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Substitute Form IL-1040-X-V Vendor

Specifications
Prepare each IL-1040-X-V form with the following information:
(1) Software/Forms Developer ID Number
(2) Primary’s Social Security Number (SSN)
(3) Spouse’s SSN
(4) Taxpayer’s Name and Address
(5) Amount of Payment - The payment amount field must show dollars and two positions for cents.
If the payment is a whole dollar amount, zero fill the cents field to the right of the dollar amount.
(6) Scan Line (See detailed instructions below.)
(7) 1D Barcode
Scan line placement and contents
The scan line must be centered horizontally on the page (the center of the scan line must be at 4.25 inches) and must fall
between .25 and .375 inches from the bottom edge of the form. The scan line contains 46 positions as described below. The
font for the scan line is “OCR-A Std”, size 10.
Positions within the scan line:
1-5 Voucher Number is always 10409
6-9 Liability Period (mmyy) Example: December 2023 is 1223.
10 Space
11 Form Code/Liability Check Digit (See detailed instructions on the next page.)
12 Space
13 1040 Voucher ID is always 2
14 Space
15-23 Primary SSN
24 Space
25 Primary SSN Check Digit (See detailed instructions on the next page.)
26 Space
27-34 Numeric Post (See detailed instructions on below.)
35 Space
36 Numeric Post Check Digit (See detailed instructions on below.)
37 Space
38-46 Amount of Payment - The payment amount field must contain 7 positions for dollars
and 2 positions for cents. Zero fill the cents field to the right of the dollar amount.
Numeric Post Formula
Determine the Numeric Post from the first four letters of taxpayer’s last name. The numeric post is calculated by numbering
the alphabet from 1 - 26 beginning with the letter A as 01, B as 02, and so on. The numeric post contains 8 digits.
Numeric post examples and special rules:
For a last name Jonee = JONE = the numeric post is 10151405
For a last name that is less than four characters, fill each ending space with 00.
Last name of Coe = COE = the numeric post is 03150500
For a last name containing an apostrophe or hyphen, omit the punctuation.
Last name of O’Connor = OCON = the numeric post is 15031514
For a last name containing a space, omit the space.
Last name of De Von = DEVO = the numeric post is 04052215
Numeric Post Check Digit Formula
EXAMPLE: Numeric Post = 1 0 1 5 1 4 0 5
Multiply the left most digit by 9, the next digit by 8 and so on, until all digits have a total.
1 0 1 5 1 4 0 5
X 9 8 7 6 5 4 3 2
= 9 0 7 30 5 16 0 10
Add the totals together. 9 + 0 + 7 +30 + 5 + 16 + 0 + 10 = 77
Divide the sum by 11. If the remainder is 0 or 1, no subtraction is necessary, the remainder is the check digit. If the
remainder is greater than 1, subtract the remainder from 11 to obtain the check digit. 77 divided by 11 = 7 with a remainder
of 0. 0 is the check digit.

Printed by the authority of the State of Illinois, Web only - 1 copy IL-1040-X-V SPECS (R-12/23)

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                       IL-1040-X-V Vendor Specifications
                                                       (continued from Page 1)
SSN Check Digit Formula
  Obtain the SSN Check Digit in four steps.  
  EXAMPLE: SSN = 0 0 0 3 4 7 6 3 1
  Step 1: Beginning at the left most digit, multiply each digit of the SSN alternating by 2 and then 1.  
                            0       0        0         3  4                              7 6  3   1
                    X       2       1        2         1  2                              1 2  1   2
                    =       0       0        0         3  8                              7 12 3   2
  Step 2: Add each digit of the two-digit result from Step 1 to obtain a one-digit number. 
              0 + 0 + 0 + 3 + 8 + 7 + (1+2) + 3 + 2 (The total of the two digit 12 is 3). 
  Step 3: Add each of the Step 2 results to obtain a total, then determine the unit (ones) position of the total. 
              0 + 0 + 0 + 3 + 8 + 7 +  3+ 3 + 2 = 26. The unit position of 2 6is 6.
  Step 4: If the result of Step 3 is zero, then zero is the check digit. Otherwise, subtract the result of Step 3 from 10. The 
  result is the check digit. For the example, 10 - 6 = 4.  4 is the check digit. 
Form Code/Liability Period Check Digit Formula
  **This is an example only. Calculate your check digit with the form code and liability period.
  EXAMPLE: Form code/Liability Period = 1 0 4 0 9 1 2 2 3
  •         Multiply the left most digit by 10, the next digit by 9, the next by 8 and so on, until all digits have a total.
                    1       0       4        0         9  1                              2 2  3
              X    10       9       8        7         6  5                              4 3  2
              =    10       0     32         0    54      5                              8 6  6
  •         Add the totals together. 10 + 0 + 32 + 0 + 54 + 5 + 8 + 6 + 6 = 121
  •         Divide the sum by 11. If the remainder is 0 or 1, no subtraction is necessary, the remainder is the check digit. If 
            the remainder is greater than 1, subtract the remainder from 11 to obtain the check digit. 121 divided by 11 = 11 
            with a remainder of 0.  0 is the check digit.
1-D Barcode
  1-D Barcode font is “Free 3 of 9 Extended”, size 30 pt (height around 5/16 inch). Leave at least 1/4 inch quiet zone 
  (white space) around the barcode. Reproduce the exact barcode shown on the voucher. The content of the barcode 
  is *66012231V*.

Important: Electronic payments are required if the taxpayer’s previous year’s annual liability was $200,000 or 
more.

  Below is an example of the payment voucher with the required preprinted fields. (Do not 
  reproduce the red numbered notes.  They are provided for reference.)  Email five drafts for 
  testing and review to REV.VendorForms@illinois.gov.

           Illinois Department of Revenue                      
                                               ID: 123 (1)
           2023 IL-1040-X-V                                          
  (R-12/23) Payment Voucher for Amended Individual Income Tax 
  Write your Social Security numbers in the order they appear on your federal return. 
                                                                                      (3)
  000-34-7631                                                                                                   500     00
                   (2)                          000-34-8787                                     $  (5)
  Your Social Security number                     Spouse’s Social Security number                Payment amount .
                                                                                                Make your check payable to and mail to
                                                                                                ILLINOIS DEPARTMENT OF REVENUE
  John and    Annie Jonee              (4)
                                                                                                PO BOX 19007
  1234 Folks Place
                                                          example                               SPRINGFIELD IL 62794-9007
  Anywhere IL  12345-1234                                                                     Write your Social Security number(s) on your check.
                                             
                                          (7)
                                                  *66012231V*

                           (6)
                              104091223 0 2 000347631 4 10151405 0 000050000

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