Form 1040-V (2011)

IF you live in . . .
Alabama, Georgia, North Carolina, South Carolina

THEN use this address:

Internal Revenue Service P.O. Box 105017 Atlanta, GA 30348-5017 Internal Revenue Service P.O. Box 1214 Charlotte, NC 28201-1214 Internal Revenue Service P.O. Box 7704 San Francisco, CA 94120-7704 Internal Revenue Service P.O. Box 802501 Cincinnati, OH 45280-2501 Internal Revenue Service P.O. Box 970011 St. Louis, MO 63197-0011 Internal Revenue Service P.O. Box 37008 Hartford, CT 06176-0008 Internal Revenue Service P.O. Box 1303 Charlotte, NC 28201-1303 USA

Florida, Louisiana, Mississippi, Texas

Alaska, Arizona, California, Colorado, Hawaii, Nevada, Oregon, Washington Arkansas, Idaho, Illinois, Indiana, Iowa, Kansas, Michigan, Minnesota, Montana, Nebraska, New Mexico, North Dakota, Ohio, Oklahoma, South Dakota, Utah, Wisconsin, Wyoming Kentucky, Missouri, New Jersey, Tennessee, Virginia, West Virginia Connecticut, Delaware, District of Columbia, Maine, Maryland, Massachusetts, New Hampshire, New York, Pennsylvania, Rhode Island, Vermont A foreign country, U.S. possession or territory, or use an APO or FPO address, or file Form 2555, 2555-EZ, or 4563, or are a dual-status alien.

TO PAY YOUR TAXES DUE BY CHECK, MAIL THIS FORM TO THE ADDRESS LISTED BELOW.

Form 1040-V (2011)

I Detach Here and Mail With Your Payment and Return I

Department of the Treasury Internal Revenue Service G G G G (99)

2011

Form 1040-V Payment Voucher

Enter the amount of your payment . . . . . . . . G REV 01/20/12 TTO 1555

Use this voucher when making a payment with Form 1040. Do not staple this voucher or your payment to Form 1040. Make your check or money order payable to the 'United States Treasury.' Write your social security number (SSN) on your check or money order.

2,879.

JULIA E DREW PO BOX 178 TRUCKEE CA 96160

INTERNAL REVENUE SERVICE PO BOX 7704 SAN FRANCISCO CA 94120-7704

653283194 NP DREW 30 0 201112 610

Voucher at bottom of page.

DO NOT MAIL A PAPER COPY OF YOUR TAX RETURN WITH THE PAYMENT VOUCHER. If amount of payment is zero, do not mail this voucher.

WHERE TO FILE:

Using black or blue ink, make your check or money order payable to the Franchise Tax Board. Write the taxpayers social security number (SSN) or individual taxpayer identication number (ITIN) and 2011 FTB 3582 on the check or money order. Detach the voucher below. Enclose, but do not staple, payment with the voucher and mail to: FRANCHISE TAX BOARD PO BOX 942867 SACRAMENTO CA 94267-0008

Make all checks or money orders payable in U.S. dollars and drawn against a U.S. nancial institution.

WHEN TO FILE:

Calendar Year File and Pay by April 17, 2012.*

When the due date falls on a weekend or holiday, the deadline to le and pay without penalty is extended to the next business day. *Due to the Emancipation Day holiday on April 16, 2012, tax returns and payments received on April 17, 2012 will be considered timely.

ONLINE SERVICES: Use Web Pay and enjoy the ease of our free online payment service. Go to ftb.ca.gov and search for payment options. Do not mail this voucher if you use Web Pay.

DETACH HERE TAXABLE YEAR

IF NO PAYMENT IS DUE, DO NOT MAIL THIS VOUCHER

DETACH HERE CALIFORNIA FORM

CAUTION: You may be required to pay electronically. See instructions.

2011

Payment Voucher for Individual e-led Returns

DREW ** E DREW

3582 (e-le)
11

653-28-3194 JULIA PO BOX 178 TRUCKEE

CA

96160
Amount of Payment

48.

For Privacy Notice, get form FTB 1131.

175

1251116

REV 12/08/11 TTO

FTB 3582 2011