Case File
efta-efta01222558DOJ Data Set 9OtherTear off hero
Date
Unknown
Source
DOJ Data Set 9
Reference
efta-efta01222558
Pages
2
Persons
0
Integrity
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Text extracted via OCR from the original document. May contain errors from the scanning process.
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Payment Voucher 4
OMB No. 154S-0074
File only if you are making a payment of estimated tax by check or money order. Return this
voucher with your check or money order payable to "United States Treasury." Write your
identifying number and "2019 Form 1040-ES (NR)" 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 Jan. 15, 2020
Amount of estimated tax you are
money order.
Dollars
Cents
Your identifying number (SSN or MN) (employer Identification number for an estate or trust)
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Your first name and Initial
Your last name
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Address (number, street, and apt. no.)
City, state, and ZIP code.
Foreign country name
! Foreign province/state/county
Foreign postal code
For Privacy Act and Paperwork Reduction Act Notice. see instructions.
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Payment Voucher
OMB No. 1545-0074
File only if you are making a payment of estimated tax by check or money order. Return this
voucher with your check or money order payable to "United States Treasury." Write your
dentifying number and "2019 Form 1040-ES (NR)" 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 Sept. 10, 2019
Amount of estimated tax you are
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money order.
Dollars
Cents
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Your Identifying number (SSN or ITIN) (employer Identification number for an estate or trust)
Your first name and Initial
Your last name
Address (number, street, and apt. no.)
City, state, and ZIP code.
Foreign country name
Foreign province/state/county
Foreign postal code
For Privacy Mt and Paperwork Reduction Act Notice, see Instructions.
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Payment Voucher
OMB No.1545-0074
File only if you are making a payment of estimated tax by check or money order. Return this
voucher with your check or money order payable to "United States Treasury." Write your
identifying number and "2019 Form 1040-ES (NR)" 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, 2019
Amount of estimated tax you are
mlenificielay
money order.
Dollars
Cents
Your Identifying number (SSN or ITIN) (employer Identification number for an estate or trust)
I
Your first name and Initial
Your last name
E Address (number, street, and apt. no.)
City, state, and ZIP code.
Foreign country name
! Foreign province/state/county
Foreign postal code
For Privacy Act and Paperwork Reduction Act Notice, see instructions.
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Payment Voucher
OMB No.1545-0074
File only it you are making a payment of estimated tax by check or money order. Return this
voucher with your check or money order payable to "United States Treasury." Write your
dentifying number and "2019 Form 1040-ES (NR)" 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 April 15, 2019
Amount of estimated tax you are
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money order.
Dollars
Cents
Your Identifying number (SSN or ITIN) (employer Identification number for an estate or trust)
Your first name and Initial
Your last name
E Address (number, street, and apt. no.)
City, state, and ZIP code.
Foreign country name
! Foreign province/state/county
Foreign postal code
For Privacy Act and Paperwork Reduction Act Notice. see instructions.
EFTA01222559
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