U.S. Individual Income Tax Return

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I.R.S. SPECIFICATIONS
TO BE REMOVED BEFORE PRINTING
INSTRUCTIONS TO PRINTERS
FORM 1040-ES (OCR) Voucher, PAGE 1 OF 2 (PAGE 2 IS BLANK)
MARGINS; TOP 76mm (3"), CENTER SIDES.
PRINTS: HEAD TO HEAD
PAPER: WHITE WRITING, SUB. 20.
INK: BLACK AND PMS 148 (ORANGE)
FLAT SIZE: 203mm (8") x 381mm (15")
PERFORATE: AT TOP, AND 3", 6", 9" AND 12" FROM TOP
DO NOT PRINT — DO NOT PRINT — DO NOT PRINT — DO NOT PRINT

Form 1040-ES (OCR)
Department of the Treasury
Internal Revenue Service
䊳
䊳
䊳

2009
OMB No. 1545-0074

Estimated Tax

Make your check or money order payable to “United States Treasury.”
Enter your SSN and “2009 Form 1040-ES” on your payment.
If your name, address, or SSN is incorrect, see instructions.

Date

Signature

O.K. to print
T:FP:F
O.K. to print
Responsible
scan organization
Revised proofs
requested

Payment
Voucher

1

Amount of estimated tax you are
paying by check or money order.

Calendar year—
Due April 15, 2009
Dollars

Cents

For Privacy Act and Paperwork Reduction Act Notice, see instructions.

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3
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Form 1040-ES (OCR)
Department of the Treasury
Internal Revenue Service
䊳
䊳
䊳

2009

OMB No. 1545-0074

Estimated Tax

Make your check or money order payable to “United States Treasury.”
Enter your SSN and “2009 Form 1040-ES” on your payment.
If your name, address, or SSN is incorrect, see instructions.

Payment
Voucher

2

Amount of estimated tax you are
paying by check or money order.

Calendar year—
Due June 15, 2009
Dollars

Cents

For Privacy Act and Paperwork Reduction Act Notice, see instructions.

Form 1040-ES (OCR)
Department of the Treasury
Internal Revenue Service
䊳
䊳
䊳

2009

OMB No. 1545-0074

Estimated Tax

Make your check or money order payable to “United States Treasury.”
Enter your SSN and “2009 Form 1040-ES” on your payment.
If your name, address, or SSN is incorrect, see instructions.

Payment
Voucher

3

Amount of estimated tax you are
paying by check or money order.

Calendar year—
Due Sept. 15, 2009
Dollars

Cents

For Privacy Act and Paperwork Reduction Act Notice, see instructions.

Form 1040-ES (OCR)
Department of the Treasury
Internal Revenue Service
䊳
䊳
䊳

2009

OMB No. 1545-0074

Estimated Tax

Make your check or money order payable to “United States Treasury.”
Enter your SSN and “2009 Form 1040-ES” on your payment.
If your name, address, or SSN is incorrect, see instructions.

Payment
Voucher

4

Amount of estimated tax you are
paying by check or money order.

Cat. No. 61900V

Calendar year—
Due Jan. 15, 2010
Dollars

Cents

For Privacy Act and Paperwork Reduction Act Notice, see instructions.