PDF document

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Specifications for Withholding Tax Deposit/Payment Voucher (8/31/22)
Ink Color:                                                         Minnesota Tax ID:                                             Scan Line:
Black 100%                                                         •  Must be seven digits                                       •   Must be 66 digits
                                                                   •   Colon required after title: 2 in. from right edge         •  Courier or Courier New 12pt
Voucher Size:                                                      •   Last digit: 1/2 in. from right edge                       •   Starts: 7 3/4 in. from right edge
8 1/2 in. wide x 3 2/3 in. high                                    •   Baseline: 2 in. from bottom                               •   Baseline: 1/2 in. from bottom
Font:                                                              Federal ID:                                                   •  See additional scan line specs
Calibri 10pt (or similar sans-serif) unless otherwise indicated.   •  Must be nine digits                                        Graphics:
Copy example exactly.                                              •   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 type                            Period End Date:                                              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                                    •   Last digit: 1/2 in. from right edge                                Mail Station 4100 
                                                                   •   Baseline: 1 1/2 in. from bottom
Preparer Tax Identification Number:                                                                                                       600 N. Robert St.
•  Must be nine digits (may have leading character)                Amount of Check:                                                       St. Paul, MN 55146-4100
•  Colon required after title: 2 in. from right edge               •  Courier or Courier New 12pt
•   Last digit: 1/2 in. from right edge                            •   Colon required after title: 2 in. from right edge
•   Baseline: 2 1/2 in. from bottom                                •   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
                                                                                                                                Minnesota Tax ID 
                        CONTACT NAME AND PHONE
                                                                                                                                 (required):                3456789                     2 in.
                        ADDRESS                                                                                           
                        CITY, STATE ZIP CODE                                                                                     Federal ID:               987654321                    1 3/4 in.
                                                                                                                                Period End Date:            mmddyy                      1 1/2 in.
                        Make check payable to: 
                        Minnesota Revenue                                                                                                                  
                        Voucher type address                                                                 Amount of Check:                              00000000 00                  1 in.

                                                                  SAMPLE                                                                                                                1/2 in.
                                004000000000000000000012312200000034567891000000000000000000001234

               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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Withholding Voucher Type

Any fields not listed on this table remain constant.

Voucher Title                                       Voucher Mailing Address                 Scan Line Tax Type  Scan Line Extension
Withholding Tax Deposit/Payment                     P.O. Box 64439, St. Paul, MN 55164-0439 004                 00

Required Voucher Approval Scenarios
You must receive approval before reproducing vouchers. Submit 3 samples of the voucher listed on the table above with fictitious names, Minnesota tax ID numbers, period end 
dates, check amounts and scan lines for testing. 
Required scenario: Minnesota tax ID number begins 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 period end date, 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 Withholding Tax Deposit/Payment Vouchers

Field element Number of digits Description
Tax type 3 004
Extension code 2 00
Filler 17 00000000000000000
Period end date 6 MMDDYY (e.g., use 123122 for December 31, 2022)
Filler 6 000000
Minnesota tax ID 7 Minnesota tax ID (field must have 7 digits AND cannot be masked)
Check digit 1 See “How to calculate the check digit” below
Filler 20 00000000000000000000
Vendor ID code 4 Your 4-digit vendor ID
TOTAL 66 Scan line must be 66 digits

Sample scan line for withholding tax deposit/payment voucher (using Dec. 31, 2022 as period end date):

004000000000000000000012312200000034567891000000000000000000001234

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

To calculate the check digit, start with the Minnesota tax ID (seven digits).

Then do the following steps:

Step 1. Multiply the left-most digit and every alternate position of the Minnesota tax ID 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
Minnesota tax ID = 3456789

Basic key field = 3 4 5 6 7 8 9
Alternate digits
(starting with left-most digit) = 3 5 7 9

Step 1. Multiply alternate digits by two 6 10 14 18
Step 2. Add digits in Step 1 to the
digits not multiplied by two 6 + 4 + (1+0) + 6 + (1+4) + 8 + (1+8) = 39

Step 3. Subtract total in Step 2 from the
next higher number ending in zero 40 – 39 = 1
The check digit is 1.

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Withholding Tax Deposit/Payment

Pay by Checkeck
If you are not required to pay electronically, you can use this voucher to pay by check.
• Make your check payable to “Minnesota Revenue.”
• Print your Minnesota Tax ID 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
Withholding Tax Deposit/Payment Identification Number: P23456789
TAXPAYER NAME
Minnesota Tax ID
CONTACT NAME AND PHONE (required): 3456789
ADDRESS
CITY, STATE ZIP CODE Federal ID: 987654321
Period End Date 123122
Make check payable to:
Minnesota Revenue
P.O. Box 64439, St. Paul, MN 55164-0439
Amount of Check: 00000000 00
SAMPLE
004000000000000000000012312200000034567891000000000000000000001234

PDF file checksum: 245646998

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