FORM
N-200V
(Rev. 2019)
STATE OF HAWAII –– DEPARTMENT OF TAXATION
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
made electronically through the State’s Internet portal. For more
information, go to tax.hawaii.gov/eservices/.
ABOUT THIS FORM
Form N-200V is designed for electronic scanning that permits faster
processing with fewer errors. To avoid delays:
1. Print amounts only on those lines that are applicable.
2. Use only a black or dark blue ink pen. Do not use red ink,
pencils, felt tip pens, or erasable pens.
3. Because this form is read by a machine, please print your
numbers inside the boxes like this:
4. Do NOT print outside the boxes.
5. Do NOT use dollar signs, commas, slashes, dashes or
parentheses in the boxes.
6. Do not photocopy this form.
PURPOSE OF FORM
Use Form N-200V to send your payment to the Department of
Taxation (Department) when you are making (1) an estimated tax
payment, (2) an extension payment, or (3) a tax return payment for
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
paying electronically, use Form N-200V to send your payment to
the Department. Form N-200V allows us to process your payment
more accurately and efficiently.
Note: Tax payments will be credited to the social security number
provided on Form N-200V.
HOW TO COMPLETE FORM
Print your name and social security number in the space provided.
If you are an alien and were issued an individual taxpayer
identification number (ITIN) by the IRS, enter your ITIN in the space
provided for the social security number. If you applied for an ITIN
but the IRS has not yet issued the ITIN, write “ITIN Applied For” in
the space above the box where you enter your name.
If you are making a tax payment for a composite Form N-15, check
the box for Composite Taxpayer. Print “Partners” or “Shareholders”
in the space provided for the first name. Print the partnership’s
or the S corporation’s name in the space provided for the last
name. Print the partnership’s or S corporation’s federal employer
identification number in the space provided for the social security
number in social security number format (i.e., 123-45-6789).
Print the date your tax year ends and the amount of your payment
in the space provided.
Make your check or money order payable in U.S. dollars to “Hawaii
State Tax Collector.” Make sure your name appears on your check
or money order. Please write your social security number (federal
employer identification number if you are a composite taxpayer),
daytime phone number, the year for which payment is made, and
the form number of the tax return you are filing (e.g., “2019 Form
N-11”) on your check or money order. Do not postdate your check.
Do not send cash.
WHERE TO FILE
Detach Form N-200V along the dotted line. Attach your check or
money order to the front of Form N-200V and send them to:
Hawaii Department of Taxation
Attn: Payment Section
P. O. Box 1530
Honolulu, Hawaii 96806-1530
— — — — — — — — — — — CUT HERE — — — — — — — — — —
STATE OF HAWAII — DEPARTMENT OF TAXATION
INDIVIDUAL INCOME TAX
PAYMENT VOUCHER
DO NOT WRITE OR STAPLE IN THIS SPACE
Form (Rev. 2019)
N-200V
DO NOT SUBMIT A PHOTOCOPY OF THIS FORM
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.
Your Social Security Number
Tax Year Ending (MM DD YY)
Amount of Payment
First name M.I. Last name Suffix
Tax Payment Type (Check only one) Check if payment is for a composite Form N-15
Estimated Tax Payment
Composite Taxpayer
Extension Payment
Tax Return Payment for
Form N-11, N-15, or N-310
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