Missouri Fiduciary Income Tax Payment Voucher

Fiduciary Income Tax Payment Voucher
MO-1041V 2022 Fiduciary Income Tax Payment Voucher
Form
MO-1041V

2023 Fiduciary Income Tax Payment Voucher

The MO-1041V voucher is used if you have an amount How do I make my payment?
due on an electronically filed return, or you do not submit
•	Attach a check or money order payable to the “Missouri
payment in full when you file your Fiduciary Income Tax
Department of Reve­
n ue” (U.S. funds only). The
Return (Form MO-1041). Your Fiduciary Income Tax
Department of Revenue may collect checks returned for
Return and payment are due no later than the 15th day
insufficient or uncollected funds electronically. Do not
of the fourth month following the end of the income tax
send cash.
year. When the due date falls on a Saturday, Sunday, or
•	Write the name of the estate or trust,Federal Employer
legal holiday, the return and payment will be considered
Identification Number, and “2023 MO Fiduciary Income
timely if filed on the next business day. Do not use Form
Tax” on your check or money order. Do not postdate
MO-1041V for making extension payments, please use the
your check; it will be cashed upon receipt. Do not submit
Application for Extension of Time to File (Form MO-60).
electronic payments.
Complete the voucher in its entirety to ensure the payment
•	Detach the payment voucher at the dotted line and
is applied to the correct account and tax period. On Line 1,
mail with your payment to the address listed on Form
the payment must be entered in whole dollars and match
MO-1041V.
the amount of the check.
Full payment of taxes must be submitted by April 15, 2024 to avoid interest and addition to tax for failure to pay. If you
pay by check, you authorize the Department of Revenue to process the check electronically. Any returned check may be
presented again electronically.
Ever served on active duty in the United States Armed Forces?
If yes, visit dor.mo.gov/military/ to see the services and benefits we offer to all eligible military individuals.
A list of all state agency resources and benefits can be found at veteranbenefits.mo.gov/state-benefits/.
Please print as shown below in black or dark blue ink.

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Federal Privacy Notice
The Federal Privacy Act requires the Missouri Department of Revenue (Department) to inform taxpayers of the Department’s legal authority for requesting identifying information, including social security
numbers, and to explain why the information is needed and how the information will be used.
Chapter 143 of the Missouri Revised Statutes authorizes the Department to request information necessary to carry out the tax laws of the state of Missouri. Federal law 42 U.S.C. Section 405 (c)(2)(C)
authorizes the states to require taxpayers to provide social security numbers.
The Department uses your social security number to identify you and process your tax returns and other documents, to determine and collect the correct amount of tax, to
ensure you are complying with the tax laws, and to exchange tax information with the Internal Revenue Service, other states, and the Multistate Tax Commission (Chapters 32
and 143, RSMo). In addition, statutorily provided non-tax uses are: (1) to provide information to the Department of Higher Education with respect to applicants for financial
assistance under Chapter 173, RSMo and (2) to offset refunds against amounts due to a state agency by a person or entity (Chapter 143, RSMo). Information furnished to other
agencies or persons shall be used solely for the purpose of administering tax laws or the specific laws administered by the person having the statutory right to obtain it [as
indicated above]. In addition, information may be disclosed to the public regarding the name of a tax credit recipient and the amount issued to such recipient (Chapter 135, RSMo). (For the Department’s
authority to prescribe forms and to require furnishing of social security numbers, see Chapters 135, 143, and 144, RSMo.)
You are required to provide your social security number on your tax return. Failure to provide your social security number or providing a false social security number may result in criminal action against
you.

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Form
MO-1041V

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2023 Fiduciary Income Tax Payment Voucher

Federal Employer Identification Number	

Taxable Year Ending (MM/DD/YYYY)	

__ __ /__ __ /__ __ __ __

1. Amount of payment
__ __ /__ __ /__ __ __ __ 	 (U.S. funds only)................

Due Date (MM/DD/YYYY)

Name of Estate or Trust	

$

•

0 0

Name and Title of Fiduciary

Department Use Only

Address

City	

Mail to: 	Taxation Division		
	
P.O. Box 3815		
	
Jefferson City, MO 65105-3815

State	

Phone:	 (573) 751-1467
Fax:
	 (573) 522-1721

Zip Code	

*
*

•

Form MO-1041V (Revised 12-2023)
E-mail: [email protected]
Visit dor.mo.gov/taxation/individual/tax-types/fiduciary/ for additional information.