Form 943-V,
Payment Voucher
Purpose of Form
Complete Form 943-V if you’re making a payment with
Form 943. We will use the completed voucher to credit
your payment more promptly and accurately, and to
improve our service to you.
Making Payments With Form 943
To avoid a penalty, make your payment with your 2019
Form 943 only if:
• Your total taxes for the year (Form 943, line 13) are less
than $2,500 and you’re paying in full with a timely filed
return, or
• You’re a monthly schedule depositor making a payment
in accordance with the Accuracy of Deposits Rule. See
section 7 of Pub. 51 for details. In this case, the amount
of your payment may be $2,500 or more.
Otherwise, you must make deposits by electronic funds
transfer. See section 7 of Pub. 51 for deposit instructions.
Don’t use Form 943-V to make federal tax deposits.
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CAUTION
Use Form 943-V when making any payment with
Form 943. However, if you pay an amount with
Form 943 that should’ve been deposited, you may
be subject to a penalty. See Deposit Penalties in section 7
of Pub. 51.
Specific Instructions
Box 1—Employer identification number (EIN). If you
don’t have an EIN, you may apply for one online by
visiting the IRS website at www.irs.gov/EIN. You may also
apply for an EIN by faxing or mailing Form SS-4 to the
IRS. If you haven’t received your EIN by the due date of
Form 943, write “Applied For” and the date you applied in
this entry space.
Box 2—Amount paid. Enter the amount paid with
Form 943.
Box 3—Name and address. Enter your name and
address as shown on Form 943.
• Enclose your check or money order made payable to
“United States Treasury.” Be sure to enter your EIN,
“Form 943,” and “2019” on your check or money order.
Don’t send cash. Don’t staple Form 943-V or your
payment to Form 943 (or to each other).
• Detach Form 943-V and send it with your payment and
Form 943 to the address provided in the Instructions for
Form 943.
Note: You must also complete the entity information
above line 1 on Form 943.
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Detach Here and Mail With Your Payment and Form 943.
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Form 943-V
Department of the Treasury
Internal Revenue Service
Payment Voucher
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Don’t staple this voucher or your payment to Form 943.
OMB No. 1545-0035
2019
1
Enter your employer identification number (EIN).
2
Enter the amount of your payment . . .
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Make your check or money order payable to “United States Treasury”
Dollars Cents
3
Enter your business name (individual name if sole proprietor).
Enter your address.
Enter your city or town, state or province, country, and ZIP or foreign postal code.