City of Columbus, Income Tax Division
         Individual Income Tax
IR -PV
         Payment Voucher

ID Type: SSN           ITIN           Account ID Payment Type

ID:                                              Return

Name:                                            Estimate

Address:                                         Extension 

City:                                            Tax Year:

State:                          Zip:             Payment Amount:
Make checks payable to CITY TREASURER 
         Columbus Income Tax Division            Check Box if Payment is for an Account Located in 
Mail to: 
         PO Box 182158                           a Joint Economic Development District (JEDD) 
         Columbus, OH 43218-2158