1. Complete using blue or black ink. Do not use gel pens on checks. Do not staple.
2. Confirmation number: Enter the eFile & Pay confirmation number.
3. Period ending: 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. Permit number: Enter your twelve-digit permit number.
5. 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 $").
6. When paying by check, make checks payable to Iowa Department of Revenue.
7. Mail your payment on or before the due date with this voucher to:
Withholding Tax Payment Voucher
Period ending:
Permit number:
Payment amount:
Mail to:
Iowa Department of Revenue
PO Box 10411
Des Moines IA 50306
-0411
Iowa Withholding Tax
Payment Voucher and Instructions
Iowa Department of Revenue
PO Box 10411
Des Moines IA 50306-0411
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.
44-105 (06/18/2020)
Iowa Department of Revenue
Confirmation number:
Name:
Address:
City, state, ZIP:
Phone:
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. Instructions for Payment Vouchers
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ cut here _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
tax.iowa.gov
File your return through eFile & Pay at the Department's website: tax.iowa.gov.
Instructions for Payment Vouchers
The payment voucher does not replace the return.
