PDF document

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Specifications for Individual Vouchers (8/21)

Ink Color:                                                        Social Security Number:                                                       Scan Line:
Black 100%                                                        •  Must be nine digits                                                        •   Must be 66 digits
Voucher Size:                                                     •  Colon required after title: 2 in. from right edge                          •  Courier or Courier New 12pt
8 1/2 in. wide x 3 2/3 in. high                                   •   Last digit: 1/2 in. from right edge                                       •   Starts: 7 3/4 in. from right edge
Font:                                                             •   Baseline: 2 in. from bottom                                               •   Baseline: 1/2 in. from bottom
Calibri 10pt (or similar sans-serif) unless otherwise indicated.  Spouse’s Social Security Number:                                              •  See additional scan line specs
Copy example exactly.                                             •  Must be nine digits                                                        Graphics:
                                                                  •  Colon required after title: 2 in. from right edge                          Graphics available from our website at www.revenue.state.mn.us.
Voucher Payment Type Title:                                       •   Last digit: 1/2 in. from right edge
•  Calibri 12pt bold                                              •   Baseline:  1 3/4 in. from bottom                                          Send samples to:
•  See table on page 2 for voucher types                          Tax-Year End:                                                                 Email (PDF): Efile.FormApproval@state.mn.us
Your 4-Digit Vendor ID:                                           •  Must be 6 digits                                                           Mail: Minnesota Department of Revenue
•   Last digit: 3 1/2 in. from right edge                         •  Colon required after title: 2 in. from right edge                                   Tax Operations - Form Approval 
•   Baseline: 3 in. from bottom                                   • Calendar or fiscal year end (mmddyy)                                                 Mail Station 4100 
Preparer Tax Identification Number:                               •   Last digit: 1/2 in. from right edge                                                600 N. Robert St.
•  Must be nine digits (may have leading character)               •   Baseline: 1 1/2 in. from bottom                                                    St. Paul, MN 55146-4100
•  Colon required after title: 2 in. from right edge              Amount of Check:
•   Last digit: 1/2 in. from right edge                           •  Courier or Courier New 12pt
•   Baseline: 2 1/2 in. from bottom                               •   Colon required after title: 2 in. from right edge
                                                                  •   Last cents field: 1/2 in. from right edge with one space separating cents 
                                                                    from dollars
                                                                  •   Baseline: 1 in. from bottom
                                                                  •   No commas or decimals

                                                                                         Cut carefully along this line to detach.
                                                                  Your check authorizes us to make a one-time electronic fund transfer from your account.                                              3 1/4 in.
                                                                                                           1234                                                                                        3 in.

                                                                                                                                 Preparer Tax
                        Voucher Title                                                                                   Identification Number:                       P23456789                         2 1/2 in.
                        TAXPAYER NAME                                                                                            Social Security                                                       2 1/4 in.
                        NAME 2
                                                                                                                                                                                                       2 in.
                        ADDRESS                                                                                                  Number (required):Spouse’s Social   123456789
                                                                                                                                 Security Number:
                        CITY, STATE ZIP CODE                                                                                                                         987654321                         1 3/4 in.
                                                                                                                                   Tax-Year End :                          mmddyy                      1 1/2 in.
                        Make check payable to: 
                        Minnesota Revenue                                                                                                                           
                        Voucher type address                                                                            Amount of Check:                             00000000 00                       1 in.

                                                                     SAMPLE
                                001020000000000000000012312130001234567891300098765432110000001234                                                                                                     1/2 in.

               8 in.   7 3/4 in.                                                             4 1/2 in.              3 1/2 in.                      2 in.                       3/4 in. 1/2 in.        0

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Individual Income Tax Voucher Types

The table below lists all Individual Income Tax voucher types with fields that are specific to the voucher type. Any fields not listed on this table remain constant for all individual vouchers.

Voucher Tltle Voucher Mailing Address Scan Line Tax Type Scan Line Extension

Income Tax Extension Payment P.O. Box 64058, St. Paul, MN 55164-0058 001 01

Individual Estimated Tax Payment P.O. Box 64037, St. Paul, MN 55164-0037 001 00

Income Tax Return Payment P.O. Box 64054, St. Paul, MN 55164-0054 001 02

Amended Income Tax Return Payment Mail Station 1060, St. Paul, MN 55145-1060 001 03

Voucher Information
Scanline Information
Font Franklin Gothic 12 pt Bold Font Franklin Goth 10 pt

Required Voucher Approval Scenarios

You must receive approval before reproducing vouchers.

Submit 3 samples for each voucher listed on the table above with fictitious names, Social Security numbers, tax-year end dates,
check amounts and scan lines for testing.

