internal Revenue Service P.O. If you do mail a check, include the portion below with your payment. 1545-0074 (99) FORM - Make your check or money order "United States Treasury" STOP STOP Before you mail a check, consider your online payment options IRS Direct Pay Pay by Card Electronic Federal Tax Payment System Go to Go to Go to to enroll Registerd users call 180 irs.gov/payments Pay with Bank account Schedule up to 30 days in advance No fees Immediate Confirmation Credit or Debit Card option Schedule in advance Service fees apply and vary by processor Registration required Business and Individuals Pay with Bank Account by phone or online No fees Online payments save time, reduce paper, and don't require postage. ![]() DO NOT FILE Form 1040-V (2016) Detach Here and Mail With Your Payment and Return Do not staple or attach this voucher to your payment or return Form 1040-V Department of the Treasury Internal Revenue Service 2016 1064 1040-V Department of the Treasury Internal Revenue Service Payment Voucher 2016 OMB No. ![]()
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