Client Name:* First Last Routing Number:*Account Number:*Date to have IRS pull fundsTax Year:*Option 1: I will mail a check with 1040 V and will put name and Soc Sec and Tax Year on the memo line Check made payable to US TreasuryYesNoOption 2: I will call 888 2 PAY TAX and put the balance on a credit cardYesNoOption 3: I need an installment agreementYesNoOption 3: Monthly payment amountOption 3: Date in the month of the paymentSubmitReset
