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FORM STATE OF HAWAII –– DEPARTMENT OF TAXATION
N-200V
(Rev. 2019) INDIVIDUAL INCOME TAX PAYMENT VOUCHER
(NOTE: References to “married” and “spouse” are also references to
“in a civil union” and “civil union partner,” respectively.)
GENERAL INSTRUCTIONS
INTERNET FILING — Form N-200V can be filed and payment HOW TO COMPLETE FORM
made electronically through the State’s Internet portal. For more
information, go to tax.hawaii.gov/eservices/. Print your name and social security number in the space provided.
If you are an alien and were issued an individual taxpayer
ABOUT THIS FORM identification number (ITIN) by the IRS, enter your ITIN in the space
Form N-200V is designed for electronic scanning that permits faster provided for the social security number. If you applied for an ITIN
processing with fewer errors. To avoid delays: but the IRS has not yet issued the ITIN, write “ITIN Applied For” in
the space above the box where you enter your name.
1. Print amounts only on those lines that are applicable.
If you are making a tax payment for a composite Form N-15, check
2. Use only a black or dark blue ink pen. Do not use red ink, the box for Composite Taxpayer. Print “Partners” or “Shareholders”
pencils, felt tip pens, or erasable pens. in the space provided for the first name. Print the partnership’s
3. Because this form is read by a machine, please print your or the S corporation’s name in the space provided for the last
numbers inside the boxes like this: name. Print the partnership’s or S corporation’s federal employer
identification number in the space provided for the social security
1 2 3 4 5 6 7 8 9 0 0 number in social security number format (i.e., 123-45-6789).
!!! !!! !!! !!, , .
Print the date your tax year ends and the amount of your payment
4. Do NOT print outside the boxes. in the space provided.
5. Do NOT use dollar signs, commas, slashes, dashes or
parentheses in the boxes. Make your check or money order payable in U.S. dollars to “Hawaii
State Tax Collector.” Make sure your name appears on your check
6. Do not photocopy this form. or money order. Please write your social security number (federal
PURPOSE OF FORM employer identification number if you are a composite taxpayer),
daytime phone number, the year for which payment is made, and
Use Form N-200V to send your payment to the Department of the form number of the tax return you are filing (e.g., “2019 Form
Taxation (Department) when you are making (1) an estimated tax N-11”) on your check or money order. Do not postdate your check.
payment, (2) an extension payment, or (3) a tax return payment for Do not send cash.
Form N-11, N-15, or N-310, but you are not making the payment
with your return. For example, if you filed electronically, but are not WHERE TO FILE
paying electronically, use Form N-200V to send your payment to
the Department. Form N-200V allows us to process your payment Detach Form N-200V along the dotted line. Attach your check or
more accurately and efficiently. money order to the front of Form N-200V and send them to:
Note: Tax payments will be credited to the social security number Hawaii Department of Taxation
provided on Form N-200V. Attn: Payment Section
P. O. Box 1530
Honolulu, Hawaii 96806-1530
CUT HERE
Form (Rev. 2019)
STATE OF HAWAII — DEPARTMENT OF TAXATION DO NOT WRITE OR STAPLE IN THIS SPACE
N-200V INDIVIDUAL INCOME TAX
PAYMENT VOUCHER
DO NOT SUBMIT A PHOTOCOPY OF THIS FORM
Your Social Security Number
First name M.I. Last name Suffix
!!! !! !!!!
Tax Year Ending (MM DD YY)
Tax Payment Type (Check only one) Check if payment is for a composite Form N-15
Estimated Tax Payment Composite Taxpayer !! !! !!Amount of Payment
o o
o Extension Payment
o Tax Return Payment for
Form N-11, N-15, or N-310 !!! !!! !!! !!, , .
MAIL THIS VOUCHER WITH CHECK OR MONEY ORDER PAYABLE
TO “HAWAII STATE TAX COLLECTOR.” Write your SSN, daytime phone
number, the year for which payment is made, and form number of the tax
return you are filing (e.g., “2019 Form N-11”) on your check or money order.
N200V_I 2019A 01 VID01 ID NO 01