Required scenarios:
• Only Taxpayer Social Security number is entered; no Spouse’s Social Security number.
• Both Taxpayer Social Security number and Spouse’s Social Security number begin with a leading zero.

Fictitious information must be different on each sample.

Please test and verify that invalid data cannot be entered. Make sure the scan line cannot have an invalid tax-year end, or blank space for the ID field.

Note: Form must be placed at bottom of 8½ x 11 inch page with instructions at the top.
SUBMIT CONTENT OF ENTIRE PAGE. See the sample form on page 4.

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Scan Line Specifications for Individual Income Tax Vouchers
Field Element Number of Digits Description
Tax type 3 001
Extension code 2 02 (to indicate a return payment)
Filler 17 00000000000000000
Tax-year end date 6 Last day of tax year (mmddyy)
ID type 1 3 (to indicate a Social Security number is being used)
Filler 3 000
Taxpayer ID #1 9 Primary taxpayer’s Social Security number (field must have 9 digits AND cannot be masked)
Check digit #1 1 See “How to Calculate the Check Digit” below.
Joint ID type 1 0 or 3 (use 0 if primary SSN is used only; use 3 if joint SSN is included)
Filler 3 000
Taxpayer ID #2 9 Secondary Social Security number if joint filers or 000000000 if not joint
(field must have 9 digits)
Check digit #2 1 See “How to Calculate the Check Digit” below.
Filler 6 000000
Vendor ID number 4 Your four-digit vendor ID number assigned to you by the department.
TOTAL 66 Scan line must be 66 digits

Sample scan line for 2021 individual income tax payment
001020000000000000000012312130001234567891000000000000000000001234
Sample scan line for 2021 individual income tax payment (joint filers)
001020000000000000000012312130001234567891300098765432110000001234

Note: The scan line is the most important part of the voucher. If any part of the scan line is masked, processing may be delayed.

How to Calculate the Check Digit
The check digit is a MOD 10 number. To calculate it, start with the “basic key field,” a 13-digit number composed of the ID type
(one digit), filler (three digits) and taxpayer ID (nine digits). Then do the following steps:
Step 1. Multiply the left-most digit and every alternate position of the basic key field by two.
Step 2. Add the digits from Step 1 to the digits in the basic key field not multiplied by two.
Step 3. Subtract the total in Step 2 from the next higher number ending in zero. The difference is the check digit.
(Note: If the difference equals 10, the check digit is zero.)
Example
ID Type and Filler = 3000 Taxpayer ID = 123456789
Basic key field = 3 0 0 0 1 2 3 4 5 6 7 8 9
Alternate digits
(starting with left-most digit) = 3 0 1 3 5 7 9
Step 1. Multiply alternate digits by two 6 0 2 6 10 14 18
Step 2. Add digits in Step 1 to the
digits not multiplied by two 6 + 0 + 0 + 0 + 2 + 2 + 6 + 4 + (1+0) + 6 + (1+4) + 8 + (1+8)
Step 3. Subtract total in Step 2 from the
next higher number ending in zero 50 – 49 = 1
The check digit is 1.

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Income Tax Return Payment

Pay by Checkeck
• Make your check payable to “Minnesota Revenue.”
• Print the last four digits of your Social Security number in the memo line of your check.
• Mail your payment and the voucher below to the address on the voucher.

Note: Your payment may be delayed if your voucher information is missing or incorrect. When printing the
voucher, set your printer to “Actual size” (not “Shrink oversized pages”).

Scan Line
The scan line is the most important part of the voucher. When submitting your voucher make sure the scan
line:
• Is printed with 66 digits – characters, symbols, or masking are unacceptable.
• Is not cut off or missing.

Pay Electronically
• Pay electronically from your bank account. Go to www.revenue.state.mn.us and type make a payment
into the Search box. Choose Bank Account from the menu. We do not charge for this service.
• Pay by credit card or debit card. Go to www.revenue.state.mn.us and type make a payment into the
Search box. Choose Credit or Debit Card from the menu. A third party processes these payments and
charges a fee for this service.
• Pay by ACH credit transfer through your financial institution. Go to www.revenue.state.mn.us and type
ACH Credit into the Search box.

Cut carefully along this line to detach.
Your check authorizes us to make a one-time electronic fund transfer from your account.
1234

Preparer Tax
Income Tax Return Payment Identification Number: P23456789

TAXPAYER NAME Social Security
NAME 2 Number (required):
123456789
ADDRESS Spouse’s Social
CITY, STATE ZIP CODE Security Number: 987654321
Tax-Year End: 123121
Make check payable to:
Minnesota Revenue

P.O. Box 64054, St. Paul, MN 55164-0054
Amount of Check: 00000000 00
SAMPLE
001020000000000000000012312130001234567891300098765432110000001234

PDF file checksum: 607656772

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