Pennsylvania PA-40 Payment Voucher

PA-40 Payment Voucher
2023 PA-40 Payment Voucher (Form and Instructions) (PA-40 V)
IMPORTANT: FILL IN FORM MUST BE DOWNLOADED ONTO YOUR COMPUTER PRIOR TO COMPLETING

PA-40 V (EX) 03-23 (FI)
PA-40 PAYMENT VOUCHER
PA-40 PAYMENT VOUCHER (PA-40 V)
Use the 2023 Form PA-40 V with a payment of tax owed with a
2023 PA-40, Personal Income Tax Return. Do not use this voucher
for any other purpose. Follow the instructions below.
SOCIAL SECURITY NUMBER (SSN)
● SSN - enter the primary taxpayer’s nine-digit SSN
without the hyphens.
● SSN - enter the spouse’s nine-digit SSN without the hyphens.
CHECK DIGIT
Print the first two letters of the last name of the taxpayer.
NAME OF TAXPAYER AND SPOUSE
● Print the last name, first name and middle initial of the
taxpayer and spouse.
ADDRESS
● First and Second Line of Address – Print the taxpayer’s
complete street address. If the address has an apartment,
suite or RR number, enter after the street address. If only one
line is needed, use the first line of Address.
● City – Print the name of the city. For foreign addresses, the
bottom line of the address should show only the country
name, written in full (no abbreviations) and in capital letters.
● State – Print the two-digit state abbreviation.
● ZIP – Print the five-digit ZIP Code.
TAXPAYER’S PHONE NUMBER
Print the taxpayer’s 10-digit phone number with area code
including hyphens.

Make the check or money order payable to the PA DEPARTMENT
OF REVENUE. Please write on the check or money order:
● The last four digits of the primary taxpayer’s SSN;
● "2023 PA-40 V"; and
● Daytime telephone number of the taxpayer(s).
If the check or money order does not include the primary
taxpayer’s name, the department will also need the name of the
primary taxpayer as well as the information requested above. In
the event the check becomes separated from the PA-40 V, the
department will need this information to accurately apply the
payment.
Electronic Funds Transfer
Payments for 2023 PA tax due may also be made using electronic
funds transfer by accessing myPATH at mypath.pa.gov. When
prompted, enter the bank account information and the payment
will be deducted from the account on the date specified. There is
no charge for using this option. Payments equal to or greater than
$15,000 must be made electronically. Payments not made
electronically will be subject to a penalty equal to 3% of the
payment amount not to exceed $500.
MAILING ADDRESS
If filing a paper return, please remit payment with the return. If filing
electronically, please use the following address to mail a payment
to the department:
PA DEPARTMENT OF REVENUE
PAYMENT ENCLOSED
1 REVENUE PLACE
HARRISBURG PA 17129-0001

PAYMENT
Check or Money Order
Carefully enter the amount of the payment.

t DetAch here t

✁
PA-40 V

03-23 (FI)

2023 PA-40 PAYMENT VOUCHER

PRIMARY SSN

CHECK DIGIT SPOUSE’S SSN

START

➜

2300910052

LAST NAME

FIRST NAME

MI

SPOUSE’S LAST NAME

FIRST NAME

MI

PAYMENT AMOUNT

FIRST LINE OF ADDRESS
SECOND LINE OF ADDRESS
CITY

STATE

ZIP

PHONE NUMBER

Make check or money order
payable to the Pennsylvania
Department of Revenue

DEPARTMENT USE ONLY
Reset Entire Form

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