INSTRUCTIONS FOR FORM 740-V
                                        KENTUCKY PAYMENT VOUCHER
                                                                                                                                                                                             2016
Who should use a payment voucher?
If you are paying tax owed on your 2016 Kentucky individual income tax return by check or money order, you must  
send the payment with Form 740-V, Kentucky Payment Voucher.
 l If filing your return electronically, complete Form 740-V and send it and your payment to the address listed on 
   the payment voucher.  Do not submit a copy of your electronically filed return with Form 740-V and payment.
 l If filing a paper return, complete Form 740-V and send it and your payment in the same envelope as your  
   paper income tax return.  Do not staple Form 740-V or your check to your return or to each other.

The Department of Revenue does not issue statements of liability prior to the April 18 deadline for payment. To avoid 
penalties and interest, payments should be postmarked on or before April 18, 2017.

How to prepare your payment:
Make your check or money order payable to the Kentucky State Treasurer.   Do not send cash.  Be sure to write your 
name, address, Social Security number, and  “2016 Form 740” on the check or money order.

Preparing your payment voucher:
 l Enter your Social Security number in the boxes above “Your Social Security Number.”  If married filing jointly or on a 
   combined return, enter spouse’s Social Security number in the boxes above “Spouse’s Social Security Number.”
 l Enter your name(s) in the boxes identified as “Last Name/Your First Name/Spouse’s initials.”  The name on your 
   voucher should match the name listed on your income tax return.
 l Enter your mailing address on the appropriate lines.
 l Enter the amount of additional tax due from Form 740, Line 37 (Form 740-NP, Line 37) in the boxes identified 
   as “Additional Tax Due.”
 l Enter the amount of interest and penalty calculated from Form 740, Line 39 (Form 740-NP, Line 39) in the boxes 
   identified as “Interest, File Late and Pay Late Penalties.”

Sending your payment with payment voucher:
Detach the payment voucher at the dotted line below.  Do not attach the payment voucher to the check or money 
order.  If filing a paper return, enclose your 2016 Kentucky tax return in the same envelope with your payment and 
voucher.   
 
Mail your payment and voucher to: Kentucky Department of Revenue, Frankfort, KY 40620-0011.

                Ú              DETACH HERE AND MAIL VOUCHER WITH YOUR PAYMENT             Ú

FORM 740V(9-16)                          Kentucky Payment Voucher                                                                                                                                2016

 YOUR SOCIAL SECURITY NUMBER                                                    SPOUSE'S SOCIAL SECURITY NUMBER

   LAST NAME                                                 YOUR FIRST NAME                                                                                                SPOUSE'S INITIALS
                                                                   Additional Tax Due

                                                                   Interest, File Late and
 NUMBER AND STREET OR P.O. BOX                                     Pay Late Penalties

                                                                   Total Payment
 CITY, TOWN OR POST OFFICE                 STATE       ZIP CODE    
                                                                                                    42A740V0002
 Make check payable to:  Kentucky State Treasurer
 Mail to:  Kentucky Department of Revenue
                Frankfort, KY 40620-0011
                                        DO NOT ATTACH CHECK TO VOUCHER
                                                 42A740-S23