Iowa Individual Income Tax
Amended Payment Voucher and Instructions
tax.iowa.gov
Note: Penalties can only be waived under limited circumstances, as described in Iowa Code section 421.27.
Failure to Timely File a Return: A penalty of
10% will be added to the tax due for failure to timely
file a return if the return is filed after the original due date of the return and if at least 90% of the correct
amount of tax is not paid by the original due date of the return.
Failure to Timely Pay the Tax Due or Penalty for Audit Deficiency: A penalty of 5% will be added to the
tax due if the return is filed by the original due date and at least 90% of the correct amount of tax is not
paid by the original due date of the return.
When the failure to file penalty and the failure to pay penalty are both applicable, only the failure to file
penalty will apply.
Penalty for Willful Failure to File: A penalty of 75% will be added to the tax due for willful failure to file a
return or for filing with intent to evade tax.
If the amended payment is for the current tax year and payment is made after April 30, the tax due
may be subject to penalty and interest. Additionally, amended payments for prior tax years may also
be subject to penalty and interest.
1.
Complete using blue or black ink. Do not use gel pens on checks. Do not staple.
2.
SSN: Enter the Social Security Number in the boxes provided below.
3.
Period ending: Enter the date of the calendar or fiscal year end. Use MMDDYY format. MM: two-digit
month. DD: two-digit day. YY: last two digits of the tax year. The period ending for December 31, 2020,
would be entered as: 123120.
4.
Payment amount: Enter dollars and cents. The two boxes separated to the right on the amount line
are for cents. Do not enter any punctuation or symbols (for example ", or $").
5.
When paying by check, make checks payable to Iowa Department of Revenue.
6.
Mail your payment on or before the due date with this voucher to:
Iowa Department of Revenue
PO Box 9187
Des
Moines IA 50306-9187
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Iowa Department of Revenue
IA 1040XV
Amended Indiv
idual Income Tax Payment Voucher
SSN:
Print name:
(Last, first MI)
Address:
City, state, ZIP:
Phone:
Period ending:
Payment amount:
Mail to:
Iowa Department of Revenue
PO Box 9187
Des Moines IA 50306-9187
Make checks payable to:
Iowa Department of Revenue. When you pay
by check, you authorize the Department of
Revenue to convert your check to a one-time
electronic banking transaction. 41-121 (06/18/2020)
Pay electronically using e-File & Pay on the Department's website: tax.iowa.gov
Instructions for Payment Vouchers
